After a certain age, one is elderly, aged, venerable, and patriarchal. Or just plain old. When I became old, I did not know it. I do know it now because of a syndrome of which I had previously been unaware. It is quite simple-when it hurts, it works; when it doesn't hurt, it doesn't work! Writing about the old is a preoccupation of the young, and that is as it should be because it is the young who must carry the burden of the old. I don't know the average age of the contributors to Franz Messerli's book, but I would guess it to be less than 50, which to me is positively pubescent! For many years I thought geriatric medicine was nonsense, and today I still think some of it is. What changes with age are principally the attitude and purposes of the individual and how much energy he or she has to carry out those purposes. It isn't so much that the goals, ambitions, and desire to alter or improve the world disappear; they just diminish along with what it takes to accomplish them. Which brings me to one particular aspect of aging, that is, the cardiovascular system. The first evidence of the cardiovascular system's aging is the failure of the heart to respond to the demands placed on it.

That geriatric cardiology has become a science and clinical discipline in its own rights is beyond dispute. Most cardiac disorders present with different symptoms and signs, require a different diagnostic and therapeutic approach, and also have a different prognosis in the elderly as compared to younger patients. Cardiovascular Disease in the Elderly provides a comprehensive, up-to-date guide to the physician, representing a pioneering work in this increasingly complex area. For this third edition most of the chapters have been completely rewritten, some by different authors. Four new chapters have been added, dealing with cardiac transplantation, invasive cardiovascular procedures, dietary considerations and ethical considerations. It cannot be denied that invasive procedures and transplantation are highly controversial in this area, and the ethical dilemmas involved are ably discussed by Dr Davis and associates. All chapters are supplied with a thorough list of references, making this third edition of Cardiovascular Disease in the Elderly the most thorough, concise guide for the practicing physician.

The kidney, similar to the heart, plays a three-fold role in essential hypertension. First, it participates in the patho genesis of arterial hypertension. Second, it suffers as a target organ of long-standing hypertension, and third, it experiences the effects of antihypertensive therapy. Perhaps most contested at the present time is the involvement of the kidney in the patho genesis of essential hypertension. More than a century ago, William Osler put forward three basic hypotheses about the "genuine contracted kidney. "l 1. "The hypertrophy can be regarded as an effect to overcome a sort of stop-cock action of the vessels when under the influence of an irritating ingredient in the blood greatly contracted and increased the peripheral resistance. " Clearly this hypothesis of an "irritating ingredient" is perhaps the most convincing nowadays, and numerous attempts have been made to identify a specific vasoconstrictive agent in the blood in essential hypertension. 2. "The obliteration of a large number of capillary territories in the kidney materially raised the arterial pressure. An additional factor of dimin ished excretion of water also heightened the pressure within the blood vessel. " Today we know that fluid volume overload in the presence of reduced renal mass seems to be the most likely mechanism accoun ting for renal parenchymal hypertension and, as shown by Guyton's group, for certain forms of experimental hypertension. 3."

That geriatric cardiology has become a science and clinical discipline in its own rights is beyond dispute. Most cardiac disorders present with different symptoms and signs, require a different diagnostic and therapeutic approach, and also have a different prognosis in the elderly as compared to younger patients. Cardiovascular Disease in the Elderly provides a comprehensive, up-to-date guide to the physician, representing a pioneering work in this increasingly complex area. For this third edition most of the chapters have been completely rewritten, some by different authors. Four new chapters have been added, dealing with cardiac transplantation, invasive cardiovascular procedures, dietary considerations and ethical considerations. It cannot be denied that invasive procedures and transplantation are highly controversial in this area, and the ethical dilemmas involved are ably discussed by Dr Davis and associates. All chapters are supplied with a thorough list of references, making this third edition of Cardiovascular Disease in the Elderly the most thorough, concise guide for the practicing physician.

The kidney, similar to the heart, plays a three-fold role in essential hypertension. First, it participates in the patho genesis of arterial hypertension. Second, it suffers as a target organ of long-standing hypertension, and third, it experiences the effects of antihypertensive therapy. Perhaps most contested at the present time is the involvement of the kidney in the patho genesis of essential hypertension. More than a century ago, William Osler put forward three basic hypotheses about the "genuine contracted kidney. "l 1. "The hypertrophy can be regarded as an effect to overcome a sort of stop-cock action of the vessels when under the influence of an irritating ingredient in the blood greatly contracted and increased the peripheral resistance. " Clearly this hypothesis of an "irritating ingredient" is perhaps the most convincing nowadays, and numerous attempts have been made to identify a specific vasoconstrictive agent in the blood in essential hypertension. 2. "The obliteration of a large number of capillary territories in the kidney materially raised the arterial pressure. An additional factor of dimin ished excretion of water also heightened the pressure within the blood vessel. " Today we know that fluid volume overload in the presence of reduced renal mass seems to be the most likely mechanism accoun ting for renal parenchymal hypertension and, as shown by Guyton's group, for certain forms of experimental hypertension. 3.

A clinical manual on hypertension for primary care physicians.

Serves as an up-to-date reference on hypertension for use in clinical practice.

Includes dozens of clear and informative tables and figures to maximize comprehension.

Addresses the most recentand crucial developments in a very common chronic condition.

Gives a comprehensive review of currently available medications and combination therapy.

Approximately one billion people worldwide are affected by hypertension. About 24% of the adult population in the US are hypertensive, and the number is expected to increase with the rising rates of obesity and diabetes. As hypertension affects so many and spans across varying ages, genders, ethnicities, and socioeconomic classes, all clinicians are likely to encounter patients with hypertension on regular basis. Hypertension is one of the major causes of cardiovascular diseases, and timely diagnosis and treatment are essential.

