Additional piece: The Impact of Daily Low-Dose Aspirin on Risk of Anemia in Seniors
Introduction:
Daily low-dose aspirin has long been prescribed to seniors as a preventative measure against cardiovascular diseases. However, recent research has shed light on a potential side effect of this common medication. A study published in the Annals of Internal Medicine revealed that seniors taking daily low-dose aspirin have a 20% increased risk of developing anemia. This revelation has caused concern among healthcare providers and has prompted a reevaluation of the use of aspirin for primary prevention in older adults.
Understanding Anemia and its Consequences:
Anemia is a condition characterized by low levels of hemoglobin, an iron-rich protein in red blood cells that carries oxygen throughout the body. It is particularly common in older individuals and can lead to symptoms such as fatigue, fast or irregular heartbeat, headaches, chest pain, and even cognitive decline and depression in seniors aged 65 and older. Furthermore, anemia can worsen existing conditions like congestive heart failure, exacerbating the overall health of older adults.
The Link between Daily Low-Dose Aspirin and Anemia:
The study conducted by researchers in the US and Australia examined hemoglobin concentrations among over 19,000 healthy adults aged 65 and older. They found that seniors taking daily low-dose aspirin were at a higher risk of developing anemia compared to those who did not take aspirin. The increased risk was attributed to clinically apparent bleeding caused by the aspirin, leading to a drop in ferritin levels, an indicator of iron levels in the body.
Changing Recommendations and the Need for Discussion:
In light of these findings, the US Preventive Services Task Force revised its recommendation on aspirin for the primary prevention of cardiovascular disease in 2022. The Task Force now advises against starting low-dose aspirin for adults aged 60 and older unless they have a specific indication for its use. For adults aged 40 to 59 with a 10-year or greater risk of cardiovascular disease, the decision to start low-dose aspirin should be made on a case-by-case basis, considering the potential benefits and risks.
The Role of Healthcare Providers:
Zoe McQuilten, MBBS, PhD, a hematologist at Monash University in Australia and the principal author of the study, emphasized the importance of healthcare providers discussing the need for aspirin with their patients. For older individuals who are taking aspirin without a specific indication, it is crucial to reassess whether it is the best treatment option for them.
Unveiling the Mystery of Anemia:
While anemia is a well-known condition, the cause of many cases remains unknown. A study published in the Journal of the American Geriatrics Society in 2021 found that about a third of anemia cases in older adults had no clear cause. This highlights the need for further research to understand the underlying factors contributing to anemia and to develop targeted treatments.
Conclusion:
The association between daily low-dose aspirin and an increased risk of anemia among seniors raises important considerations regarding its use for primary prevention. Healthcare providers should engage in open discussions with their patients about the potential risks and benefits of taking aspirin. Furthermore, more research is needed to better understand the underlying causes of anemia, especially in cases where it cannot be attributed to known factors. By gaining a deeper understanding of this potential side effect, we can improve the overall health and well-being of older adults.
Summary:
Seniors taking daily low-dose aspirin have a 20% increased risk of developing anemia, according to a study published in the Annals of Internal Medicine. Anemia, characterized by low hemoglobin levels, is common in older individuals and can lead to various symptoms and worsen existing health conditions. The link between daily low-dose aspirin and anemia highlights the need for healthcare providers to reassess the use of aspirin for primary prevention. The revised recommendations by the US Preventive Services Task Force urge caution in prescribing aspirin to older adults without a specific indication. Additionally, the cause of many cases of anemia remains unknown, emphasizing the need for further research in this area.
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June 20, 2023: Seniors taking daily low-dose aspirin have a 20% increased risk of developing anemiashows new research.
The study, posted on monday in it Annals of Internal Medicineexamined hemoglobin concentrations among more than 19,000 healthy adults in the US and Australia who were 65 years of age or older.
Low levels of hemoglobin, an iron-rich protein in red blood cells that carry oxygen throughout the body, can lead to anemiawhich is common in older people and can cause fatigue, fast or irregular heartbeat, headaches, chest pain, and pounding or hissing in the ear. It can also worsen conditions such as congestive heart failure, cognitive decline, and depression in people 65 and older.
“We knew from large clinical trials, including our … trial, that daily low-dose aspirin increased the risk of clinically significant bleeding,” said Zoe McQuilten, MBBS, PhD, a hematologist at Monash University in Australia and author study principal. “From our study, we found that low-dose aspirin also increased the risk of anemia during the trial, and this was likely due to bleeding that was not clinically apparent.”
He The US Preventive Services Task Force changed its recommendation on aspirin as primary prevention of cardiovascular disease in 2022, recommending against starting low-dose aspirin for adults 60 years and older. For adults ages 40 to 59 with a 10-year or greater risk of cardiovascular disease, the agency recommends that patients and health care providers make the decision to start low-dose aspirin on a case-by-case basis, since the profit is small.
McQuilten said that doctors can’t find the cause of many cases of anemia. A published study in it Journal of the American Geriatrics Society in 2021 it found that about a third of anemia cases had no clear cause.
About 50% of people involved in the latest study took aspirin for prevention between 2011 and 2018. That number likely dropped after the guideline changes in 2022, according to McQuilten, but may have continued long-term between the older patients. The researchers also looked at ferritin levels, which serve as an indicator of iron levels (and can indicate anemia at low levels), at the start of the trial and again after 3 years.
People taking aspirin were more likely to have lower blood serum ferritin levels at 3 years than those taking a placebo. The average drop in ferritin among people in the study who took aspirin was 11.5 percent greater than those who took a placebo.
The estimated probability of anemia within 5 years was 23.5% in the aspirin group and 20.3% in the placebo group. Overall, aspirin therapy resulted in a 20% increased risk of anemia.
Basil Eldadah, MD, PhD, supervising medical officer for the US National Institute on Aging, said the findings should encourage health care providers to discuss the need for aspirin with their patients.
“For someone who is taking aspirin and is older, and it’s not for an indication like cardiovascular disease, seriously consider whether that’s the best treatment option,” said Eldadah, who was not involved in the study.
The study did not examine the consequences of anemia in the participants, which, he said, could be the subject of future research. The researchers said one limitation was that it was not clear whether the anemia was enough to cause symptoms that affected the quality of life of the people in the study, or whether unknown bleeding caused the anemia.
The investigators also did not document whether patients saw their usual physicians and received treatment for anemia during the trial.
https://www.webmd.com/healthy-aging/news/20230620/aspirin-warning-anemia-may-increase-with-use-in-older-adults?src=RSS_PUBLIC
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