Pewsner et al take no account of age or race when assessing accuracy of electrocardiography (ECG) for diagnosing left ventricular hypertrophy (LVH).1 Ignoring them reduces specificity,2 and results in ?disease of electrocardiographic origin? in screening programmes. In particular, the upper normal limits of QRS voltages in black men are greater than in white men, while the difference between black and white women increases with age.3

We routinely report upper limits of …