Product Description

A strong international team of contributors presents a detailed discussion of all aspects of the disease, including chapters on genetics, molecular pathology and a comprehensive overview of current and developing treatment strategies.

Product Details

• Amazon Sales Rank: #732967 in Books
• Published on: 2001-01-24
• Original language: English
• Number of items: 1
• Binding: Paperback
• 108 pages

South African Medical Journal
An excellent book...completely up to date. I unreservedly recommend it to you.

Customer Reviews

Everything you need to know about hypertension and bit more
Up-to-date version of this BMJ classic first published in 1981. Invaluable in general practice

Hypertension and medicalization
Another edition of the secondary sourcebook that informs of one aspect of a characteristic of our age: the medicalization of large sections of the population.

The book summarises an enormous medical literature. The new edition has been extensively re-written by the industrious authors. Probably in order to include the most recent opinion, the authors have removed some material. For the non-expert, the 4th edition may be of more value. Certainly I preferred the older, less fussy diagrams with references included. As before, results are often wrapped into example-situations for didactic purposes. But the statistics-based message from the medico-industrial complex remains the same as it has done for the past decade (or more?); the need to reduce population blood pressure (BP) mostly by requiring the incessant ingestion of drugs.

Newcomers should be aware that a majority of the over-60 years population has BP of >140/OR>90 mm Hg. when not treated with BP-lowering drugs. All above these limits are declared hypertensive. Opti-tensive levels are less certain but <130/AND<80 are quoted with approval. Given such small differences between approved and unapproved BPs, it seems important to obtain reliable measurements.

The era of disputes between measurements from the original equipment of mercury manometers with listening devices, and automated oscillometric instruments, appears to be drawing to a close; hence some changes between 4th and 5th editions. It might be expected that sound engineering practice should have helped to standardise measurements and reports. However "accuracy" is continually used to refer to three items: the exactitude of a BP measurement, BP monitor accuracy and (implicitly) BP measurement precision. Until instrumental and subjective variability (eg posture) are resolved, we will probably have to be satisfied with results quoted as a singular mean (eg "Senator J. McCain has a systolic BP of 134 mm Hg" (what, always?)) rather than a more usual scientific measurement within a range. This leads to the running-sore difficulty that no confidence interval can be ascribed to a difference between two singular values.

Throughout the text, the impressive risk reductions claimed (often as high as 30%), contrast surprisingly with the difficulties of demonstrating that treatment is better. Frequently pooled data from numerous trials, each containing many thousands of subjects, is required to generate statistical significance. It seems likely that professional preference for stating relative risks, and not absolute risks and NTTs, accounts for this perception: much more could be written on this topic.

After 26 diligent years of revision to the 5th edition, two of the authors are old enough to be expected to fall into the hypertensive category. We may be taking advice from patients!