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Low-Dose Aspirin and Anemia in Older Adults

Older adults taking low-dose aspirin may need periodic measurements of hemoglobin concentrations, conclude authors who conducted a post hoc analysis of the ASPREE (ASPirin in Reducing Events in the Elderly) randomized controlled trial. In otherwise healthy older adults, low-dose aspirin increased incident anemia and decline in ferritin levels.

In primary and community care settings in Australia and the United States, 19,114 persons aged 70 years or older (65 years for Black and Hispanic persons) randomly received aspirin 100 mg or placebo daily. Annual hemoglobin concentrations were measured annually, and ferritin was measured at baseline and 3 years after random assignment.

“Anemia incidence in the aspirin and placebo groups was 51.2 events and 42.9 events per 1,000 person-years, respectively (hazard ratio, 1.20 [95% CI, 1.12 to 1.29]),” the authors report. “Hemoglobin concentrations declined by 3.6 g/L per 5 years in the placebo group and the aspirin group experienced a steeper decline by 0.6 g/L per 5 years (CI, 0.3 to 1.0 g/L). In 7,139 participants with ferritin measures at baseline and year 3, the aspirin group had greater prevalence than placebo of ferritin levels less than 45 µg/L at year 3 (465 [13%] vs. 350 [9.8%]) and greater overall decline in ferritin by 11.5% (CI, 9.3% to 13.7%) compared with placebo. A sensitivity analysis quantifying the effect of aspirin in the absence of major bleeding produced similar results.”

Source: Annals of Internal Medicine