To the Editor We read with great interest the Research Letter by Mueller et al1 on the notion that blood pressure does not rise with age in a remote Venezuelan population. Already in 1985, epidemiologist Geoffrey Rose, MD, emphasized the importance of comparisons between populations when designing preventive strategies in addition to the identification of individuals at high risk within a single population.2 Comparisons between populations can reveal risk factors that would remain unnoticed or underestimated in populations where these risk factors are omnipresent. Rose illustrated this concept by stating that clinical studies could never identify smoking as a risk factor for lung cancer in a population where everyone smokes 20 cigarettes a day.
Schalkwijk FH, van Bodegom D. Absence of the Association of Blood Pressure With Age in a Remote Venezuelan Population Renews the Call for Population-Wide Interventions. JAMA Cardiol. 2019;4(5):496–497. doi:10.1001/jamacardio.2019.0658
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