Using low-dose aspirin was associated with a 20% increased incidence of anemia and decline in ferritin, or blood iron levels, in otherwise healthy older adults, according to a new analysis of a study conducted a decade ago. Photo by LizM/
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June 19 (UPI) -- Using low-dose aspirin was associated with a 20% increased incidence of anemia and decline in ferritin, or blood iron levels, in otherwise healthy older adults, according to a new analysis of a study conducted a decade ago.
Publishing their findings in the Annals of Internal Medicine on Monday, 15 researchers from Australia, New Zealand and the United States determined that low-dose aspirin appeared to reduce the levels of ferritin, a blood protein in cells that contains iron, and increase anemia.
"Aspirin may contribute to an increased anemia risk through occult blood loss, resulting in anemia," the researchers wrote. "To our knowledge, this is the first large-scale prevention trial to examine the effect of long-term, low-dose aspirin use on ... anemia."
Headed by lead author Zoe K. McQuilten, of Monash University in Melbourne, they added: "Although the risk for overt bleeding due to aspirin has been well-characterized, very few studies have measured the effect of aspirin on anemia, particularly in older populations."
Symptoms of iron-deficiency anemia, or having too few red blood cells, include feeling tired, weak or dizzy, and perhaps having pale skin and cold hands and feet.
Other symptoms include headaches, swollen legs, restless leg syndrome and dry and brittle hair and nails, according to the non-profit Parsemus Foundation.
Researchers noted that some 50% of older people in the United States take aspirin for preventative reasons, including what is commonly called thinning the blood to counter cardiovascular disease and prevent stroke.
However, because of the risk of bleeding, the U.S. Preventative Services Task Force last year recommended against initiating low-dose aspirin use for the primary prevention of cardiovascular disease in adults 60 years and older.
For the new research, investigators from Monash University conducted a new analysis of the 2010-2014 ASPREE trial, which employed placebos for some of those studied and was double-blinded, meaning the researchers did not know who was getting the aspirin and who among the 19,114 subjects aged 70 and older was getting the sugar pill.
ASPRESS stands for "Aspirin in Reducing Events in the Elderly," and involved giving some participants 100 mg. of enteric-coated aspirin. Much of the low-dose aspirin in this country is sold in 81-mg. tablets, though some people take two a day.
During the trial, hemoglobin was measured annually, and ferritin was measured at baseline and three years after randomization.
The data showed that the risk for developing anemia was 23.5% among those assigned to receive low-dose aspirin. These results were accompanied by a small but greater decrease in mean hemoglobin and a greater decline in ferritin concentrations among those receiving aspirin, according to a news release.
Clinically significant bleeding events did not account for the overall difference in anemia or the decline in ferritin observed in the ASPREE trial, which were "most likely due to occult [not visible] blood loss given the observed steeper decline in ferritin in participants allocated to aspirin," the researchers said.
