Anemia contributes to cardiovascular disease through reductions in nitric oxide

Given the crucial role of the microcirculation, the elusive nature of NO, and the uncertainties surrounding the actual clinical role of Hb as carrier and donor of NO, further research is necessary. For example, relevant information may derive from the assessment of forearm blood flow adjusted to changes in blood pressure, heart rate, and viscosity in blood donors before and after donation or in polycythemic patients before and after phlebotomy in the presence and absence of the NO synthase inhibitor L-N-methylarginine. In the meanwhile, it is our viewpoint that a plausible interpretation of the data is that anemia contributes to CVD through reduced NO as well as reduced oxygen bioavailability