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—We thank Dr D'Agostino and colleagues for sharing their interesting data from the Framingham Heart Study. In their data, as in ours, the use of one through six aspirin per week was associated with decreased risks of CVD, whereas seven or more was not.Whether the absence of benefit in the latter group is attributable to the higher dose or frequency of aspirin ingestion or to confounding by the underlying indication for aspirin or related health habits remains unclear. It is of interest that low-dose aspirin was associated with greater reductions in stroke than in MI in the Framingham data. We agree that further investigation is warranted and believe that only randomized clinical trials of adequate sample size will provide conclusive evidence on the risk:benefit ratio of low-dose aspirin in primary prevention of CVD in women.Dr Yawn comments on the potential importance of the indications for aspirin
Manson JE, Stampfer MJ, Colditz GA, Willett WC, Speizer FE, Hennekens CH. Aspirin Use and Cardiovascular Disease in Women-Reply. JAMA. 1992;267(3):365. doi:10.1001/jama.1992.03480030042026