A recent large clinical trial published in the Annals of Internal Medicine validates the concept that aspirin at low-doses causes damage to the GI tract. 

In the ASPREE (Aspirin in Reducing Events in the Elderly) randomized clinical trial that included 19,114 people aged 65 years or older, taking a 100-mg dose of aspirin each day was associated with a 20% higher risk of anemia compared with a placebo.

Anemia in older people—likely caused by aspirin-induced GI bleeding, is tied to functional decline, fatigue, and higher mortality. 

The findings therefore reinforce new guidelines that promote aspirin as a tool for secondary—not primary—prevention of cardiovascular disease in older people, and support regular monitoring of hemoglobin in patients who use the drug. 

JAMA. June 28, 2023. doi:10.1001/jama.2023.11954  

Read more: https://jamanetwork.com/journals/jama/fullarticle/2806856