Norman M. Kaplan, MD. 7th Edition. 444 pp.
Baltimore, Md: Williams & Wilkins; 1998. $79.00.
Clinical Hypertension, 7th edition, by Norman M. Kaplan with a chapter by Ellin Lieberman, is the latest version of a book that first appeared in 1973 with the aim of providing a practical guide to the diagnosis and treatment of hypertension. The book is essentially a single-authored text but is balanced and comprehensive. It provides the reader with sufficient pathophysiological detail to permit reasoned decisions regarding diagnosis and treatment for specific patients. This text is not a compendium of knowledge on the subject of hypertension and the mechanisms that underlie it. It is not aimed at research questions in hypertension but rather seeks to provide a practical overview of the subject for the clinician. Controversies are filtered through the eyes of the author but are presented in a generally balanced fashion. At times, two conflicting representative references are simply cited in association with the author’s opinion. Although this approach is not comprehensive, it is practical. The book succeeds, as did previous editions, in providing the clinician with practical, in-depth knowledge useful in the treatment of the patient.
This latest edition contains updated chapters on the pathogenesis of primary hypertension, and while some readers may quest for more detailed information on the newly emerging field of genetics in hypertension, the chapter is, in fact, reasonably comprehensive. Treatment guidelines and options, as well as nondrug treatments, are discussed fully, as are the various forms of secondary hypertension and hypertension in specific populations, including pregnant women and patients with renal disease, pheochromocytoma, Cushing’s syndrome, renal artery stenosis, and other disorders. The comprehensive nature of these discussions is perhaps best illustrated by noting that the chapter on pheochromocytoma contains a preamble regarding the appropriate workup of incidentally discovered adrenal masses, and the chapters on therapy include discussions of such topics as stepping down pharmacological therapy in patients whose disease is well controlled. These and similar discussions are undoubtedly of value to most clinicians.
The chapter by Dr Lieberman deals with hypertension in childhood and adolescence. It also is comprehensive, well written, and practically directed. It includes such interesting topics as recommendations for athletic participation in children with mild hypertension, as well as the management of sustained hypertension. It builds on earlier discussions by Dr Kaplan of epidemiological studies dealing with hypertension and its prevention.
In sum, this is an extremely valuable book. It will likely be of considerable interest and value to all those interested in hypertension, its treatment, and its prevention, including research scientists. For clinicians, however, it is an all but indispensable guide because it is both clinically comprehensive and easy to use. Although in the past this reader has questioned the style and quality of the diagrams and charts, I must admit that some of them, after 20-odd years, are becoming old friends, and all of them certainly convey the information they are intended to in a straightforward fashion. Also, although the recommendations of the Sixth Report of the Joint National Committee are fully discussed, the book came out before the report was published, leading to an “in press” citation; this should be updated in subsequent printings. These are minor issues. Clinical Hypertension, 7th edition, should be on the bookshelf of every physician caring for hypertensive patients.
Richard N. Re, MD
Division of Research
Alton Ochsner Medical Foundation
New Orleans, La