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Monday, September 11, 2023

Unexpected Side Effect of Daily Aspirin Usage in Older Adults

Might cause anemia


A recent analysis of data from the landmark ASPREE trial revealed that prolonged daily aspirin consumption increased anemia risk by 20 percent in individuals predominantly aged 70 and above.

In light of these findings, researchers recommend routine anemia checks for elderly individuals on low-dose aspirin. Additionally, they advise such adults to consult their GP regarding any health or medication concerns.

The Monash University-led study, published in Annals of Internal Medicine, followed 18,153 initially healthy older adults in Australia and the USA and recorded incidents of anemia over an average of 4.7 years. The risk of developing anemia was found to be 20 percent higher in the aspirin group compared to those in the placebo group.

It was the largest study to investigate anemia in older people as part of a randomized controlled trial, ASPREE (ASPirin in Reducing Events in the Elderly) – with half the participants taking a placebo and the other half a daily low dose (100mg) of aspirin.

Anemia is commonly experienced by older adults, potentially affecting overall function and increasing fatigue, disabilities, depressive symptoms, and cognitive problems. 

In addition to a higher risk of anemia, blood tests revealed a faster decline of hemoglobin and reduced ferritin (a protein that carries iron) levels in the aspirin group compared to the placebo group.

Lead author, Associate Professor Zoe McQuilten from Monash University’s School of Public Health and Preventive Medicine, said while bleeding was a known side-effect of aspirin, few previous studies had looked at the effect of prolonged aspirin use on the progressive development of anemia in older adults.

“This study gives a clearer picture of the additional risk of becoming anemic with aspirin use and the impact is likely to be greater in older adults with underlying diseases, such as kidney disease,”  Associate Professor McQuilten said.

Associate Professor McQuilten said the new data gave doctors insight into the risk of anemia from prolonged aspirin use by their older patients. “Older adults are more likely to become anaemic generally and now doctors can potentially identify patients at higher risk of developing anaemia,” she said.

Associate Professor McQuilten urged patients to follow the advice of their doctor about their daily use of aspirin. She cautioned that for some older adults, aspirin was recommended as a valuable therapy to prevent recurring heart attacks or stroke. “Patients should not change their aspirin regimen without speaking to their GP,” she said.

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, Le Thi Phuong Thao, Sant-Rayn Pasricha,Andrew S. Artz, Michael Bailey, Andrew T. Chan, Harvey Jay Cohen, Jessica E. Lockery, Anne M. Murray, Mark R. Nelson, Hans G. Schneider, Rory Wolfe, Robyn L. Woods, Erica M. Wood and John J. McNeil, July 2023, Annals of Internal Medicine.
DOI: 10.7326/M23-0675

The study was funded by the National Institute on Aging, the National Cancer Institute, the National Health and Medical Research Council, and the Victorian Cancer Agency.