Cardiovascular Disease in the Elderly: ed 3, Revised and Expanded.

Cardiovascular Disease in the Elderly: ed 3, Revised and Expanded

Aronow WS, Fleg JL, eds. New York, NY 10016, Marcel Dekker Inc, 2004, hardcover, 869 pp, illus, ISBN: 0-8247-4769-0, $235.

This book is a timely and comprehensive update on the epidemiology, pathophysiology, and management of cardiovascular disease (CVD) in older people. The principal goal of this book is to prepare all physicians to better prevent, diagnose, and treat CVD in their elderly patients. This new edition has been well organized into 8 parts: "Aging Changes in the Cardiovascular System," "Coronary Artery Disease: Risk Factors and Epidemiology," "Coronary Artery Disease," "Valvular Heart Disease," "Cardiomyopathies and Heart Failure," "Arrhythmias and Conduction Disorders," "Cerebrovascular Disease," and "Miscellaneous Topics."

The first part is divided into 4 chapters on the topics of normal aging changes of the cardiovascular system, including noninvasive and necroscopic measurements of the cardiovascular decline in elderly people, and the complex pharmacological management of CVD in the presence of comorbidities. Part II is an extensive evidence-based approach on the risk factors and epidemiology of coronary artery disease (CAD), with particular emphasis on hypertension and hyperlipidemia. Part II also contains a new chapter on diabetes. The third part provides an update of the interventions that have been developed to treat CAD. The chapters in part III focus on angina and acute myocardial infarction and the treatment of CAD through medication, surgery, percutaneous coronary intervention, and exercise training. Parts IV through VI offer modern perspectives on valvular heart disease, cardiomyopathies and heart failure, arrhythmias and conduction disorders, and cerebrovascular disease, including the evaluation of syncope in the elderly patient. The concluding part documents the latest research on miscellaneous topics, including anticoagulation, pulmonary embolism, peripheral vascular disease, cardiovascular considerations of elderly patients who are undergoing noncardiac surgery, and ethical decisions with older patients with cardiovascular disease.

The book includes summary tables, illustrations, and recent references to clinical trials. Each chapter contains a critical analysis that is done in a consistent manner, along with summaries and conclusions that are based on evidence in the cardiovascular medicine literature.

Despite the lack of reference to physical therapy, the book warrants a look from instructors who would like to bring the most recent evidence on the medical and surgical management of elderly people with CVD to their students. Although the book is aimed at physicians, which limits its ability to serve as a textbook for physical therapist students, it may serve as an adjunct reference for clinicians in the field.

Janna Beling, PT, PhD

California State University, Northridge 

Northridge, Calif

Dr Beling is Associate Professor in the Department of Physical Therapy and teaches in the areas of cardiopulmonary physical therapy, geriatric rehabilitation, physiology, and pharmacology. She conducts research in clinical exercise science and practices in the area cardiovascular and pulmonary rehabilitation.