Book Review

Calcium Antagonists in Clinical Medicine
3rd Edition.
MurrayEpstein 852 pages . Philadelphia, PA ; Hanley & Belfus, Inc. ; 2002 $78 . ISBN 1560534966

From the time calcium channel blockers were introduced to the medical community, the perception of their utility in the management of cardiovascular disease has seen great shifts. This book provides the reader great insight and understanding of the reasons why this class of agents was initially seen as an important tool in fighting cardiovascular disease, why it fell into disgrace in some groups of patients, and why the pendulum may have swung back, with the class again being universally accepted as valuable in the management of cardiovascular disease. This is facilitated by a better understanding of the differences between different agents and preparations, the introduction of newer dihydropyridines, and their use in combination with not just other antihypertensives but also lipid-lowering agents.

Starting with a discussion of physiologic bases of actions of these agents, the book concludes with emerging concepts regarding the utility of calcium channel blockers. Bridging the span between these two sections, Epstein walks the reader through basic concepts like the role of altered calcium metabolism in metabolic syndrome, endothelial dysfunction, atherosclerosis, and the use of calcium channel blockers in the treatment of cardiovascular disease to prevent complications from different organ systems. The section devoted to a discussion of the controversy surrounding these agents gives an explanation for the possible causes of the negative cardiovascular outcomes associated with their use.

This textbook provides a very comprehensive overview of calcium channel blockers. It is not just a source of education for someone researching or newly introduced to calcium channel blockers; it is also an excellent source of reference for the more experienced practitioner or clinical investigator.—Puneet Narayan, MD, Hypertension Research, Department of Veterans Affairs Medical Center, Washington, DC