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In Reply: In response to Dr Zhao and colleagues, the population of Olmsted County receives a substantial proportion of its care at Mayo Clinic and is mostly white. These points, acknowledged in our article, indicate that our study needs replication in groups not represented in the county; no regional population could be representative of a whole country, let alone the world. However, the medical records linkage system of the Rochester Epidemiology Project encompasses all local providers of medical care, and studies under the auspices of the Rochester Epidemiology Project have consistently demonstrated that trends observed in Olmsted County for chronic diseases in general and cardiovascular diseases in particular are similar to those observed in similar populations in the United States and the world.¹ Thus, Olmsted County data are of broad relevance.

The pool of diagnostic codes from which any given disease might be validated will vary depending on local coding . . . [Full Text of this Article]

Véronique L. Roger, MD, MPH
roger.veronique@mayo.edu
Division of Cardiovascular Diseases and Internal Medicine
Mayo Clinic
Rochester, Minnesota

A. Selcuk Adabag, MD, MS
Division of Cardiology
Veterans Affairs Medical Center
Minneapolis, Minnesota

Susan A. Weston, MS
Department of Health Sciences Research
Mayo Clinic
Rochester

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