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In Reply: In response to Drs Rashid and Khandaker, our study was conducted in urban centers in several locations in 5 South Asian countries. Other studies that we are currently conducting will compare cardiovascular risk factors and heart disease in rural vs urban populations in India. They will include evaluation of the dietary components in each of these populations.

At the time of our study, we were not aware of any adequate studies that have addressed whether arsenic-contaminated groundwater is an important cause of cardiovascular disease. We did not collect relevant information in this study and so are unable to shed light on this issue.

Financial Disclosures: None reported.

Salim Yusuf, MD, DPhil
yusuf@ccc.mcmaster.ca
Population Health Research Institute
McMaster University
Hamilton, Ontario

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;297:1881.