Book Review

Current Management of Hypertensive and Vascular Diseases

N Engl J Med 1993; 328:1206April 22, 1993

Article

Current Management of Hypertensive and Vascular Diseases
Edited by John P. Cooke and Edward D. Frohlich. 380 pp., illustrated. St. Louis, B.C. Decker/Mosby-Year Book, 1992. $79.50. ISBN: 1-55664-356-X

This book, one of a series on current therapy, can be read over a reasonable period of time. The chapters are brief (usually five or six pages), with succinct and valuable tables and suggested readings. The material is geared to the clinician, who will gain valuable information from the sections on hypertension, coronary artery disease, cerebral vascular disease, and peripheral arterial and venous diseases. The various approaches to the treatment of hypertension in selected populations (elderly, young, and racial groups) are well explained. A valuable section provides a coordinated nonpharmacologic program for the treatment of hypertension. There is an excellent chapter on the noninvasive assessment of arterial disease, which is one of the simplest yet best summarized presentations I have read.

There are a few disappointments, as well. Diabetes and smoking, both of which contribute to vascular disease, are not allotted separate chapters, although their importance in vascular medicine is clearly pointed out by the editors in the preface. Despite a very well edited text, there is a rare howler. For example, ISIS-1 does not stand for the International Study on Infant Survival but for the first International Study of Infarct Survival. In fact, this chapter on chronic ischemic heart disease and its medical management has an excellent review of some of the clinical trials of various groups of drugs that might affect post-infarct mortality. Unfortunately, there is no information on the role of angiotensin-converting-enzyme inhibitors in patients who have had infarctions. I would take exception to the naming of agents that lower blood pressure as “hypotensive agents,” since their purpose is to bring pressure down to normal, not to lower-than-normal levels. This terminology is used in the otherwise excellent chapter on hypertension in children.

My overall impression is that this book will make the clinician want to read further because each chapter provides just enough information to stimulate interest. In regard to suggested reading, the recommended references are for the most part current and widely available. This book is recommended for the general internist or family practitioner who wants a comprehensive evaluation of vascular medicine, including hypertension, has limited time, and yet wants to obtain an initial grasp of a field that flows through all aspects of clinical medicine.

Philip R. Liebson, M.D.
Rush Medical College, Chicago, IL 60612