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Use of Aspirin as Primary Prevention of Cardiovascular Events—Reply
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In Reply: Dr Ridker and colleagues discuss differential effects in subgroups. Due to the inherent limitations of study-level meta-analyses, we did not attempt to define the clinical benefit and risk of aspirin therapy in particularly high-risk subgroups such as persons with advanced age or diabetes. We agree that age is a risk factor for cardiovascular events and would expect that more events would be prevented by an effective treatment in a higher risk population. Within any population of human subjects, even those enrolled in a single clinical trial, there is a range of benefit and risk associated with any intervention, as pointed out by the Women's Health Study. The NNT and NNH are only averages of responses of patients across the spectrum of risk and benefit and should always be interpreted as such.
Dr Dalen questions whether myocardial infarction might not have been prevented in women because of the relatively . . . [Full Text of this Article]
Jeffrey S. Berger, MD
Duke University Medical Center
Durham, NC
David L. Brown, MD
davbrown@notes.cc.sunysb.edu
SUNY-Stony Brook School of Medicine
Stony Brook, NY
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