A recent study published in the Annals of Internal Medicine suggests that taking low-dose aspirin to increased risk of iron-deficiency anemia in individuals aged 70 or older. Researchers from Monash University in Melbourne analyzed data from the ASPREE (ASPirin in Reducing Events in the Elderly) randomized controlled trial, which involved over 19,000 participants. The trial monitored the blood iron levels of individuals in the aspirin group, who took 100 milligrams of aspirin daily.
Findings from the Study
The results of the study indicate that the low-dose aspirin to increased risk of developing anemia was 23.5% higher among those assigned to receive low-dose aspirin. The researchers noted that differences in bleeding events did not explain the low-dose aspirin to increased risk of anemia or the decline in iron levels observed during the trial.
Dr. Basil A. Eldadah, chief of the Geriatrics Branch at the division of Geriatrics and Clinical Gerontology at the National Institute on Aging, highlighted the importance of periodic monitoring of hemoglobin levels in patients taking aspirin, particularly those at a higher risk of anemia due to chronic diseases. He also mentioned that the findings provide another reason to reconsider the use of low-dose aspirin for primary prevention of cardiovascular disease in individuals aged 60 or older.
Low-dose aspirin to increased risk
Aspirin use has been previously associated with an increased risk of gastrointestinal bleeding, which can lead to anemia in older adults. Dr. David Cutler, a family medicine physician, explained that chronic or recurrent bleeding from the gastrointestinal tract can result in iron-deficiency anemia over time, as iron is necessary for the production of hemoglobin in red blood cells. Symptoms of anemia include fatigue, weakness, shortness of breath, and reduced oxygen-carrying capacity of the blood.
While not all older adults who take aspirin will develop anemia, the risk varies depending on factors such as overall health, dose and duration of aspirin use, and underlying conditions. Dr. Cutler noted that there are alternative medications available with a lower risk of gastrointestinal bleeding, and protective medication can be used to prevent bleeding when aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed.
What do Doctors Recommend?
Dr. Cutler recommended discussing the risks and benefits of aspirin use with healthcare providers, taking into account individual medical conditions and previous adverse reactions. Alternatives to aspirin for pain relief and anti-inflammatory purposes include acetaminophen (Tylenol) and ibuprofen (Advil or Motrin), while clopidogrel (Plavix) is an antiplatelet drug used to prevent blood clots.
Ultimately, decisions regarding medication use should be made in consultation with healthcare professionals, considering the specific goals of treatment and conducting a thorough risk-benefit analysis for each patient.