Terapéutica cardiovascular [Cardiovascular therapy] Volumes I and II
Edited by Andrés Iñíguez Romo. Medicina STM
Editores, S.L., Barcelona, Spain. 2004. 1137 pages, 247 figures, and 276 tables. ISBN: 84-95670-46-1.
When writing a scientific or, rather, medical text, especially when the work consists of 2 volumes, as it does in this case, the author must have an accurate idea of the goals to be achieved and, at the same time, have a clear perception that there a need for the work that justifies the undertaking. A scientific book is not, as a literary work can be, the result of inspiration. It is, instead, the transformation of a need to transmit information of potential use to society into a concrete form. On the other hand, within the last 2 decades information technology has progressed to the point where the publication of a classic text must be subjected to a rigorous process of selection and evaluation since it must compete, often at a great disadvantage, with numerous alternative ways of acquiring knowledge via the plethora of information channels that enable new knowledge to be readily accessible around the world within a short space of time and at a very low cost. Despite these considerations, Dr Iñíguez Romo thought it appropriate to compile a text, which is necessarily long and comprises 63 chapters, on current knowledge of cardiovascular therapy. I believe he had good reason to do so. Although cardiovascular disease is experiencing a boom in epidemiological terms, it is continuously becoming more susceptible to effective prevention and treatment, thereby bringing about a situation that was little more than a dream only a few decades ago and which was regarded as only being feasible in the very long term. On the other hand, the treatments at our disposal are subject to an accelerating process of change, almost on a day-to-day basis, as they are modified in response to reports of the latest clinical research. New therapeutic options, whether involving novel drugs or interventions, are constantly appearing and the indications for and recommended doses of current therapeutic agents are subject to continuous review. Therefore, from time to time and at an increasingly shorter interval, we have to set about bringing our libraries up to the minute with texts that, such as the one under discussion here, attempt to update and organize the almost unmanageable avalanche of new knowledge. Such an undertaking should be supplemented by a firm commitment to carry out regular updating, without which, especially in therapeutic topics, publications of this kind are condemned at birth to a premature old age.
I think that Dr Iñíguez Romo has managed to produce a complex and wide-ranging text with remarkable skill. It is possible to see his guiding hand in the work despite the large number of authors involved in its production, not only in devising new chapters, but also overall, in his function as an expert editor involved in specifying content and presentational level and in achieving an appropriate balance between the different chapters. Overall, the work is of a high standard. The authors have all provided workmanlike updates in the chapters with which they were entrusted and have, in many places, enriched the text with details of their own experience.
The first chapter, for which the late Dr Zarco Gutiérrez was responsible, I believe, encapsulates the wisdom and humanism for which he was renowned. As a whole, Terapéutica cardiovascular provides up-to- date moment information on the range of options available and the problems involved in applying therapeutic approaches in cardiology.
There are probably excesses and omissions, as must be expected in a work of such scope. The text lacks a chapter devoted to the influence of daily diet on the prevention and treatment of cardiovascular disease that could have summarized and expanded upon the information on diet contained in Chapter 2 and dispersed piecemeal throughout the other chapters. I believe that obesity is a public health problem whose consequences extend outside the bounds of cardiology, but which also leads, almost inexorably, to greater cardiovascular morbidity and mortality in our society. Therefore, its prevention and treatment are of great interest to cardiologists. Concern about diet is principally communicated to society through the mass media, but not always in an appropriate way. As cardiologists, we cannot avoid participating in discussions on this topic in the light of solid data that dietary modification can affect cardiovascular risk factors and help in the treatment of heart disease. Chapter 24, which was skillfully written by Dr Ribera Casado and whose central theme is cardiac therapy in the elderly, should have been followed by another chapter addressing pediatric cardiac therapy as a whole since chapters 35 and 36 both refer exclusively to interventional therapy in children. Moreover, chapters 30 and 31 could have been merged into a single chapter. On the other hand, I feel that Chapters 25, 56, 57, and 58 contain little to do with the general intention of the work. Nor do I think that it was appropriate to dilute the factual content of some chapters by dividing the authorship between so many individuals, whose actual contribution to the final text could be questioned. In addition, I tend to disagree with the authors of Chapter 63, which is nevertheless very stimulating and philosophical. I stand by the scientific nature of medical knowledge. The biological sciences, including medicine, are indeed sciences, although they may not be exact sciences.
I enjoyed reading the preface, for which Dr Castro Beiras was responsible. In general, the reference lists of the individual chapters are well selected, being broad but not overwhelming. The excellent presentational quality of the work and its careful editing are very satisfying.
In summary, I would like to emphasize that, in my judgmentjudgement, it is the many positive qualities of this important work that predominate, and congratulate Dr Iñíguez Romo and all the other authors on their achievement.
I can recommend this work to all cardiologists and cardiology residents. For internists and physicians working in primary care it is, without doubt, a good reference text to consult on the treatment and prevention of cardiovascular disease, which, incidentally, is taking up a growing proportion of their time and energy.