JD Swales; ed. 1320 pages. Boston: Blackwell Scientific; 1994. $195.00. ISBN 0-632-03527-7. Order phone 617-876-7000.
Textbooks on hypertension are too numerous to count; thus, this review was approached with some trepidation and cynicism. The questions asked were these: Does this book offer anything new? Are the layout, the illustrations, the approach, the writing style, or the index different, new, or exciting? As the editor so convincingly points out in his lucid and well organized introduction (at times both entertaining and informative), the knowledge base in hypertension is exploding before our eyes, and no single textbook can hope to capture all that needs to be known in this rapidly evolving field.
This book contains a healthy helping of molecular biology to complement the physiology and biochemistry of hypertension. This is mixed, as always, with discussions of epidemiologic concerns, treatment methods, and long-term results. Refreshing aspects of this book were its easy readability, thoughtful layout, interpretable figures and tables, and common-sense approach to the index, which is organized by general topic headings.
Nonetheless, this reviewer must express some reservations. First, the writing style varies from author to author and from section to section. Some authors begin with an introduction and then launch immediately into discussions of pathophysiology; others start with epidemiology or etiopathogenesis. Part Two is about circulation but never makes clear whether circulatory changes represent cause or effect in hypertension. Part Five deals with special groups of patients in whom hypertension is a particular clinical problem, but fails to speak specifically about the problems of the elderly, in whom hypertension is a particular concern. This is covered in the section on treatment (Part Eight) but not in other areas of the book. Finally, as expected, much is written about renin and angiotensin from many different perspectives. This work admittedly parallels the advance of scientific inquiry into this field but provides far too much overlap. It would have been more effective if the contributing authors had made a greater effort to coordinate their respective approaches.
All in all, Textbook of Hypertension is comprehensive and readable and should serve as a respectable reference. It will be most useful for clinicians who treat primarily adults and who deal with problems of hypertension on an almost daily basis.