A recent analysis of the ASPREE trial has revealed that the use of low-dose aspirin among older adults can lead to a 20% higher incidence of anemia and a decrease in ferritin levels. The study suggests that hidden blood loss, rather than significant bleeding events, may be the primary cause of these effects.
The ASPREE trial, also known as ASPirin in Reducing Events in the Elderly, was examined by researchers from Monash University, Melbourne. The trial involved 19,114 participants aged 70 or older who were randomly assigned to receive a daily dose of either 100 mg of aspirin or a placebo. Hemoglobin levels were measured annually, and ferritin levels were assessed at the beginning and three years after randomization. The data indicated a 23.5% risk of developing anemia in the low-dose aspirin group. This risk was accompanied by a slight but significant decrease in average hemoglobin levels and a more pronounced decline in ferritin levels among the aspirin group.
It is worth noting that around half of the elderly population in the United States reportedly use aspirin for preventive purposes. However, aspirin usage can potentially lead to major bleeding, particularly in the gastrointestinal tract. While the risk of overt bleeding from aspirin use is well-documented, only a limited number of studies have explored its impact on anemia, especially among older individuals.
The findings from the ASPREE trial analysis highlight the importance of regularly monitoring hemoglobin levels in older patients taking aspirin. Clinically significant bleeding events did not account for the observed difference in anemia occurrence or the decline in ferritin levels. Instead, hidden blood loss, as indicated by the greater decrease in ferritin among aspirin users, appears to be the primary contributing factor.
This research, titled “Effect of Low-Dose Aspirin Versus Placebo on Incidence of Anemia in the Elderly: A Secondary Analysis of the Aspirin in Reducing Events in the Elderly Trial,” was published on June 20 in the Annals of Internal Medicine. The study emphasizes the need for caution when considering low-dose aspirin use in older adults and provides important insights into potential risks and implications.
Reference: “Effect of Low-Dose Aspirin Versus Placebo on Incidence of Anemia in the Elderly: A Secondary Analysis of the Aspirin in Reducing Events in the Elderly Trial” by Zoe K. McQuilten, MB, BS, PhD, Le Thi Phuong Thao, PhD, Sant-Rayn Pasricha, MB, BS, PhD, Andrew S. Artz, MD, MS, Michael Bailey, PhD, Andrew T. Chan, MD, MPH, Harvey Jay Cohen, MD, Jessica E. Lockery, MB, BS, PhD, Anne M. Murray, MD, MSc, Mark R. Nelson, MB, BS, PhD, Hans G. Schneider, MD, Rory Wolfe, PhD, Robyn L. Woods, PhD, Erica M. Wood, MB, BS and John J. McNeil, MB, BS, PhD, 20 June 2023, Annals of Internal Medicine.
DOI: 10.7326/M23-0675
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Frequently Asked Questions (FAQs) about anemia risk
What did the analysis of the ASPREE trial reveal about low-dose aspirin use in older adults?
The analysis revealed that low-dose aspirin use among older adults can lead to a 20% increase in the occurrence of anemia and a decrease in ferritin (blood iron) levels. The primary cause appears to be hidden blood loss rather than significant bleeding events.
How many participants were involved in the ASPREE trial?
The ASPREE trial included 19,114 participants aged 70 or older. They were randomly assigned to receive either a daily dose of 100 mg of aspirin or a placebo.
Did the study find a higher risk of anemia among those taking low-dose aspirin?
Yes, the data from the ASPREE trial analysis indicated a 23.5% risk of developing anemia among the group taking low-dose aspirin. This risk was accompanied by a minor decrease in mean hemoglobin levels and a more significant decline in ferritin levels compared to the placebo group.
Should older patients taking aspirin be regularly monitored for hemoglobin levels?
Yes, based on the study findings, it is advisable for older patients taking aspirin to be regularly monitored for hemoglobin levels. This can help detect and manage anemia early, considering the increased risk associated with low-dose aspirin use.
Are bleeding events the main cause of anemia in this context?
No, the analysis suggests that hidden blood loss, rather than significant bleeding events, is the primary cause of anemia in older adults using low-dose aspirin. The steeper decline in ferritin levels among aspirin users supports this hypothesis.
What are the implications of these findings?
The findings highlight the need for caution when considering low-dose aspirin use in older adults. Healthcare providers should be aware of the increased risk of anemia and monitor patients’ hemoglobin levels regularly. Further research may be necessary to better understand the mechanisms behind hidden blood loss and explore preventive measures.
More about anemia risk
- ASPREE Trial: https://www.nejm.org/doi/full/10.1056/nejmoa1805819
- Annals of Internal Medicine: https://www.acpjournals.org/doi/10.7326/M23-0675
5 comments
oh wow, so they say aspirin is good but now they’re saying it can make you anemic?? that’s scary stuff. elderly people need to be careful with this stuff. hope doctors keep an eye on them.
interesting study! so aspirin can increase anemia risk by 20%? that’s quite a lot. gotta watch those hemoglobin levels in older folks, for real.
i’m shocked! aspirin has always been praised, but now it can lower ferritin levels too? that’s not cool. older peeps need to be extra careful.
who knew? i always thought aspirin was safe. but now they’re saying it can cause hidden blood loss? that’s mind-boggling. we need more research to understand this better.
thanks for sharing this info! i didn’t know aspirin could lead to anemia. it’s important to stay informed about these things, especially when it comes to our health.