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September 19, 2012

Benefits and Risks of Aspirin Use

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Wegmans Pharmacy, Ithaca, New York (Dr DiNicolantonio; jjdinicol@gmail.com); Mid America Heart Institute, University of Missouri, Kansas City (Dr O’Keefe); and Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, Louisiana (Dr Lavie).

JAMA. 2012;308(11):1088-1089. doi:10.1001/2012.jama.10717

To the Editor: Ms De Berardis and colleagues1 stated, “The benefit of aspirin for the primary prevention of cardiovascular events is relatively small for individuals with and without diabetes. This benefit could easily be offset by the risk of hemorrhage.” We disagree with their conclusion that aspirin use is associated with harm (major gastrointestinal or cerebral bleeding episodes) because they conducted a population-based cohort study, not a randomized controlled trial (RCT), and thus cannot prove causation.1

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