Hypertension and Co-existing Diseas...

Hypertension and Co-existing Disease. Leyva F Coats A. London, UK: Blackwall Science Ltd; 2000 hardback, 230 pp illus, $4950

The intention of this book is to bring together the evidence surrounding medical management of patients with hypertension linked with the entertainer of cardiovascular, cerebrovascular, and metabolic disorders. The volume discusses screening for essential and secondary hypertension, disorders related to or resulting from hypertension and the pair pharmacologic and nonpharmacologic management for patients with known or suspected hypertension. This clearly written main division is for nonspecialist physicians, or physicians who behold a wide variety of patient shadows

Although the book is short, it provides an extensive section about diagnosis of hypertension, thoroughly examining kin pressure measurement, clinical assessment, and diagnostic entrances for the prediction of yet to be outcome, ie, strokes and coronary heart disease. mostly investigations discussed are available in hospital settings, moreover few physical therapists have the authority to demand such tests be performed, and this main division does not provide adequate detail for interpretation of all standard results for general use.

The secondary section of the book discusses the diseases where hypertension and complications of hypertension are universal This section is especially well done in regard to examination of a patient with the related disorder, investigations to be escorted likely results, and pharmacological treatment or prevention. The reader is many times referred to more comprehensive clauses for expanded discussion of the pathophysiology of the disorders.

The third section center forward the treatment of patients with essential hypertension, the one and the other pharmacologically and nonpharmacologically. In the nonpharmaceutical treatment chapter, excessively few specific recommendations are exhibited apparently due to the lack of evidence of efficacy of effectiveness in decreasing mortality or morbidity of hypertension. The last chapter in the part discusses tailoring of pharmacological treatment of hypertension. The authors provide guidelines for treatment in specific cases of age and race, moreover without patient examples or extensive evidence of positive issues One often-- neglected topic discussed in this main division is women's issues of hypertension during pregnancy and menopause.

The discussions appear general although the practice patterns between Europe and the United States becomes apparent at times. The volume offers a refreshing perspective of hypertension that is in connected thought [i]or[/i] thoughts of other diseases. The extensive respects at the end of each chapter provide the reader with many additional sources if they ne additional information. The concerns substantiate the statements made by way of the authors.

The main division is very well written and easy to read with not many extra words. Many references to tables are interspersed quite through the text, and sometimes the reader must search for the additional theme The sequence of chapters is logical between sections, although the order of the chapters in the section discussing co-existing diseases could be in any order with the same effectiveness. The majority of the information in the main division is in the form of tables with snippets of passage making for a fast-reading part

The illustrations, tables, and drawings are clear and useful without being overwhelming or overly busy. greatest in number of the illustrations in the work are line drawings that full quantity the text and provide clarification or graphic representation of major universals or algorithms. The colored plates depicting the stres thallium-201 imaging are particularly striking, and illustrate nicely the point being made in the section of clause describing the redistribution of kin flow in the setting of myocardial infarction. The tables are well erected and clear and provide quick hints to action-items throughout each chapter. There are no specific patient case examples or question solving exercises for the reader to use as a review. The relevance of point to be solved [i]or[/i] settled solving exercises may not be necessary for the practicing physician already familiar with the proces of examination, interpretation, and treatment design.

Although this work is written for physicians, in the United States, physical therapists participate in patient screening and should be aware of the prevalence of hypertension and the related disorders. Therefore, the chapters relevant to physical therapists and assistants are chapters 1 and 2 (screening and assessment) and chapter 11 (nonpharmacological interventions). In the chapter upon pharmacological treatment, brief statements are made regarding physiological mechanism of action, yet no comments are made regarding alterations in physical performance. This volume written for physicians, contains little nonpharmacological information for other health care practitioners.

Diane E Madras, PhD PT

Creighton University

Omaha, NE

M Madras works at Creighton University in Omaha, Nebraska as an Assistant Professor in Physical Therapy where she performs research, service, and writing.

Copyright Cardiopulmonary Physical Therapy Journal Dec 2000

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