Source: British Journal of Anaesthesia 86 (1) 157-158 (2001)

Date received: 28/02/2001

This book reviews in an elegant matter 150 articles published between 1997 and 1999. For each paper, the background, interpretation and relevant data are presented and commented on. Articles are grouped in sections and in each of these there is a clear introduction, a short conclusion and additional background references. This is extremely helpful. In turn, sections are grouped together in four parts, each with an overall heading. Part I entitled 'Clinical trials and guidelines' reviews recent trial results, and current guidelines, and describes ongoing trails. The current guidelines section makes it clear how difficult it is to issue guidelines with 'universal' applicability. Maybe the most important message is that, in the ling-term, the extent of control of blood pressure must take into consideration associated disorders (i.e. diabetes, coronary heart disease, cerebrovascular disease) and risk factors. This may have implications for surgical hypertensive patients, though this is not discussed in any way.

Part II deals with the interface of hypertension and other cardiovascular risk factors, especially diabetes, hypercholesterolaemia, and hormone replacement therapy. Part III deals with emerging concepts and reviews articles on specific gene markers, the role of nitric oxide and super oxides, the role of mineralocorticoids, insulin resistance, hypertension and endothelial function. Part IV addressed the current issues in practice. These include the place of angiotensin II receptor antagonists, 24-h blood pressure assessment, surrogate measures of cardiovascular disease (i.e. left ventricular dysfunction, atheromatous vascular disease, endothelial dysfunction, microalbuminuria) and finally, cost-effectiveness in cardiovascular therapeutics.

For those interested in hypertension, this book is an incredibly useful source of information based on original articles reviewed and commented on by experts. It is superb reference 'bank' to broaden our knowledge and understanding of arterial hypertension including the most recent concepts. However, it does not address our concerns about the surgical hypertensive patient and its management.

Pierre Foex