The manual will give the reader a thorough overview of antihypertensive lifestyle modifications, first-line therapy, combination therapies, comorbid conditions, therapeutic challenges, and the latest trends in antihypertensive therapy.

Pharmaceutical companies can use this clinician s manual as an excellent educational giveaway, as the booklet includes the latest clinical research results and treatment options for hypertension.

The manual will give the reader a thorough overview of antihypertensive lifestyle modifications, first-line therapy, combination therapies, comorbid conditions, therapeutic challenges, and the latest trends in antihypertensive therapy.

Pharmaceutical companies can use this clinician s manual as an excellent educational giveaway, as the booklet includes the latest clinical research results and treatment options for hypertension.

The manual will give the reader a thorough overview of antihypertensive lifestyle modifications, first-line therapy, combination therapies, comorbid conditions, therapeutic challenges, and the latest trends in antihypertensive therapy.

Pharmaceutical companies can use this clinician s manual as an excellent educational giveaway, as the booklet includes the latest clinical research results and treatment options for hypertension.

Approximately one billion people worldwide are affected by hypertension. About 24% of the adult population in the US are hypertensive, and the number is expected to increase with the rising rates of obesity and diabetes. As hypertension affects so many and spans across varying ages, genders, ethnicities, and socioeconomic classes, all clinicians are likely to encounter patients with hypertension on regular basis. Hypertension is one of the major causes of cardiovascular diseases, and timely diagnosis and treatment are essential.

The manual will give the reader a thorough overview of antihypertensive lifestyle modifications, first-line therapy, combination therapies, comorbid conditions, therapeutic challenges, and the latest trends in antihypertensive therapy.

Pharmaceutical companies can use this clinician s manual as an excellent educational giveaway, as the booklet includes the latest clinical research results and treatment options for hypertension.

The manual will give the reader a thorough overview of antihypertensive lifestyle modifications, first-line therapy, combination therapies, comorbid conditions, therapeutic challenges, and the latest trends in antihypertensive therapy.

Pharmaceutical companies can use this clinician s manual as an excellent educational giveaway, as the booklet includes the latest clinical research results and treatment options for hypertension.

The manual will give the reader a thorough overview of antihypertensive lifestyle modifications, first-line therapy, combination therapies, comorbid conditions, therapeutic challenges, and the latest trends in antihypertensive therapy.

Pharmaceutical companies can use this clinician s manual as an excellent educational giveaway, as the booklet includes the latest clinical research results and treatment options for hypertension.

Approximately one billion people worldwide are affected by hypertension. About 24% of the adult population in the US are hypertensive, and the number is expected to increase with the rising rates of obesity and diabetes. As hypertension affects so many and spans across varying ages, genders, ethnicities, and socioeconomic classes, all clinicians are likely to encounter patients with hypertension on regular basis. Hypertension is one of the major causes of cardiovascular diseases, and timely diagnosis and treatment are essential.

The manual will give the reader a thorough overview of antihypertensive lifestyle modifications, first-line therapy, combination therapies, comorbid conditions, therapeutic challenges, and the latest trends in antihypertensive therapy.

Pharmaceutical companies can use this clinician s manual as an excellent educational giveaway, as the booklet includes the latest clinical research results and treatment options for hypertension.

The manual will give the reader a thorough overview of antihypertensive lifestyle modifications, first-line therapy, combination therapies, comorbid conditions, therapeutic challenges, and the latest trends in antihypertensive therapy.

Pharmaceutical companies can use this clinician s manual as an excellent educational giveaway, as the booklet includes the latest clinical research results and treatment options for hypertension.

The manual will give the reader a thorough overview of antihypertensive lifestyle modifications, first-line therapy, combination therapies, comorbid conditions, therapeutic challenges, and the latest trends in antihypertensive therapy.

Pharmaceutical companies can use this clinician s manual as an excellent educational giveaway, as the booklet includes the latest clinical research results and treatment options for hypertension.

"

After a certain age, one is elderly, aged, venerable, and patriarchal. Or just plain old. When I became old, I did not know it. I do know it now because of a syndrome of which I had previously been unaware. It is quite simple-when it hurts, it works; when it doesn't hurt, it doesn't work! Writing about the old is a preoccupation of the young, and that is as it should be because it is the young who must carry the burden of the old. I don't know the average age of the contributors to Franz Messerli's book, but I would guess it to be less than 50, which to me is positively pubescent! For many years I thought geriatric medicine was nonsense, and today I still think some of it is. What changes with age are principally the attitude and purposes of the individual and how much energy he or she has to carry out those purposes. It isn't so much that the goals, ambitions, and desire to alter or improve the world disappear; they just diminish along with what it takes to accomplish them. Which brings me to one particular aspect of aging, that is, the cardiovascular system. The first evidence of the cardiovascular system's aging is the failure of the heart to respond to the demands placed on it.

Das Buch behandelt die strukturellen und funktionellen Schadigungen infolge arterieller Hypertonie (Endorganschadigungen) an Blutgefassen, Herz und Niere. Unter Einbeziehung neuester wissenschaftlicher Erkenntnisse werden praktische Hinweise fur die Fruhdiagnostik und Therapie der hypertensiven Herzkrankheit, der Nephropathie und Vaskulopathie gegeben. Die praktische Bedeutung liegt in der fruhzeitigen Erkennung und Behandlung ruckbildungsfahiger Veranderungen, um einen schleichenden Ubergang in irreversible Schadigungen zu vermeiden."