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An Elderly Physician's Plea

      To the Editor:
      I read with interest the article by Bavishi et al
      • Bavishi C.
      • Goel S.
      • Messerli F.
      Isolated systolic hypertension: an update after SPRINT.
      in the December 2106 issue of The American Journal of Medicine. As a review article, it was very interesting, but I'd like to comment on 2 points, one somewhat frivolous and the other more pointed.
      The abstract states “With a rapidly aging population, the prevalence of hypertension is expected to increase substantially.”
      • Bavishi C.
      • Goel S.
      • Messerli F.
      Isolated systolic hypertension: an update after SPRINT.
      The last time I reviewed the data, the current population is not aging any more rapidly than at any other time in history; the current rate of aging is still approximately 12 months every year; a 10-year-old is aging approximately 10% per year compared with a 50-year-old who is aging at approximately 2% per year. I have no idea what the authors' statement means, and they do not cite a source for this statement.
      On a more serious side, in discussing hypertension, Bavishi et al
      • Bavishi C.
      • Goel S.
      • Messerli F.
      Isolated systolic hypertension: an update after SPRINT.
      quote the 1999 to 2010 National Health and Nutrition Examination Survey.
      • Egan B.M.
      • Li J.
      • Hutchison F.N.
      • Ferdinand K.C.
      Hypertension in the United States, 1999 to 2012: progress toward Healthy People 2020 goals.
      In this study, adults with hypertension were then subdivided by age <45 years, 45 to 64 years, and ≥65 years; however, in the article by Bavishi et al,
      • Bavishi C.
      • Goel S.
      • Messerli F.
      Isolated systolic hypertension: an update after SPRINT.
      the age groupings of 18 to 39 years, 40 to 59 years, and 60 years and older are used, different groupings than in the article they quote. Equally important is Bavishi et al's
      • Bavishi C.
      • Goel S.
      • Messerli F.
      Isolated systolic hypertension: an update after SPRINT.
      use of the word “elderly,” which has no medically agreed upon definition at all. It tends to often connote infirmity, which may be offensive to those of us aged more than 60 years and are still practicing physicians. The authors state “In the elderly population, women, non-Hispanic blacks … were more likely to be affected.”
      • Bavishi C.
      • Goel S.
      • Messerli F.
      Isolated systolic hypertension: an update after SPRINT.
      They should use age parameters, rather than a poorly defined term such as “elderly.” In fact, Bavishi et al
      • Bavishi C.
      • Goel S.
      • Messerli F.
      Isolated systolic hypertension: an update after SPRINT.
      reference Lui et al,
      • Liu X.
      • Rodriguez C.J.
      • Wang K.
      Prevalence and trends of isolated systolic hypertension among untreated adults in the United States.
      in “Prevalence and Trends of Isolated Hypertension Among Untreated Adults in the United States,” in which the authors use the term “old” to describe those aged more than 60 years.
      I would like to make a plea to The American Journal of Medicine and all journals and authors to use cross-culturally understandable terms, such as age ranges in a group (ie, 40-65 years) rather than “young adult, middle age, and old,” as Liu et al
      • Liu X.
      • Rodriguez C.J.
      • Wang K.
      Prevalence and trends of isolated systolic hypertension among untreated adults in the United States.
      do, or “elderly,” as Bavishi et al
      • Bavishi C.
      • Goel S.
      • Messerli F.
      Isolated systolic hypertension: an update after SPRINT.
      do.
      It is a shame that an otherwise good article was flawed by the interchange of poorly defined terms rather than readily understandable age brackets.

      References

        • Bavishi C.
        • Goel S.
        • Messerli F.
        Isolated systolic hypertension: an update after SPRINT.
        Am J Med. 2016; 129: 1251-1258
        • Egan B.M.
        • Li J.
        • Hutchison F.N.
        • Ferdinand K.C.
        Hypertension in the United States, 1999 to 2012: progress toward Healthy People 2020 goals.
        Circulation. 2014; 130: 1692-1699
        • Liu X.
        • Rodriguez C.J.
        • Wang K.
        Prevalence and trends of isolated systolic hypertension among untreated adults in the United States.
        J Am Soc Hypertens. 2015; 9: 197-205

      Linked Article

      • The Reply
        The American Journal of MedicineVol. 131Issue 1
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          In the Letter to the Editor regarding our article,1 Dr Luger makes 2 comments—in his words “one somewhat frivolous, and the other more pointed.”
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