Reviewed by: Barry J Goldlist, MD, FRCPC, FACP
CLINICAL CARDIOLOGY IN THE ELDERY
2nd EDITION
Chesler, Eliot M.D., Editor
Futura Publishing Company, Inc
Armonk, New York, 1999
ISBN #0-87993-421-2
Why produce a textbook on geriatric cardiology? The obvious answer is the incredible growth of the elderly population and the tremendous increase in the prevalence of cardiac disease (clearly and elegantly described in chapter one of this text by McLaughlin and Cassel). However, as a practising Geriatrician, I think there is another important reason to produce such a volume. There is ample evidence in the literature that effective treatments for cardiac disease (e.g. ASA, beta-blockers, and thrombolytic agents) are underused in the elderly. Any publication that might change this is indeed welcome.
Like any multi-authored text, there is some variability from chapter to chapter, and some authors do not use enough tables or charts, thus making their chapters intimidatingly dense. As well, the inevitable delay between writing a chapter and the publication date of the book means that few chapters have any references past 1997. Nevertheless this is an excellent text. It is not likely that any reader would read this text cover to cover. Rather the reader would use the book to review particular topics or answer specific clinical questions. The chapter on 'Physiology of the Aging Heart' is tremendously helpful to a practicing physician. The chapter on 'Management of Lipid Disorders' clearly summarizes the current literature and notes where data is insufficient for firm recommendations (primary prevention in the elderly), and gives practical management advice to the physician. The chapter on 'Congestive Heart Failure' unfortunately was written before the role of beta blockers and spironolactone were clearly established, but does review vasodilators, diuretics, and digoxin very clearly.
In summary, this is an ambitious, and for the most part, very successful textbook. It would be particularly useful for Geriatricians, Internists and Cardiologists. However, primary care providers with large numbers of elderly patients in their practice could also profit from purchasing this book.
