Authors' reply on aspirin for primary prevention

doi:10.1136/bmj.322.7279.171

BMJ 2001;322:171 ( 20 January )

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Authors' reply on aspirin for primary prevention

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EDITOR $---$ By implying disagreements with our study¹ which are largely misplaced or non-existent, Ramsay et al may have confuseddoctors who are deciding about aspirin in the primary preventionof coronary heart disease.² We pointed out that the BritishHypertension Society,³ the hypertension optimal treatment trial,⁴and our trial¹ all say that aspirin treatment should be startedonly when blood pressure is satisfactory. Since both aspirin andraised blood pressure are risk factors for cerebral haemorrhage,this seems to be good clinical practiceanyway.

In citing the physicians' health study from the United States⁵ Ramsay et al (despite their reservations about subgroupanalyses, which we also drew attention to) did not quote the non-significanttrend for its finding on response according to blood pressure(P=0.48) compared with the interaction term for the associationof pressure on entry with response to aspirin in our trial (P=0.0004).The published data from . . . [Full text of this article]

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