Lionel H. Opie, Bernard J. Gersh, eds.
426 pp. Philadelphia, Pa: Saunders; 2001. $39.95. ISBN 0-7216-8757-1
James K. Alexander, MD
Houston VA Medical Center
Although Professor Opie states in the preface that this book is not intended to be a textbook of cardiovascular pharmacology, it includes reference to virtually the entire spectrum of cardiovascular drugs in clinical use and is exceedingly well referenced. It does provide, as Professor Opie suggests, “crucial information in a readily accessible format.” This paperbound edition is only 426 pages. Professor Opie has assembled 8 distinguished contributors with specialized expertise in their respective areas of interest. The book includes 3 chapters on antianginal agents, 3 chapters on antifailure agents, 4 chapters on other cardiac drugs, and a final chapter on choice of drugs. Of particular note is the fact that Professor Opie is the lead author of 6 chapters and appears as a coauthor in all the rest. This must at least partially account for the uniform degree of continuity that characterizes the book.
Use of drugs in each class is considered in relation to various clinical settings, together with pertinent drug interactions and use of drug combinations. In the chapter on β-blocking agents, for example, there are separate presentations on unstable angina, Prinzmetal’s angina, cold intolerance angina, effort and rest angina, silent myocardial infarction, and myocardial infarction. Mechanisms of drug action are described at molecular levels in association with well-constructed illustrations and diagrams, which is a very special feature of the book. Pathophysiology of disease is consistently reviewed in relation to specific drug effects, with appropriate reference to mechanisms. Moreover, the book actually provides an accurate and lucid exhibition of many cardiac physiological and pathophysiological processes in health and disease that are concisely iterated, well illustrated, well referenced, and indexed.
Results of clinical trials are critically reviewed, with special attention to clinical implications of outcomes and cautions in this regard. Both generic and trade names are listed in tabular form, and dosages are spelled out with attention to various contingencies.
Thus, the book has a format structure that is not usually found in pharmacology texts and is designed to encompass, insofar as possible, all important aspects of drug use at the clinical level, with appropriate background information on physiological and pharmacological mechanisms. Especially noteworthy is this connection in the chapter by Professors Gersh and Opie on choice of drugs, with information on drug therapy in a variety of cardiovascular disease states, including a classification of evidence for recommendations and relative efficacy of different therapeutic regimens.
In my view, the book is a unique and outstanding contribution to the cardiovascular literature, updated to 2001, and an excellent resource for all those with an interest in cardiovascular pharmacology.