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
Hennekens CH. Which Categories of Patients Are Known to Benefit From Aspirin?. Arch Intern Med. 1991;151(12):2489–2490. doi:10.1001/archinte.1991.00400120115034
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