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Edited by John C. LaRosa, an outstanding clinical investigator in his own right, the book deals with a full array of established risk factors. LaRosa's chapter summarizes basic lipid metabolism and then takes readers logically through the currently recommended approaches to controlling hyperlipidemia. Separate chapters address hypertension and smoking and other lifestyle risks. These chapters include brief but scholarly reviews of the evidence implicating these risk factors in atherosclerosis, possibly at the expense of more practical instruction for the clinician. Later chapters, on the other hand, are decidedly "how to" chapters. A detailed discussion of cost effectiveness is very pertinent, and I hope it will be read by those who manage health maintenance organizations as well as by front-line practitioners. Additional chapters cover topics that are under active investigation but do not yet qualify as "treatment" (such as antioxidants and gene therapy), but sophisticated clinicians will want to know what may be coming down the pike.
At 326 pages, this book on atherosclerosis will be read in its entirety only by very serious practitioners. On the other hand, in the chapters dealing with established risk factors, practitioners will find valuable suggestions on its management.
Reviewed by Daniel Steinberg, M.D., Ph.D.
Copyright © 1998 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
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