Abstract
This is an intriguing book. Is it really devoted entirely to the safety and efficacy of different combinations of lipid lowering therapies? In practice, the answer is no. The preface provides an explanation. It was born of frustration that recent guidelines are overwhelmingly based on evidence from randomised trials, which rarely test combination therapies. The authors feel that these treatment approaches have been overlooked as a result. They encourage the reader to consider primary sources of evidence that never found their way into guidelines. This may bring them into conflict with evidence-based purists, but there is value in considering much of the data they review.
Ten chapters individually cover the major classes of lipid lowering therapies, and discuss the role of each, on their own, and as adjuncts to statin therapy. There are then chapters on dietary supplements, apheresis and various formulations of the cardiovascular ‘Polypill’. Later chapters are incongruous. A chapter on ‘Fenofibrate & Simvastatin’ adds little to a generic chapter covering the same material earlier in the book. And although a chapter on ‘Olmesartan & Rosuvastatin’ discusses the benefits of combined preparations on compliance, this is not covered in any useful degree of detail, and the discussion of one particular antihypertensive is out of place.
So the real value of this book is its review of some of the primary evidence for the efficacy of lipid-lowering therapies. It is extensively referenced, and to produce the finished book with so many up to date references must have been a significant editorial challenge. There are niggles and weaknesses. There is inconsistency in style between the chapters. Some discuss basic science while others focus entirely on clinical data. There is also overlap, as some authors conclude there is little future for the drug that is the subject of their chapter, and cannot resist discussing a more promising alternative, which is covered elsewhere. English is not the first language of many of the authors, or the editor, so unusual grammar makes the text hard to follow in places. Overall though, it is succinct, and the whole book could easily be read in an afternoon. Does it merit space in the departmental reference library? No. But would any lipidologist benefit from reading it and then looking for themselves at a selection of the primary data referenced in it – yes, and that is arguably the whole point.