Source: Hospital Medicine vol 64, no 8, page 498, August 2003
Date received: 01/09/2003
This text is a comprehensive summary of the latest important publications in hypertension. Professor Lip and Dr Lee, both from the City Hospital in Birmingham, have produced a useful book for the specialist in hypertension.
The ‘Year in…’ series are all designed in a similar format. Their objective is to summarize all the important recent publications. In this case the papers that are discussed were published predominantly in 2001 but also in 2000. The data that are discussed are therefore very recent and the text more contemporary than competing books on the subject.
The book is split into four main sections: basic science, co-existing conditions, therapy and current practical issues. The main publications in each section are then presented. The authors present a significant volume of data in a thoroughly digestible and helpful format. For each paper there is a summary of the background, the authors’ interpretation of the trial and then the authors’ commentary, which allows the reader to place each paper in the context of current best evidence. The authors manage to help the reader develop a significant depth of knowledge in an efficient manner. The authors have also included tables and charts summarizing the main trial end-points. These figures greatly help the reader in data interpretation.
This book is an extremely thorough summary of the best evidence available in hypertension. As such it is an important addition for all hypertension specialists and should be available as a reference text for all medical and cardiology departments.
Nick Robinson, St Bartholomew’s Hospital, London
Source: British Journal of Anaesthesia 90 (4): 529-532 (2003)
Date received: 09/04/2003
In this book, the authors comment on over 240 articles published mostly in 2001 and 2002. Articles are grouped under four main headings: basic science, hypertension and co-existing conditions, therapy, and current practical issues. In each part of the book, the chapters make it easy to find up-to-date information on epidemiology, risk factors, stroke, pregnancy and hypertension, current drugs, new developments in pharmacological therapy, clinical features, and finally, clinical evaluation. There is also a list of further readings for each major section. Within each chapter, a number of articles based on meta-analyses are cited and discussed. General comments are also included to place articles in a more general context. This is very informative.
Over one-third of the adult UK population suffers from hypertension. The benefits of treatment of hypertension are undisputed; there are well-publicized guidelines, yet only a third of hypertensive patients are adequately treated. The need to treat isolated systolic hypertension is emphasized as wide pulse pressure is a major determinant of adverse cardiovascular outcome. The risk of adverse events increases with age, smoking, obesity, diabetes, and with the presence of left ventricular hypertrophy. In the long-term, white coat hypertension is again identified as increasing the risk of adverse outcome. Newer antihypertensive agents are effective, but, in the long term, may not offer greater protection then diuretics and beta-blockers. Recently, a neuropeptidase inhibitor (omapatrilat) and a rennin inhibitor (aliskiren) have been shown to be effective in lowering blood pressure. Of the ACE inhibitors, ramipril protects hypertensive and normotensive patients against cardiovascular events suggesting that it has vasoprotective properties.
Unfortunately, the authors do not address the issue of hypertension in surgical patients. However, for those interested in hypertension, this book provides a unique resource.
P Foex, Oxford, UK