Bmj Usa: Letter

RAPID RESPONSES FROM BMJ.COM

BMJ 2003; 327 doi: https://doi.org/10.1136/bmjusa.03090003 (Published 19 November 2003) Cite this as: BMJ 2003;327:E253
  1. William E Osmun, assistant profession (wosmun@uwo.ca)
  1. University of Western Ontario, Mount Brydges, Canada.
  2. Sutton, Canada.
  3. Sheffield, UK.
  4. Birmingham, UK.
  5. Chesterfield Royal Hospital, UK.
  6. St James's University Hospital, Yorkshire, UK.
  7. Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
  8. University of Dundee, UK
  9. Noncommunicable Diseases & Mental Health, World Health Organization
  10. Belfast, UK.

    As of August 25, 2003, this controversial paper had generated 85 Rapid Responses, which can be read in their entirety at http://bmj.com/cgi/eletters/326/7404/1419. Following are edited excerpts—Editor

    From BMJ USA 2003;September:481

    Editor—I am just wondering if the “compelling” observational evidence that lowering serum homocysteine reduces heart disease is as “compelling” as the observational evidence that estrogen did the same thing.

    1. Eddie Vos, maintains www.health-heart.org (vos@health-heart.org)
    1. University of Western Ontario, Mount Brydges, Canada.
    2. Sutton, Canada.
    3. Sheffield, UK.
    4. Birmingham, UK.
    5. Chesterfield Royal Hospital, UK.
    6. St James's University Hospital, Yorkshire, UK.
    7. Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
    8. University of Dundee, UK
    9. Noncommunicable Diseases & Mental Health, World Health Organization
    10. Belfast, UK.

      Editor—Even in “high risk” populations, statins failed to reduce overall mortality in ALLHAT, PROSPER and ASCOT while the number needed to treat for 1 year to postpone 1 death in HPS was about 300. These are the last 12 months of statin trials. The concept of all-cause mortality is glaringly missing in the Wald and Law analysis.

      1. Barry A Groves, independent researcher (barry@second-opinions.co.uk)
      1. University of Western Ontario, Mount Brydges, Canada.
      2. Sutton, Canada.
      3. Sheffield, UK.
      4. Birmingham, UK.
      5. Chesterfield Royal Hospital, UK.
      6. St James's University Hospital, Yorkshire, UK.
      7. Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
      8. University of Dundee, UK
      9. Noncommunicable Diseases & Mental Health, World Health Organization
      10. Belfast, UK.

        Editor—I have read some rubbish in my time, but this just about takes the biscuit. Let's take this to its logical conclusion and put every drug known to medical science in the water supply. That way we will prevent and cure every disease humanity is subject to.

        Or, of course, we could cut mortality by 100% by preventing the most important “risk factor” of them all: being born.

        1. Eugene A Rybinski, general practitioner (erybinski@compuserve.com)
        1. University of Western Ontario, Mount Brydges, Canada.
        2. Sutton, Canada.
        3. Sheffield, UK.
        4. Birmingham, UK.
        5. Chesterfield Royal Hospital, UK.
        6. St James's University Hospital, Yorkshire, UK.
        7. Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
        8. University of Dundee, UK
        9. Noncommunicable Diseases & Mental Health, World Health Organization
        10. Belfast, UK.

          Editor—Wald and Law's Polypill is an intriguing proposition. Their calculations are based on pooled data in large populations. While it may be true that age is the single most …

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