The widespread use of aspirin as a preventive medication in the United States is well known. However, recent studies have raised concerns about its potential risks, particularly for older adults. While aspirin has been traditionally recommended for preventing heart attacks and strokes, experts have cautioned against its blanket use due to the increased risk of major bleeding outweighing the benefits.
Now, researchers have explored another potential downside of aspirin usage: its association with anemia, a condition characterized by reduced oxygen levels in the blood. Anemia is a prevalent health issue among the elderly, often underestimated compared to heart attacks and strokes. Studies indicate that around 30% of adults aged 75 and older worldwide suffer from anemia, which is linked to various health problems such as fatigue, cognitive difficulties, depression, and increased mortality.
A study published in the Annals of Internal Medicine focused on over 18,000 adults aged 65 and older from the United States and Australia. A daily dose of 100 milligrams of aspirin was administered to half the participants, while a placebo was given to the other half. . Over the course of approximately five years, the researchers conducted regular doctor visits and blood tests to measure hemoglobin and ferritin levels, which indicate anemia and iron storage in blood cells, respectively.
The findings revealed a small yet significant difference. Adults who took aspirin had a 20% higher likelihood of developing anemia compared to those who did not take it. The researchers estimated that within five years, 24% of seniors in the daily aspirin group would experience anemia, in contrast to 20% in the placebo group.
Additionally, the study found slightly lower levels of hemoglobin and ferritin in the aspirin group, both crucial for carrying oxygen in the blood. The results remained consistent even after adjusting for factors like cancer, major bleeding events, age, sex, diabetes, kidney disease, and the use of nonsteroidal anti-inflammatory medications (NSAIDs). Although the study did not explore the specific mechanisms through which aspirin contributes to anemia, the authors propose a possible explanation. Aspirin hampers blood clotting by preventing platelets from aggregating, while also blocking an enzyme called Cox-1, which plays a role in maintaining the gastrointestinal lining. With this protective barrier compromised, small amounts of blood may gradually leak from the gut, leading to anemia over time.
Given the broad impact observed across different participant groups, irrespective of their underlying health conditions, the researchers emphasize that this effect is of particular concern for individuals with additional risk factors for anemia, such as inflammatory diseases like arthritis or chronic renal insufficiency. They recommend that doctors closely monitor hemoglobin levels in patients with multiple risk factors, including those who use aspirin.
While aspirin continues to have its place in certain cases, caution is necessary when considering its long-term use, especially among older adults who may be more susceptible to complications. As always, consulting with healthcare professionals and discussing individual circumstances and risks is crucial in making informed decisions about medication usage.