American Journal of Epidemiology Vol. 153, No. 7 : 715-716
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
BOOK REVIEW |
Handbook of Hypertension. Volume 20. Epidemiology of Hypertension. Edited by C. J. Bulpitt.
Division of General Medicine Columbia University College of Physicians and Surgeons New York, NY
The epidemiology of hypertension, in terms both of its importance as a risk factor for cardiovascular and other diseases and of its own etiology, continues to be a major field of investigation with an enormous peer-reviewed literature each year. As stated by Paul Elliot in the opening sentence of this book, "Raised blood pressure is one of the most important underlying risk factors for morbidity and mortality in the world today, ranking alongside tobacco in estimates of the worldwide attributable burden of mortality" (1, p. 1).
Interest in the pressure level in the circulation dates from 1733, when Hales placed a glass tube in a horse's artery, about 100 years after Harvey demonstrated the circulation of blood (2
). Such direct measurements of arterial pressure were clearly impractical in clinical practice, and efforts to develop devices for indirect measurement persisted throughout the 19th century, culminating in Riva-Rocci's description in 1896 of a cuff inflated by a pump to occlude the palpated pulse. The occlusion pressure was recorded by a mercury manometer. By 1901, it was appreciated that Riva-Rocci's cuff, which was 5 cm wide, gave erroneously high occlusion pressures, and larger cuffs were introduced. In 1905, Korotkoff published his paper reporting the use of a stethoscope to auscultate the diastolic and systolic blood pressures. This technique became widely accepted within a few years and, along with relatively inexpensive sphygmomanometers, opened the way for routine collection of blood pressure data in large numbers of people. Sources of measurement artifact other than cuff size and the need to standardize measurement methods to reduce these artifacts were well appreciated prior to World War I (2). Actuarial studies soon showed increased risk of mortality among those at the higher end of the blood pressure distribution (3). The emergence after World War II of chronic disease epidemiology, and particularly of cardiovascular epidemiology, was followed by the development of effective pharmacologic treatments in the 1950s, and their testing in randomized trials starting in the 1960s. The fields of hypertension epidemiology, treatment, and control in populations began to take their modern forms.
The Handbook of Hypertension is a multivolume series that encompasses these fields as well as experimental, pathophysiologic, and genetic aspects. The present volume is an updated version of the 1985 edition of the Epidemiology of Hypertension (4) and includes 41 chapters by different authors on various aspects of the epidemiology of hypertension. The uniformly very high quality of these chapters is evidence of a strong editorial hand, both in the selection of authors and oversight of the work. There are sections on hypertension in populations; blood pressure measurement; blood pressure and the environment; blood pressure and nutrition; secondary forms of hypertension; genetics and clustering of risk factors; blood pressure, hormone replacement, and oral contraceptives; community control of hypertension; community control of hypertension in different countries; and problems in community control. This last section has two chapters, both exemplary, the first on issues of clinical labeling (effects of telling people they are hypertensive), and the second on the pervasive role of the pharmaceutical industry in influencing prescribing decisions.
A strength throughout this book is the directness of the authors in articulating the limitations of data, the controversies that remain unresolved, and the conflicting views of experts in the field. Another strength, for a US reader, is the largely European author list and the consistent citation of European publications. The literature cited is highly international and is generally very up to date through 1998. Some of the chapters that I thought were particularly excellent included Safar and Smulyan's chapter on systolic versus diastolic blood pressure, Prineas' chapter on blood pressure in children and adolescents, Sever and Poulter's chapter on blood pressure and migration, Simpson's chapter on sodium intake, Robertson's comprehensive review of the renin-angiotensin system, and Alderman's chapter on work site hypertension treatment programs. A number of others could be included in this list.
The main limitations of this book are its exorbitant cost and the fast decay of topical reviews. I can recommend the book highly based on its quality. It will be most useful now and in the near future, but less so as new data are published. However, even as new findings appear, many of these chapters will provide useful conceptual frameworks and will retain their utility in this regard. This is a highly useful book for people working the field of cardiovascular epidemiology and for those who want a comprehensive overview of the epidemiology of hypertension, and I would expect it to be a high priority for most medical and public health school libraries.
NOTES
ISBN 0-444-82779-X, Elsevier Scientific B.V., Amsterdam, the Netherlands, (Telephone: 1-888-437-4636 (toll-free), Fax: 212-633-3680), 2000, 706 pp., $275
REFERENCES
- Elliott P. High blood pressure in the community. In: Bulpitt CJ, ed. Handbook of hypertension. Vol. 20. Epidemiology of hypertension. Amsterdam, the Netherlands: Elsevier Scientific B.V., 2000:1–18.
- O'Brien E, Fitzgerald D. The history of indirect blood pressure measurement. In: O'Brien E, O'Malley K, eds. Handbook of hypertension. Vol. 14. Blood pressure measurement. Amsterdam, the Netherlands: Elsevier Science Publishers B.V., 1991:1–54.
- Society of Actuaries. Build and blood pressure study. Chicago, IL: Society of Actuaries, 1959–1960.
- Bielpitt CJ, ed. Handbook of hypertension. Vol. 6. Epidemiology of hypertension. New York, NY: Elsevier Science, 1985.
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