 |
 |
A recent report in the BMJ showed that the ACE inhibitor ramipril reduced the risk of stroke independently of BP reduction. Yet again, the results were presented as relative risk reduction. The authors report a 32% RRR in all strokes and a 61% RRR in fatal strokes. Others have already commented in electronic responses to the BMJ that it would have been more useful to have the ARRs presented. These translate as 1.5% and 0.9% respectively. Similar observations can be made on the other outcomes studied by the authors (namely cognitive impairment). Is this simply a case of old habits die hard or of spin? An added potential spin is that the period of time over which the reductions are achieved are not mentioned in the results section of the abstract or table 1. (They are mentioned in the methods section). SIXTY SEVEN patients need to take ramipril for an average of FOUR AND A HALF years to prevent ONE stroke. Not such a good headline. Ref: Use of ramipril in preventing stroke: double blind randomised trial Jackie Bosch, Salim Yusuf, Janice Pogue, Peter Sleight, Eva Lonn, Badrudin Rangoonwala, Richard Davies, Jan Ostergren, and Jeff Probstfield BMJ 2002; 324: 699 http://bmj.com/cgi/content/abridged/324/7339/699 -- Kev (Kevork) Hopayian GP, The Surgery, Main St, Leiston, Suffolk, IP16 4ES, England Tel +44 (0)1728 830526 Fax +44 (0)1728 832029 www.suffolk-mag.ac.uk/kevhop