Preventive Cardiology

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9780070718562: Preventive Cardiology

This book summarizes the extensive literature on heart disease risk factors and prevention and provides evidence-based protocols for reducing risks for heart disease and for secondary episodes, such as repeat heart attacks. It offers clear clinical strategies to successfully screen, identify, and control cardiovascular risk factors.

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From The New England Journal of Medicine:

Cardiovascular diseases, especially coronary heart disease and ischemic stroke, are the leading cause of morbidity and mortality in the Western world. Although the importance of primary and secondary prevention has been recognized, the decline in rates of mortality from coronary heart disease and stroke slowed or ceased in the past decade. Current practice in secondary prevention falls short of providing the best care to the patient. Guidelines from leading medical societies in the United States and in Europe strongly recommend clear strategies for secondary prevention, but the application of these recommendations in daily practice is at a far from acceptable level. For these reasons, a thorough survey of the prevention of cardiovascular diseases is timely.

Preventive Cardiology is a comprehensive overview of current knowledge of primary and secondary prevention in coronary heart disease as well as cerebrovascular and peripheral artery disease. The book has five parts, covering the epidemiologic background, screening for cardiovascular disease, assessment and management of risk factors, prevention in special populations, and the concepts of prevention. Each chapter summarizes the main facts and contains adequate tables and illustrations, with a comprehensive reference list that allows further reading. In some chapters, practical information in the form of questionnaires, therapeutic algorithms, and even cooking plans is included. These recommendations emphasize a patient-oriented approach to some of the key problems in preventive cardiology. The chapters on the evidence, assessment, and management of risk factors take up about half the book. Most of these chapters adequately illustrate the importance of risk factors, especially for readers who are not familiar with preventive cardiology. However, some of the chapters could have been shortened (e.g., the discussion of family history and genetic factors), or focus could have been shifted from negative experiences and failures (e.g., all the unsuccessful approaches to smoking cessation) to positive approaches.

A strength of the book is the combination of theory and guidelines with a practical approach to the patient at risk for cardiovascular disease. The two chapters on screening for cardiovascular risk factors critically discuss the role of established procedures (exercise testing or use of the brachial-ankle index for peripheral vascular disease) and newer procedures (calcium scoring by electron-beam computed tomography and magnetic resonance imaging of the coronary arteries) in assessing clinical and subclinical disease.

The chapter I liked best is the one on the epidemiologic background. It provides a wealth of information on practical risk assessment, especially the Framingham Heart Study's risk charts for coronary heart disease, stroke, and peripheral artery disease. Although this chapter is based almost exclusively on data from the Framingham Heart Study, it presents the basis and background of the global risk assessment recommended by leading cardiologic societies in the United States and in Europe.

Preventive cardiology is a fast-moving field, and this book does not include the latest findings, such as the negative results of trials of vitamin E supplementation for secondary prevention, the recommendation of the American Heart Association to increase the intake of n-3 fatty acids, or the benefit of angiotensin-converting-enzyme inhibition for secondary prevention. Nevertheless, Preventive Cardiology is an excellent book, which is structured in a way that invites the reader to use it as a comprehensive reference for a particular topic as well as a survey of current principles in cardiovascular prevention.

Alois Sellmeyer, M.D.
Copyright © 2001 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Review:

"Preventive Cardiology is a comprehensive overview of current knowledge or primary and secondary prevention in coronary heart disease as well as cerebrovascular and peripheral artery disease." "A strength of the book is the combination of theory and guidelines with a practical approach to the patient at risk for cardiovascular disease." "Preventive Cardiology is an excellent book, which is structured in a way that invites the reader to use it as a comprehensive reference for a particular topic as well as a survey of current principles in cardiovascular prevention." (New England Journal of Medicine 2001-09-20)

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