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To the Editor:
Bress et al. (Aug. 24 issue)
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report on the Systolic Blood Pressure Intervention Trial (SPRINT) cost-effectiveness analysis of intensive blood-pressure lowering. However, the generalizability of such simulations is dependent on the external validity of the risks of adverse events attributed to the intervention. In our community-based, prospective cohort study that was representative of the community-dwelling population of Ireland,
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among participants who were 75 years of age or older and who met the inclusion criteria for SPRINT, the rates of injurious falls and syncope were approximately five times the rates among participants who were 75 years of age . . .