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Therapeutic Strategies in Cardiovascular Risk

Price: £49.99

Source: Cardiology News

Date received: 01/09/2010

The editors of this book have brought together an international authorship to concisely and comprehensively review all that any cardiologist would want to know regarding cardiovascular risk prediction, or as one author more correctly terms it, risk estimation. The chapter authors largely hail from groups that have worked in this field either side of the Atlantic, respectively on the well-established Framingham epidemiological study and on the European Society of Cardiology-endorsed SCORE project and are thus well-placed to comment authoritatively on this subject. Although the editors have targeted this book at ‘hard-pressed health professionals’, the detail of some of the chapters perhaps goes a little further than most clinicians and allied professionals with anything less than a major focus in this field would require, and certainly more than a casual reader would find necessary. Most clinicians will no doubt find areas of interest within the text, but in practical terms, the title is somewhat misleading, as there is relatively little on therapeutic strategies per se, and much more on cardiovascular risk and risk factors. Such reservations aside, there are excellent sections that inform and often surprise, particularly the emphasis on how advances in computing speed and statistical methodology have been principal drivers in this field, and the discussions surrounding appropriate utilisation of study endpoints and novel surrogates for such endpoints that might be used as future risk markers for subclinical disease. The fact that there appear to be disagreements between chapter authors in some of these regards (eg. the utility of apolipoprotein B [apoB] as a more appropriate risk marker than low-density lipoprotein [LDL] cholesterol) serves to illustrate the evolving nature of the front-line of this field. Promising as they are, these novel additional markers have not yet been demonstrated to significantly improve risk estimation over the conventionally-recognised risk factors of blood pressure, cholesterol, smoking and diabetes mellitus and hence the reliance of most currently-used scoring systems on these parameters. The book is clearly written, often exhaustively referenced and well-illustrated with graphs and tables that enhance the text’s message. However, whether the ‘hard-pressed’ readers that the book is aimed at will take away anything more than a better understanding of the concepts of cardiovascular risk and a copy of the SCORE risk charts is a matter of debate.

Nick West, Consultant Cardiologist, Papworth Hospital, Cambridge, UK.

Source: Doody’s Book Reviews™ Doody Enterprises, Inc.

Date received: 08/09/2008

"This a comprehensive review of the history of cardiovascular risk estimation from a European perspective. Brief overviews of lifestyle and drug treatment of dyslipidemia and hypertension are provided. The authors are international experts in the field of cardiovascular epidemiology and have played critical roles in the development of existing risk stratification algorithms.

"...The editors state that the purpose is to outline the concepts of risk estimation and lessons from major epidemiologic studies, which they do admirably. Another stated purpose is to find common ground between the various risk estimation schemes and guidelines...

"The editors also state that the audience for this book is hard-pressed health professionals. If the health professional is a policy maker or an epidemiologist, this book would be of considerable interest...

"As a cardiovascular epidemiologist and a preventive cardiologist, I found the historic aspect of cardiovascular risk estimation quite interesting. Most books in this field focus on management of the patient at risk for cardiovascular disease."


Weighted Numerical Score: 75 - 3 Stars (Very good)

Jennifer G Robinson, MD, MPH University of Iowa College of Public Health

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