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November 24, 2004

Systolic Hypertension in Elderly Persons

Author Affiliations

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

JAMA. 2004;292(20):2465-2466. doi:10.1001/jama.292.20.2465-b

To the Editor: The prevalence of obesity is increasing in elderly persons as well as in the general population, and excess body weight adversely affects cardiovascular risk factors, including hypertension, in this population.1 Nevertheless, Dr Chaudhry and colleagues2 did not list obesity as an identifiable cause of hypertension in their treatment algorithm for systolic hypertension in older persons. This oversight is in line with the common failure by physicians to recognize obesity as an identifiable cause of hypertension as well as a condition requiring additional workup (such as assessment of medication use, endocrine function, nutritional deficiencies, and treatable causes of immobility).3 While the efficacy of pharmacological treatment for obesity in elderly persons has not been established,4 surgical treatment of obesity has been shown to significantly improve cardiovascular risk factors, including hypertension, even in elderly individuals.5 Obesity should be considered a medical condition requiring proper medical management in its own right.3

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