Editors: Nadar S, Lip GY
I have always been fascinated by how primary care and secondary care look at hypertension in different lights. This pocket reference, written by cardiologists, demonstrates those differences and will mainly be of interest to their specialist colleagues. Examples of this are the inclusion of echocardiograms as basic investigations, whilst home blood pressure monitoring is never mentioned.
Mostly written by Sunil Nadar, it is a collection of chapters that often repeat statements from previous chapters, particularly involving the epidemiological and pathophysiological aspects of the subject. Whilst this detracts from reading the book as a continuous text, it does facilitate its use as a handy reference. You can easily dip in and out.
Of particular note, specialists will find the summary of imaging studies for renal artery stenosis in chapter three very useful. Chapter eight gives a comprehensive account of target organ damage whilst chapter nine, on left ventricular hypertrophy, and chapter 10, on atrial fibrillation, are also excellent. As one would expect from our cardiology colleagues, beta blockers are extensively covered. Chapter 18 covers renal denervation, the very subject that reignited interest in hypertension among cardiologists, until Simplicity HTN-3 put this treatment concept on ‘hold’. The part that I most appreciated was in chapter 20, which covers risk assessment, where Sunil Nadar recommends that the decision to treat should be based on relative risk, not absolute risk alone.
All books are out of date as soon as they are published and the authors of this tome have been particularly unlucky because after several lean years in terms of new discovery in hypertension, we have just had a flurry of activity. PATHWAY 2 and 3 (featured in our BJC report from ESC 2015, available at http://bjcardio.co.uk/podcasts/) will change future guidelines and SPRINT will at the very least cause plenty of discussion. Sadly they all arrived long after this book was put to bed at the printers.
General Practitioner, and Honorary Reader at Hull York Medical School
Whitby Group Practice, Spring Vale Medical Centre, Whitby, North Yorkshire, YO21 1SD
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1. In the PATHWAY 2 study, what drug was compared against placebo?
2. What is the new suggested definition of resistant hypertension?
3. Which two diuretics were included in the PATHFINDER 3 study?
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