A post-hoc analysis of the ASPREE (ASPirin in Reducing Events in the Elderly) trial has revealed that the use of low-dose aspirin is linked to a 20% higher incidence of anemia and a decline in blood iron levels (ferritin) in otherwise healthy older adults.
These findings suggest that older patients taking aspirin should consider periodic monitoring of hemoglobin levels.
The study highlights the importance of recognizing this potential complication of aspirin use among older individuals.
Background and Study Details
Approximately half of older individuals in the United States use aspirin as a preventative measure.
While the risk of major bleeding, particularly gastrointestinal bleeding, due to aspirin use is well-documented, there have been limited studies on the impact of aspirin on anemia, especially in older populations.
Researchers from Monash University in Melbourne conducted a post-hoc analysis of the ASPREE trial, which involved 19,114 participants aged 70 or older.
Participants were randomly assigned to take 100 mg of aspirin daily or a placebo. Hemoglobin levels were measured annually, and ferritin levels were measured at the beginning of the study and three years after randomization.
Key Findings
The analysis revealed that the risk of developing anemia was 23.5% higher among those assigned to take low-dose aspirin.
This increased risk was accompanied by a small but notable decrease in average hemoglobin levels and a greater decline in ferritin concentrations among those taking aspirin.
Underlying Causes
The study found that the difference in clinically significant bleeding events did not explain the overall increase in incident anemia or the decline in ferritin observed in the ASPREE trial.
Instead, the findings suggest that occult blood loss, not readily apparent, contributed to these outcomes, as evidenced by the steeper decline in ferritin levels in participants allocated to aspirin.
Conclusion
This research underscores the importance of monitoring anemia and blood iron levels in older adults taking low-dose aspirin as a preventative measure. While aspirin can offer benefits, including reduced risk of certain health events, it’s essential to consider potential side effects and complications.
Healthcare providers should be vigilant in assessing the overall health of older patients using aspirin and consider periodic hemoglobin monitoring to detect anemia early and address it appropriately.
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The research findings can be found in the Annals of Internal Medicine.
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