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The habitual use of the blood pressure instrument has brought me a number of surprises, none greater than the frequency with which hypertension occurs in women. The majority of the cases can be classified in a distinct and definite group having the following features in common: The patients are usually stout, overweight and undersize. They have borne many children. They have neither a history nor any stigmata of syphilis. They are over 45 years of age, the greater number falling between 50 and 60 years. They are practically all constipated and some of them suffer from intestinal indigestion. Up to a certain point they show an amazing tolerance to pressures of high degree. In most instances the heart is enlarged, chiefly to the left. The arteries are soft and even the retinal vessels rarely show any involvement. The kidneys, as far as it is possible to determine, are competent. The
David Riesman (1919) studied this question.