We appreciate the interest of Drs Etminan and Takkouche who express concerns about the conclusions in our article1 and indicate that the combination of aspirin and ACE inhibitors may pose a problem. They contend that our result "indicates a clear antagonism between aspirin and ACE inhibitors." We strongly disagree with this characterization. As stated clearly in our article, we found that aspirin and ACE inhibitors were each associated with a lower mortality than no therapy, which we expected according to the findings of other randomized trials. Moreover, when prescribed together, the joint effect of aspirin and ACE inhibitors seemed to be greater than the effect of either therapy alone, which supports current recommendations from clinical practice guidelines.
Krumholz HM. Interaction Between Angiotensin-Converting Enzyme Inhibitors and Aspirin—Reply. Arch Intern Med. 2001;161(16):2048-2049. doi: