Earlier concerns that high iron stores plays a significant harmful role in causing heart disease have proven unfounded.  At the present time, neither low not high iron stores appear to clearly play a harmful role.  However, most foods associated with high iron, e.g. mammal meat, tend to be harmful to the heart, although alcohol is an exception if the drinking is in the range of 1 drink or less per day.  Whole grains, which tend to lower iron stores, have been found helpful to the heart and to a long life.  My opinion is that iron stores that are abnormally low (<20 microg/L) are unhealthy and a supplement should be taken.  Iron stores that are in the high normal or abnormally high range (200-500 microg/L) are also probably unhealthy and iron supplements should definitely be avoided.

Iron: Increased Stores Unfavorable: Men with low serum transferrin receptor concentration/serum ferritin ratio 2.9 and 2.0 times risk of acute MI compared to men in highest third. 99 Finnish men s/p MI vs 98 control. Tuomainen, U Kuipio, Circ 4/98;97:1461; Heme iron, supplemental iron, vitamin C, and alcohol are all associated with increased iron and caffeine is associated with decreased iron stores measured by serum ferritin in Framingham elderly. Fleming, Tufts, Am J Clin Nutr 4/98;67:722; increased LDL, apoB, and electrophoretic LDL are associated with increased iron stores. Measured by ferritin. Ferritin 200-500 strong risk factor in Finnish.; Among elders, intakes of highly bioavailable forms of iron (supplemental iron and red meat) and of fruit, a dietary source of an enhancer of nonheme-iron absorption (vitamin C), promote high iron stores, whereas foods containing phytate (whole grains) decrease these stores. Individual dietary patterns may be important modulators of high iron stores. Am J Clin Nutr. 2002 Dec;76(6):1375-84

Iron: Iron Stores Not Related to Heart Disease and Only Possible Link to Stroke: 1612 adults with long follow-up. Hazard Ratio for coronary heart disease of highest ferritin tertile to lowest 0.96. and for stroke 1.48. Serum ferritin and cardiovascular disease: a 17-year follow-up study in Busselton, Western Australia. Knuiman MW, Divitini ML, Olynyk JK, Cullen DJ, Bartholomew HC.

Iron: No Relationship with Coronary Arteriosclerosis: In larger study of patients undergoing angiography, 200 with and 200 without arteriosclerosis were compared. Serum levels of ferritin and of other organic iron indicators--transferrin saturation, total iron-binding capacity, hemoglobin and hematocrit--were neither risk factors nor risk markers for coronary atherosclerosis. Sao Paolo. Serum ferritin levels and other indicators of organic iron as risk factors or markers in coronary artery disease. Armaganijan D, Batlouni M. Rev Port Cardiol. 2003 Feb;22(2):185-9

Iron: Review of Iron Stores Says Unproved: Says 8 epidemiological studies find an association between increased coronary heart disease and high iron stores and 18 do not find such a relationship. Meyer, Kansas, Clin Cardiol, 12/96;19:925

Reducing Iron by Phlebotomy Helps: At Near Iron Deficiency levels, caused by phlebotomy of 31 patients, a significant increase of HDL-cholesterol (p < 0.001) and reductions of blood pressure (p < 0.001), total and LDL-cholesterol (p < 0.001), triglyceride (p < 0.001), fibrinogen (p < 0.001) and glucose and insulin responses to oral glucose loading (p < 0.001) were noted, while homocysteine plasma concentration remained unchanged. These effects were largely reversed by a 6-month period of Fe repletion with reinstitution of Fe sufficiency. Thus, although individuals at high risk for ASCVD are not Fe-overloaded, they seem to benefit, metabolically and hemodynamically, from lowering of body Fe to levels commonly seen in premenopausal females. Ann N Y Acad Sci 2002 Jun;967:342-51