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January 10, 1996

Cholesterol and Coronary Heart Disease Mortality in Elderly Patients-Reply

Author Affiliations

Senior Editor, JAMA Chicago, Ill
University of Texas Southwestern Medical Center Dallas

JAMA. 1996;275(2):110-111. doi:10.1001/jama.1996.03530260024019

In Reply.  —We appreciate the comments of Dr Krumholz and colleagues and agree that the methods used at each independent site of EPESE were not identical. We also appreciate that the measures used in the study were relatively standard: measurements of lipid levels presumably were comparable across sites, and the measurements of outcomes, while not standardized for secondary analyses, were consistent in terms of mortality, the primary end point of the combined site analysis.1 The verification of myocardial infarction and unstable angina with chart review at the New Haven site2 would not explain the differences in mortality rates between New Haven and the other sites.We also appreciate that the New Haven cohort had "unique sample characteristics and health status characteristics,"3 with the "lowest CHD mortality... but the highest death rate from non-CHD cardiovascular disease."1 While this may have been a reason to publish the results