NEJM 23 Aug 2007 Vol 357

The world’s largest swede weighed in at 171.56kg, according to a highly entertaining website mocking the rutabaga (which is the American word for this estimable root vegetable); but it was held to be the product of genetic engineering, so the official Guinness record is still held by a swede of merely 34.43kg.
My vegetable love should grow
Vaster than empires, and more slow.
as Marvell observed to his coy mistress. However, slowly getting vaster is not good for human Swedes. This study collected those who weighed an average of 119kg (Swedish Obese Subjects, SOS) and from 1987 onwards they were randomised to bariatric surgery or conventional treatment. The surgical group lost weight dramatically and then regained some, whereas the others remained the same or got fatter. From about ten years on, the mortality of the two groups begins to diverge increasingly – in favour of the operated-on.

If you look retrospectively at outcomes of bariatric surgery in the USA, the message is the same.  Total mortality at a mean follow-up of 7 years was reduced, particularly deaths from diabetes, heart disease and cancer. However, accidents and suicide were higher in the surgical group.

You think it horrible that lust and rage
Should dance attention upon my old age;
They were not such a plague when I was young;
What else have I to spur me into song?
wrote Yeats when he was 71. Leaving aside the rage, this study sheds some light on how common lust is at Yeats’ age and indeed beyond. Not uncommon at all; if he were an modern American male in his early seventies, there would be about a one-third likelihood of him having sex at least once a month. Should you need more detail, horrible or otherwise, turn to the extensive tabulation of this masterly, or rather Mastersly-Johnsonian, study.

Isolated systolic hypertension is really just the main subset of a condition which could be called EPPA – elevated pulse pressure of age. I think I’ve coined that acronym myself, but somebody may have got there first, so save your rotten eggs for her/him, not me. Without some magic way of rejuvenating stiffened (sometimes calcified) main capacitance arteries, it is always going to be hard to treat. I can’t say I found this article much help.