Effects of statins have been in addition to those of aspirin and

EDITOR—Ferner acknowledges the apparent similarity between the abilities of continuing aspirin and simvastatin to prevent “bad things.”1 He overlooks the fact that the positive outcomes of the secondary prevention statin studies were additional to the use of both aspirin and β blockers according to the investigators' cardiological practices at the time (table).2^–4 Since the inception of the Scandinavian simvastatin survival study over a decade ago, subsequent trials have tested lipid modification with statins against a background of increasingly optimal practice, comfortably exceeding that described in the survey by Campbell et al.5