Anemia associated with heart failure (HF) is "under-recognized and under-evaluated," according to a Cleveland Clinic study published in the Feb. 5 issue of the Journal of the American College of Cardiology (JACC). Low hemoglobin (molecules inside red blood cells that carry oxygen to the organs) or hematocrit (the percentage of red blood cells in the blood) levels can indicate anemia. There are several different types of anemia, caused by a variety of different factors, including iron deficiency and chronic disease. Anemia (defined in the JACC study as a hemoglobin level of <12 g/dL for men and <11 g/dL for women) was prevalent in 17.2 percent of the 6,159 HF patients studied. (Normal levels are 13.8 to 17.2 g/dL in men, 12.1 to 15.1 g/dL in women.) Persistent anemia was associated with poor survival in patients with HF; however, after six months, 43 percent of the patients with anemia at the start of the study had normal hemoglobin levels and did not have an increased mortality risk.