2023-06-28 13:44:03
Older people who take aspirin daily are at greater risk of anemia and iron deficiency. You can read here what you should pay attention to in your patients.
Some patients benefit from the regular intake of acetylsalicylic acid (ASA; Aspirin®), for example because of an increased risk of heart attack or stroke. However, studies have already shown that prophylactic use can also have an effect on the risk of bleeding. Researchers have now shown that regular ASA intake apparently also influences the risk of anemia.
The WHO defines anemia as hemoglobin concentrations below 12 g/dl in women and below 13 g/dl in men. There are many reasons for the development of anemia, but by far the most common reason is iron deficiency. In older people, chronic diseases and inflammation are often the cause.
Risk of anemia increases by 20%
The Study, the in Annals of Internal Medicine was published, includes around 19,000 people aged 70 years and older who were randomized to receive either 100 mg of ASA daily or a placebo. The researchers included the annually measured hemoglobin concentrations of all subjects and the ferritin concentrations measured at baseline and three years later in a subset of participants.
The risk of developing anemia was 20% higher in the ASA group than in the placebo group (51.2 events per 1,000 person-years vs. 42.9; hazard ratio: 1.20). In the placebo group, the hemoglobin concentration decreased by an average of 3.6 g/L over a period of 5 years, while the ASA group saw a larger decrease of 4.2 g/L. In nearly 7,000 participants whose ferritin levels were measured at baseline and in year 3, the prevalence of ferritin levels below 45 µg/L was higher in the ASA group (13.0 vs. 9.8%). In addition, the ASA group had a greater overall decrease in ferritin of 11.5% compared to the participants who received placebo.
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Anemia: Check older people more often
The authors conclude that daily intake of low-dose ASA may lead to an increased incidence of anemia and a decrease in ferritin in otherwise healthy older adults. Therefore, regular hemoglobin monitoring should be considered in elderly people taking aspirin. The authors speculate that the reason for the anemia after regular ASA intake could be occult blood loss.
Image source: Pawel Czerwinski, unsplash
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