Intravenous iron delivers a sustained (8-week) lowering of pulmonary artery pressure during exercise in healthy older humans

Hung-Yuan Cheng, Matthew C Frise, M Kate Curtis, Nicole K Bart, Nayia Petousi, Nick P Talbot, George M Balanos, Peter A Robbins, Keith L Dorrington

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In older individuals, pulmonary artery pressure rises markedly during exercise, probably due in part to increased pulmonary vascular resistance and in part to an increase in left-heart filling pressure. Older individuals also show more marked pulmonary vascular response to hypoxia at rest. Treatment with intravenous iron reduces the rise in pulmonary artery pressure observed during hypoxia. Here, we test the hypothesis that intravenous iron administration may also attenuate the rise in pulmonary artery pressure with exercise in older individuals. In a randomized double-blind placebo-controlled physiology study in 32 healthy participants aged 50-80 years, we explored the hypothesis that iron administration would deliver a fall in systolic pulmonary artery pressure (SPAP) during moderate cycling exercise (20 min duration; increase in heart rate of 30 min-1 ) and a change in maximal cycling exercise capacity ( V ˙ O 2 m a x ). Participants were studied before, and at 3 h to 8 weeks after, infusion. SPAP was measured using Doppler echocardiography. Iron administration resulted in marked changes in indices of iron homeostasis over 8 weeks, but no significant change in hemoglobin concentration or inflammatory markers. Resting SPAP was also unchanged, but SPAP during exercise was lower by ~3 mmHg in those receiving iron (P < 0.0001). This effect persisted for 8 weeks. Although V ˙ O 2 m a x remained unaffected in the iron-replete healthy participants studied here, this study demonstrates for the first time the ability of intravenous iron supplementation to reduce systolic pulmonary artery pressure during exercise.

Original languageEnglish
Article numbere14164
Pages (from-to)e14164
JournalPhysiological reports
Issue number13
Early online date3 Jul 2019
Publication statusPublished - 1 Aug 2019

Bibliographical note

© 2019 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.


  • Exercise
  • iron
  • pulmonary circulation
  • pulmonary hypertension

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)


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