Doody's Review ServiceReviewer: Joseph R. Hartmann, MD (Good Samaritan Hospital)
Description: This book attempts to elucidate important issues in the evaluation and treatment of the elderly. The editors endeavor to cover the most frequently encountered problems of CHF, AMI, hypertension, and stroke.
Purpose: This book is intended as a summary and the chapters are short and easily readable. There is not a lot of new material here, but some very important questions are addressed, such as cost effectiveness in the treatment of myocardial infarction, a rational assessment of CPR outcomes, and recommended goals for hypertension therapy. Each chapter reviews the most recent information and makes reasonable suggestions for treatment in the elderly.
Audience: It is aimed at the busy practitioner.
Features: The chapter on CHF gives an excellent review of systolic and diastolic dysfunction and gives a reasoned approach to work-up and treatment. Systolic and diastolic hypertension is reviewed with very practical guidelines as to which drugs to use and why. Perhaps the most valuable information is contained in pharmacologic management. This is an excellent review of why drugs work differently in the elderly and what we need to know to not only make intelligent decisions but how to get our patients to take the drugs. The chapter on stroke is not optimal as it deals with post stroke treatment rather than prevention and newer forms of aggressive treatment. There is no information on the treatment of hypercholesterolemia other than with Vitamin E. Although the chapter on abdominal aortic aneurysms gives strong recommendations about how and when to intervene, there is not enough emphasis on the necessity for preoperative coronary angiography to evaluate cardiac risk.
Assessment: This is an accurate, short review of the current information on the topics covered. The editors and contributors are advocates for thoughtful, rational, and caring treatment of the elderly.