Effectiveness and safety of aspirin may be overrated

doi:10.1136/bmj.324.7329.0/a

Effectiveness and safety of aspirin may be overrated

Despite the vast size of the aspirin meta-analysis in this week's issue, Cleland (p 103) states that the effectiveness andthe safety of aspirin have been overrated. He argues that aspirinmay change the way vascular events present, rather than preventthem, and that this may lead to a "cosmetic" reduction in non-fatalevents and an increase in sudden death. Data on safety and cost-benefitof aspirin are inadequate, and advocating the use of aspirin forpreventing atherosclerotic events diverts attention from other,more effective, drugs such as ACE inhibitors, $beta$ blockers, andstatins.