Should a neurologist recommend that an asymptomatic and healthy man take aspirin for prophylactic purposes on a long-term basis? This communication reviews the issues engendered by this question.
The results of two large studies have been published in the past 2 years in which healthy male physicians were randomized for long-term prophylactic aspirin treatment or for assignment to a control cohort. The subjects were followed up for an average of 5 to 6 years. The Physicians' Health Study (PHS),1 done in the United States (aspirin, 325 mg every other day), showed a 44% reduction in the risk of myocardial infarction (MI); the P value was less than.00001. The British study (BS)2 showed no such benefit (aspirin, 300 to 500 mg daily). Rates for deaths from all causes were somewhat lower in the aspirin cohorts in both studies, but the reductions were not statistically significant. In both studies, the
Jonas S. The Physician's Health Study: A Neurologist's Concern. Arch Neurol. 1990;47(12):1352–1353. doi:10.1001/archneur.1990.00530120098017
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