Routine Chest Roentgenograms and ECGs in Hypertension

To the Editor.—  The title of my editorial, "A Bit of Heresy?" (Archives 138:1207, 1978), indicated that I expected it to draw flak; I was not disappointed. In their editorial response, Frohlich and Dustan ("Routine Chest Roentgenograms and ECGs in Hypertension") emphasized that Bartha and Nugent (Archives 138:1211-1213, 1978) found abnormalities in 54 (actually it was 53) of 109 ECGs and in 24 of 102 roentgenograms of the chest made routinely in evaluating the conditions of 116 patients with hypertension.Frohlich and Dustan failed to point out, however, that all but seven of the abnormal chest x-ray films related to pulmonary pathology and included such trivial things as calcified granulomas, pulmonary fibrosis, and pleural thickening with calcification. Five patients had calcified or tortuous thoracic aortas, one had cardiomegaly, and one had possible ventricular aneurysm. None of these cardiovascular abnormalities would alter the therapeutic approach to hypertension for these patients.Frohlich