Health
Daily low-dose aspirin may cause anemia in older people
People taking low doses daily aspirin may be more likely to develop anemiaaccording to new information Research on June 20, Annals of Internal Medicine. Researchers have found that it lasts longer. daily aspirin use There was a 20 percent increase in the risk of anemia, mainly in people over the age of 70.
Importantly, these findings were in people who had no signs of internal bleeding. Stomach A co-author of the study said of the gastrointestinal tract where aspirin-induced bleeding is expected: Dr. Harvey CohenProfessor of Medicine, Duke University School of Medicine, Durham, North Carolina.
“It is still likely that the anemia was caused by bleeding, and it is either simply asymptomatic or not severe enough to be immediately observable. Even if you don’t have it, it suggests that you should be monitored for possible iron deficiency,” says Cohen.
Study reveals ‘hidden’ blood loss from daily aspirin
They say this is the first large-scale study to look at the long-term adverse effects of aspirin. Dr. Rachel McGurkA family medicine physician at The Ohio State University Wexner Medical Center in Columbus, he was not involved in the study.
“Although we already know that aspirin can cause serious bleeding problems requiring hospitalization in some people, this study also suggests that people who take aspirin daily may also be ‘hidden’. Indicates that blood loss may be present. People who have taken aspirin for years may lose small amounts of blood in their stool due to stomach irritation,” she says.
100 milligrams of aspirin increases chance of anemia and bleeding
Researchers analyzed data from about 18,000 initially healthy elderly people in Australia and the United States. Asprey The Aspirin in Reducing Events in the Older trial is the first to show that aspirin does not extend healthy life expectancy in initially healthy older adults (mainly those over 70).
The incidence of anemia over a median of 4.7 years was 51.2 per 1000 person-years in the group taking 100 milligrams (mg) of aspirin daily, compared with 42.9 per 1000 person-years in the placebo group. People who took fake pills instead of aspirin.
The estimated probability that participants would develop anemia within five years was 23.5 percent in the aspirin group compared to 20.3 percent in the placebo group.
People taking aspirin were also more likely to have clinically significant bleeding events. In the aspirin group, 3% of him experienced at least one event, compared with 2.1% of him in the placebo group.
Anemia in the elderly is associated with cognitive impairment and depression
There are three types of anemia. The main types of anemia observed in this trial are thought to be: iron deficiency anemiasays Cohen.
As the name suggests, iron deficiency anemia is caused by iron deficiency. johns hopkins medicine. Without enough iron, the body cannot produce enough hemoglobin, the substance in red blood cells that carries oxygen. Blood loss from gastrointestinal bleeding, injury, menstrual bleeding, etc. can cause this type of anemia.
The incidence of anemia is known to increase with age and is estimated to be about 10 percent of adults over the age of 65 that is anemia, with higher prevalence among people in nursing homes and hospitals. 39.5 percent of men and 21.9 percent of women over the age of 85 are anemic. Centers for Disease Control and Prevention (CDC).
anemia in older adults is associated with decreased function, increased fatigue, disability, depressive symptoms, and cognitive problems. National Institutes of Health (NIH).
What are the current guidelines regarding aspirin?
Note that participants in this trial were taking aspirin for primary prevention of heart disease, and while it is still recommended for secondary prevention, daily low-dose aspirin is no longer recommended for primary prevention. Cohen says it should.
“But despite this, there are actually still a significant number of people taking aspirin for primary prevention. These findings probably encourage people to use low-dose aspirin for primary prevention.” I think it’s another indicator of why it might be beneficial to be more cautious when using low-dose aspirin, because there’s yet another potential downside to using low-dose aspirin.” he says
Primary prevention recommendations are aimed at preventing the initial occurrence of a heart attack, stroke, or cardiovascular disease event, whereas secondary prevention of cardiovascular disease already includes heart attack, stroke, or coronary artery It is intended to prevent recurrent events in people who have had reconstructive surgery. Procedures (such as stents or bypass surgery).
United States Preventive Services Task Force (USPSTF) in 2022 Starting low-dose aspirin is not recommended Consistent recommendations with other national agencies for the primary prevention of cardiovascular disease in people over the age of 60 include: American Heart Association (AHA).
This update builds on growing evidence of potentially fatal internal bleeding caused by regular aspirin use, suggesting that the risks may outweigh the protective benefits.
Recommendations apply only to the primary prevention group. It does not apply to people who already have cardiovascular disease in any way, the statement said.
experts agree Do not take low-dose aspirin daily without consulting your doctor. If you are taking low-dose aspirin for secondary prevention of heart disease, do not stop taking it.
Do I need to talk to my doctor if I take aspirin daily?
“I think the risks and benefits of taking aspirin every day definitely need to be debated. I think people need to understand that there are still downsides,” Cohen said.
“In recent years, primary care physicians have not recommended daily aspirin use as much as they used to. It could be bigger,” says McGurk.
What are your considerations when making decisions? Aspirin helps prevent blood clots from forming in blood vessels, such as in the brain, heart, and legs, says McGurk. “People who have had a heart attack or stroke before need drugs such as aspirin to prevent it from happening again,” she says.
Aspirin may also benefit people who are at high risk of future heart attacks, such as those with diabetes, smokers, and people with a strong family history of heart disease, McGurk said.
“However, aspirin may not be suitable for people at increased risk of bleeding. It is important to talk to your doctor about whether aspirin is right for you. You can weigh the benefits and the risks,” she says.
Recommendations for Older Adults Taking Aspirin Daily
“People who need to take aspirin daily should talk to their doctor about how to eat an iron-rich diet. Also, avoid using alcohol or other substances that can irritate the stomach, such as alcohol.” Limitations should also be considered. NSAIDS like ibuprofen and Naproxen‘ says McGurk.
Testing for anemia and low iron in adults for no apparent reason is not currently standard treatment, but this latest study suggests that people taking aspirin should have regular blood tests for anemia and low iron. It raises the question of whether it should, McGurk said. “People who take aspirin long-term should consider asking their doctor if they need to be tested for anemia or iron deficiency,” she says.
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