Low-dose Administration of Aspirin Might Cause Anemia in Older Adults

According to a recent follow-up study utilizing information from an international clinical trial financed by the National Institutes of Health, using low-dose aspirin daily raises the risk of anemia in adults 65 and older by about 20%. These findings suggest that older adults on low-dose aspirin and those who care for them may want to consider routinely checking hemoglobin or red blood cells. Functioning decline, increased fatigue, impairments, depressive symptoms, and cognitive issues are all linked to anemia in older persons. 

Researchers from the Aspirin in Reducing Events in the Elderly (ASPREE) research looked at how long-term low-dose aspirin use affected changes in hemoglobin concentration and ferritin levels, a marker of iron deficiency, and how aspirin use affected incident anemia. This study was published in the Annals of Internal Medicine. Despite the older persons being in good health at enrolment, the researchers discovered that low-dose aspirin increased the incidence of anemia without regard to significant bleeding. 

Previous analysis of the ASPREE data indicated that daily low-dose aspirin does not reduce the risk of dementia and cognitive decline and does not impact the healthy lifespan of older adults. National Institute of Health reported that In this study, patients were given a daily dose of 100 mg of aspirin or a placebo, and all participants had their hemoglobin concentration tested once a year. A sizable subset’s ferritin levels were assessed at baseline and three years after random assignment. Every year, hemoglobin was measured. The causes of anemia were not known. 

To ascertain the impact of low-dose aspirin on survival absent of dementia or disability, the U.S. and Australian governments collaborated on the ASPREE study, which started recruiting participants in 2010 and ended in 2014. It was a randomized, double-blind, placebo-controlled, primary prevention experiment with a treatment duration of, on average, 4.5 years in a population of healthy older individuals in the United States and Australia. The research, which included 19,114 persons 65 and older, stood out for its scope, methodological rigor, and high retention rate of participants. 

Although the study didn’t examine it, the authors had a theory as to how aspirin might be causing anemia. Because it prevents platelets from adhering to one another, aspirin makes it more difficult for blood to clot. Additionally, it inhibits an enzyme called Cox-1, which is crucial for maintaining the lining of the stomach and intestines. When this layer of protection is compromised, it is simpler for slow-moving blood leaks from the gut, which eventually leads to anemia. 

It’s likely to be a more significant issue for those with other anemia risks, such as inflammatory disorders like arthritis or chronic renal insufficiency, as the researchers observed this effect across a wide range of groups, regardless of their underlying health. They advise physicians to think about more closely monitoring the hemoglobin levels of their patients if they have several risk factors, such as aspirin use.