Back to past leeches: Repeated phlebotomies and cardiovascular risk

Melania Manco, Josè M. Fernandez-Real

Research output: Contribution to journalArticlepeer-review


In patients with metabolic syndrome, body iron overload exacerbates insulin resistance, impairment of glucose metabolism, endothelium dysfunction and coronary artery responses. Conversely, iron depletion is effective to ameliorate glucose metabolism and dysfunctional endothelium. Most of its effectiveness seems to occur through the amelioration of systemic and hepatic insulin resistance.In a study published by BMC Medicine, Michalsen et al. demonstrated a dramatic improvement of blood pressure, serum glucose and lipids after removing 550 to 800 ml of blood in subjects with metabolic syndrome. This effect was apparently independent of changes in insulin resistance, in contrast to previous cross-sectional and cohort studies investigating the association between iron overload, insulin resistance and cardiovascular disease.Despite drawbacks in the study design, its findings may lead the way to investigations aimed at exploring iron-dependent regulatory mechanisms of vascular tone in healthy individuals and patients with metabolic disease, thus providing a rationale for novel preventive and therapeutic strategies to counteract hypertension.Please see related article:

Original languageEnglish
Article number53
JournalBMC Medicine
Publication statusPublished - May 30 2012


  • Blood pressure
  • Insulin sensitivity
  • Iron
  • Metabolic syndrome
  • Phlebotomy

ASJC Scopus subject areas

  • Medicine(all)


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