Abstract
By Nicholas Wald and David Misselbrook
London: RSM Press, 2011
Price: £20
ISBN: 978-185315-974-9
This book discusses a major current epidemic that presents a significant challenge to preventative medicine. It seeks to interest a wide range of readers involved in the prevention and treatment of cardiovascular disease (CVD). Individual chapters are based on presentations at a Royal Society of Medicine symposium including the 2011 ‘Jeffcott Lecture’. This is reflected in the range of different styles of presentation employed.
The book is divided into four sections. Chapters within the first two sections are centred on hot topics of debate in the management of CVD, such as use of the polypill in primary prevention, NHS health checks and the merits of the NHS Quality Outcomes Framework (i.e. QOF targets). These chapters provide a thorough background to these policies, a brief account of their implementation, an insight into the challenges that these programmes face and their impact on the dynamics of the doctor–patient relationship. In the subsequent section, the authors discuss the need for a tax on sugar, alcohol, saturated fat and salt (memorably abbreviated to SASS) illustrating its impact in preventing specific disorders. However, the bottom line is that a tax alone is not sufficient to steer individuals away from disease and that there has to be a more collective approach that includes the management of other risk factors. The final section weighs the pros and cons of medicalization and the role of the pharmacist in overseeing prevention in the community.
What I particularly liked about the book was its well-presented description of dialogues that took place after each presentation in the meeting. In particular, the opinions and concerns of many participants, and the presenters' responses to them provide added value as they introduce many issues that are not covered elsewhere in the text. The chapters also come with an up-to-date list of references and some useful website addresses. As a downside, it would have helped to have more figures and tables, and the figures that were included would be more engaging if they were coloured (as presumably they were at the original presentation).
Overall this book is a worthwhile read for those who did not attend the symposium and especially for students who will appreciate the assembly of a range of succinct information in a single source, removing the need to access multiple websites or policy documents. Some information in the book will however quite quickly become out of date with changes in health policy and the implementation of new guidelines.