A new analysis from the ASPREE trial has raised important concerns about the long-term use of low-dose aspirin in people aged 70 and older. Published in the Annals of Internal Medicine, the study suggests that taking 100 mg of aspirin every day could increase the risk of developing anemia, a condition marked by low levels of red blood cells or hemoglobin.
The ASPREE trial was a large clinical study involving more than 19,000 older adults. Participants were randomly assigned to take either a daily low-dose aspirin or a placebo. Researchers followed them for several years, measuring their hemoglobin levels — an indicator of anemia — and ferritin levels, which reflect how much iron is stored in the body.
The results were striking. About 23.5% of the people taking aspirin developed anemia, which was noticeably higher than in the group not taking the drug. The aspirin group also showed lower ferritin levels, suggesting a drop in iron — an essential mineral needed to make healthy red blood cells.
Doctors have long known that aspirin can cause bleeding in the stomach or intestines, especially in older adults. But this study shines a light on a lesser-known issue: ongoing, hidden blood loss that doesn’t cause obvious symptoms but may slowly lead to anemia over time. This type of hidden bleeding is called “occult” blood loss, and it may be hard to detect without regular blood tests.
Anemia in older adults can be serious. It can lead to fatigue, weakness, dizziness, and even increase the risk of falls and hospitalizations. It can also make existing health conditions, such as heart disease or diabetes, harder to manage.
The researchers behind this study are not saying that all older people should stop taking aspirin. In some cases — for example, those who have already had a heart attack or stroke — the benefits may still outweigh the risks.
However, the findings do suggest that doctors and patients should think more carefully about the long-term use of aspirin, especially for people taking it as a preventative measure without a history of heart disease.
One practical takeaway from the study is the recommendation that older adults on aspirin should have their hemoglobin and iron levels checked regularly. This simple step could help detect early signs of anemia before it becomes more serious.
In short, this research is a reminder that even familiar medications like aspirin can carry risks — especially when used for a long time. It highlights the importance of personalized care, where treatment decisions are based on an individual’s overall health, age, and risk factors.
For older adults currently taking low-dose aspirin, it’s a good idea to talk with a healthcare provider about whether to continue and how to monitor for potential side effects. This study adds to our understanding of how medications affect the aging body and helps patients and doctors make more informed, balanced decisions.
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