Anemia Risk in Older Adults: The Impact of Daily Low-Dose Aspirin

Anemia Risk: OLDER adults who take a daily low-dose aspirin run a 20 percent greater risk of developing anemia than those who avoid the commonly recommended preventive treatment, experts say.

Some health care providers suggest patients use the over-the-counter pills — which range from 75 to 100 milligrams each — to ward off clot-related heart attacks and strokes due to the drug’s blood-thinning properties.

But a National Institutes of Health–funded clinical trial suggests folks aged 70 and older may face elevated odds of anemia — a condition in which the body does not have enough healthy red d blood cells.

The vital cells contain hemoglobin, an iron-containing oxygen-transport protein, and anemia in seniors has been linked to functional decline, increased fatigue, disabilities, depressive symptoms and cognition problems.

While aspirin use sometimes causes bleeding in the gastrointestinal tract — which can lead to a low red blood cell count — researchers note the anemic subjects did not show obvious evidence of that side effect.

“It’s still likely the anemia was caused by bleeding. It’s just subclinical — or not severe enough to be readily observable,” says Dr. Harvey Cohen, a professor at Duke University School of Medicine and coauthor of the study.

“That suggests people who are receiving low-dose aspirin should be monitored for the potential of iron deficiency — even when they don’t have obvious bleeding.”

In 2022, the U.S. Preventive Services Task Force recommended against aspirin use for the primary prevention of cardiovascular disease in people aged 60 and up — but said the advice did not apply to those with established issues.

Experts agree patients should follow the advice of their personal physician.