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In Reply: Dr Rockhill claims that the prevalence of conventional risk factors is similar between patients with and without CHD, as the number of individuals with at least 1 conventional risk factor did not differ dramatically between coronary heart disease and noncoronary heart disease cohorts in the study by Greenland et al.¹ However, this is not the same as showing that the prevalence of conventional risk factors are similar in the 2 groups. In fact, data from Table 4 of the article by Greenland et al clearly support our statement showing that the prevalence of cigarette smoking, diabetes, hyperlipidemia, and hypertension were significantly higher in individuals with CHD compared with individuals without CHD in nearly all subgroups. Thus, we believe that it remains accurate to state that the prevalence of conventional risk factors in patients with CHD is substantially greater than the prevalence in the general population.

We do agree . . . [Full Text of this Article]

Umesh N. Khot, MD; Monica B. Khot, MD; Eric J. Topol, MD
Department of Cardiovascular Medicine
The Cleveland Clinic Foundation
Cleveland, Ohio

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