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- W4233433478 abstract "Anesthesia and Hypertensio, Vol. 17, No. 3 of Anesthesia Clinics of North America.Goldberg ME, Larijani GE, eds. Philadelphia: WB Saunders, 1999. ISSN: 0889-8537. 206 pages, $1200.00 for four issues. This issue contains several useful isolated facts about hypertension that make the volume worth reading. The issue falls far short of its potential, however. The article on pathophysiology and mechanisms of hypertension is poorly organized and written, ending abruptly without any summary. No clear picture of the pathophysiology of hypertension emerges. Rather, a jumbled array of possible mechanisms is mentioned. The article on preoperative evaluation of the hypertensive patient is redundant, presenting current dogma without much supporting evidence. The sections pertaining to coronary artery disease and hypertension are better. There are particularly interesting and useful discussions of the physiologic response to prolonged hypertension. What is not included in the issue? There should be a discussion of strategies for making a transition from IV, short-acting antihypertensive medications, such as sodium nitroprusside or fenoldopam, to longer-acting formulations that could be used to control the patient’s blood pressure outside of an acute-care area. A brief review of the most common therapeutic approaches taken by primary care physicians to manage hypertension would have been useful. A survey of therapeutic classes of antihypertensive medications with a few examples of each class most commonly used would have been helpful. The articles do not particularly reinforce each other. Each article should ideally present a single piece of a coherent, integrated picture that provides the practicing anesthesiologist with an understanding of hypertension and its relevance to anesthesiology and perioperative management. This issue fails to satisfy that ideal. However, there are several well written, informative chapters. The chapter, “Perioperative Hypertension and Outcome,” provides important, evidence based, discussions on the effect of management of hypertension and outcome. This section follows a logical progression to make important recommendations about the perioperative management of these patients. The section on perioperative treatment of hypertension offers important insights into new therapies for intraoperative management of hypertension, with clear mechanisms of action and pharmacology of all classes of antihypertensive agents important to the perioperative physician. Recommendations on the treatment of hypertensive emergencies would have been a useful addition to this excellent chapter. The specialty subsets, coronary artery bypass grafting and vascular surgery are concise, well written, and insightful. The only criticism is that many ideas are presented in these latter sections repeatedly. This volume contains some useful information relevant to the daily practice of anesthesiology and is worth reading despite several shortcomings mentioned above." @default.
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- W4233433478 date "2000-05-01" @default.
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- W4233433478 title "Anesthesia and Hypertensio, Vol. 17, No. 3 of Anesthesia Clinics of North America." @default.
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