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It is strongly associated with elevated red cell distribution width (RDW), a correlate of several iron status biomarkers. High RDW values can signal early-stage iron deficiency or iron deficiency anaemia. This study investigated whether elevated RDW is causally associated with PAH.<\/jats:p><jats:p>A two-sample Mendelian randomisation (MR) approach was applied to investigate whether genetic predisposition to higher levels of RDW increases the odds of developing PAH. Primary and secondary MR analyses were performed using all available genome-wide significant RDW variants (n=179) and five genome-wide significant RDW variants that act<jats:italic>via<\/jats:italic>systemic iron status, respectively.<\/jats:p><jats:p>We confirmed the observed association between RDW and PAH (OR 1.90, 95% CI 1.80\u20132.01) in a multicentre case\u2013control study (cases n=642, disease controls n=15\u200a889). 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