(Circulation. 1998;98:1041.)
© 1998 American Heart Association, Inc.
Vascular Disease in the Elderly
W.S. Aronow, E.A. Stemmer, S.E. Wilson, eds. 574 pp. Armonk, NY: FuturaPublishing Co Inc; 1997. $120.00. ISBN 0-87993-646-0.
D. W. Kitzman, MD
Section of Cardiology,
Bowman Gray School of Medicine,
Wake Forest University,
Winston-Salem, NC
There are now many texts on heart disease in the elderly. To the
best of my knowledge, however, this is the first on vascular disease in
the elderly. Vascular disease is a major cause of morbidity and
mortality in older Americans and one that has been largely ignored or
treated as an orphan of mainstream cardiology. This
deficiency in the specialty of cardiovascular disease
is beginning to be addressed by medical specialty boards and training
programs. The National Institute on Aging has also recognized the
pivotal importance of vascular function and dysfunction in several
recent reports regarding recommended research
emphases.1
This multiauthored text is well done. Spanning 571 pages, it is
thorough but concise and focused. The editorsDrs Aronow, Stemmer, and
Wilsonset high authorship standards with their own invaluable chapter
contributions. The introduction by Dr Stemmer is a lucid, concise
overview of the fundamental principles of the impact of the aging of
our population on health care. It hits all the highlights and is
insightful and authoritative. This outstanding contribution by Dr
Stemmer, a professor of surgery, is an example of how improvements in
care of the elderly are often accomplished by persons of stature in
multiple subspecialty areas who develop an interest and passion for
aging and care of the elderly. This chapter sets the tone for the
entire book.
The chapters in the book are uniformly good with many outstanding
original treatments of the topics. For instance, chapter 4, "Vascular
Aging," by Dr John Walsh, is meaty and well referencednot simply a
regurgitation of others' reviews as one sometimes
finds in multiauthored texts. Chapter 21, "Infrainguinal
Arterial Occlusive Disease in the Elderly," thoroughly
covers a topic important to a significant percentage of
cardiology patients but one which many cardiologists
are only superficially aware of. Chapter 23, "Abdominal Aortic
Aneurysms in the Elderly: Special Considerations," like most
of the chapters, successfully maintains a focus on data and information
specific to the older population rather than giving a few parenthetic
comments about the elderly after a general review, a flaw often seen in
specialty texts of geriatrics.
This book offers an excellent remedy to a serious deficiency by
providing long-overdue substance for the "vascular" that has been
missing from the oft-used phrase "cardiovascular
disease in the elderly."
References
1.
Premen AJ, NIA Cardiovascular Aging
Advisory Panel. Research recommendations for
cardiovascular aging research. J Am Geriatr
Soc.. 1996;44:11141117.[Medline]
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