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EDITORIALS: William R Hiatt Aspirin for prevention of cardiovascular events BMJ 2008; 337: a1806 [Full text]

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Building relationships

Jonathan Cooke   (22 October 2008)

Aspirin for primary prevention

Chris J Hall   (26 June 2009)

Building relationships 22 October 2008
Jonathan Cooke, Director of Researcha nd Development, Director of Pharmacy UHSMFT M23 9LT Send response to journal: Re: Building relationships	One of the builders doing work at our property has just suffered a heart attack and has been given the "all clear" from his GP. As well as stopping smoking he is on the usual cocktail of medicines for AMI but informed me that the aspirin had been shown not to work in a recent study. I confirmed that in fact aspirin does work post MI and used the opportunity to inform his colleagues of the benefits of stopping smoking. It concerns me that the messages that we try to give out are often either not communicated well enough or misinterpreted by the public and the media. Perhaps we need to do more research on the best methods for conveying details of health benefits from primary research to the public. Competing interests: None declared
Aspirin for primary prevention 26 June 2009
Chris J Hall, GP West Common Lane Medical Centre, Dorchester Road, Scunthorpe, DN171YH Send response to journal: Re: Aspirin for primary prevention	Professor Hewitt in his editorial in the BMJ of November 1st 2008 is adamant that clinicians and guideline developers should heed the evidence and not use aspirin for primary prevention of cardiovascular events. The recently published NICE clinical guideline 87 on the management of type 2 diabetes continues to advocate the use of aspirin for this indication. In a personal communication the NICE guideline development team criticise the recent trials and advocate no change in the use of aspirin for primary prevention in both diabetic and non-diabetic patients How then am I to advise my patients, many of whom are aware of the controversy through media coverage? Either the evidence points clearly in one direction or it does not. I can live with uncertainty and use my clinical judgement accordingly. However diametrically opposed views from respected and eminent sources are unhelpful. Clearly a consensus is urgently required. Competing interests: None declared