Aspirin is one of the most commonly used drugs, but you should be careful with it.
Research shows that more than 40 percent of adults over the age of 60 take aspirin every day to prevent the formation of dangerous blood clots that can lead to a heart attack or stroke. N1.
In recent years, experts have backed away from general use of the drug for all older adults, however, after studies showed it carried an increased risk of major bleeding that likely outweighed any benefit in preventing first heart attacks or strokes.
However, in some cases it is still recommended for people who have had a heart attack or stroke to prevent another one.
Because aspirin can contribute to the risk of major bleeding such as aneurysms, the researchers wanted to know if it could also be a factor in more subtle blood loss: the kind that can lead to anemia, or reduced oxygen in the blood.
Anemia is another major problem in the elderly, although it may not receive enough attention compared to heart attacks and strokes.
Studies show that 30 percent of adults age 75 and older worldwide are anemic, and anemia is generally associated with poorer health, including fatigue, memory and thinking problems, depression, and an increased risk of death.
A study published in the "Annals of Internal Medicine" followed more than 18.000 adults over the age of 65 from the US and Australia.
Half took 100 milligrams of aspirin a day, low doses, while the other half took a placebo. The researchers followed them for about five years.
Study participants had annual doctor visits and blood tests for hemoglobin and ferritin, a protein in blood cells that stores iron.
They saw a small but clear difference. Adults who took aspirin were 20 percent more likely to be anemic than those who did not.
Based on their results, the researchers estimated that 24 percent of the elderly in the daily aspirin group would develop anemia within five years, compared to 20 percent of those in the placebo group.
Those taking aspirin also had slightly lower levels of hemoglobin and ferritin, which help blood cells carry oxygen.
The difference remained even when the researchers adjusted their data to account for cancer and major bleeding during this study, as well as other differences between participants such as age, gender, diabetes, kidney disease and use of nonsteroidal anti-inflammatory drugs, or NSAIDs.
The study did not look at how aspirin might contribute to anemia, but the authors have an idea of how this might happen. Aspirin makes it difficult for blood to clot because it prevents platelets from sticking together. It also blocks an enzyme called Cok-1, which is important for maintaining the lining of the stomach and intestines.
As this protective barrier is damaged, it is easier for small amounts of blood to leak out of the intestines over time, eventually leading to anemia.
The researchers wrote that because they saw this effect in many different groups, regardless of their underlying health, it is likely to be of greater concern for people who have other risks of anemia, such as inflammatory diseases such as arthritis or chronic kidney disease.
They say doctors should consider monitoring patients' hemoglobin levels more closely if they have multiple risk factors, including aspirin use.
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