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December 1991

Which Categories of Patients Are Known to Benefit From Aspirin?

Arch Intern Med. 1991;151(12):2489-2490. doi:10.1001/archinte.1991.00400120115034

To the Editor.—  I read Dalen's recent article1 on aspirin and cardiovascular disease with interest, but I respectfully disagree with some of the conclusions that he reached. His account of research advances in the study of aspirin and cardiovascular disease provides a fascinating look at the history of medicine, but the implication that conclusive evidence of aspirin's benefit may have been available as early as the 1950s is, I believe, poor science.Dalen describes several patient series reported by a California physician, Lawrence Craven, in the early 1950s that raised the question of aspirin's benefit in cardiovascular disease prevention. Dalen writes: "Lookingback at Craven's reports, 40 years later and after dozens of clinical trials, what can we conclude? I would conclude that if his rule of 'an aspirin a day' had been adopted by Americans in 1950, hundreds of thousands of myocardial infarctions and strokes might have been prevented."As

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