We agree with Jamali that inflammatory diseases such as rheumatoid arthritis are associated with cardiovascular disease, as we have shown in the Nurses' Health Study.1 Of note, the 3 references pointed out by Jamali, as well as the one from our group, deal with rheumatoid arthritis, which is uncommon in men (1.5% of the individuals in our study). To fully address Jamali's concerns, we reran our multivariate models with the additional inclusion of rheumatoid arthritis, osteoarthritis, and gout as covariates. The relative risks comparing men who used analgesics 6 to 7 days per week compared with nonusers were 1.30 (95% confidence interval, 0.99-1.72) (P value for trend, .03) for acetaminophen, 1.37 (95% confidence interval, 1.08-1.73) (P value for trend, .003) for nonsteroidal anti-inflammatory drugs, and 1.27 (95% confidence interval, 1.14-1.41) (P value for trend, < .001) for aspirin. As can be seen from these results that are similar to those in the original publication,2 the interpretation of our data remains unchanged after consideration of these inflammatory conditions.
Forman JP. Arthritis Is Associated With Cardiovascular Disease in the Users of Analgesics and Nonsteroidal Anti-inflammatory Drugs—Reply. Arch Intern Med. 2007;167(21):2372. doi:10.1001/archinte.167.21.2372-a