Hyperlipidaemia Diagnosis and Management PDF

Preface to third edition

I completed writing the second edition of this book in 1994 just on the eve of the announcement of the results of the first randomized clinical trial of a statin, the 4S. This and the subsequent statin trials have brought the management of lipid disorders into the mainstream of medical practice.Why then has there been such a long gap since the previous edition? Perhaps because, extraordinarily, it is now difficult for an academic in a scientific field in Britain to write a book. According to our national university ratings system, books are only an indication of scholarly endeavour in the arts! More accurately, the delay has probably been the result of the rapidly expanding evidence base both for the clinical management of common dyslipidaemias and in our understanding of the fundamental processes that link lipoproteins with cardiovascular disease and, with this growing knowledge, the redefinition of the areas about which we continue to be ignorant. A book of this type is like one of those old photographs of many hundreds of people gathered in a cathedral for a royal wedding at the beginning of the last century. Some of the congregation will have their faces turned towards the camera. Others will be less easy to recognize and some will be obscured. The Royal Family will be there and their traditional role will be clear, but others who are present, the politicians, the hangers-on, society's current darlings, would not have received their invitation had the occasion been a few months earlier. Others now fallen from grace would have taken their place. As L.P. Hartley has written, ‘the past is a foreign place'. The picture, like a book, is frozen in time, and how long either has any relevance depends on how active are the forces of change even now howling at the city gates.And in the field of hyperlipidaemia a major revolution has undoubtedly been in progress.Now there are signs of a period of relative stability in which even official recommendations for clinical practice are closely informed by the evidence and not some watered-down or misinterpreted version of it. So perhaps the moment is opportune.

Once again I am highly indebted to numerous colleagues for their advice and sharing of ideas with me, in particular Deepak Bhatnagar, Kennedy Cruickshank,Valentine Charlton-Menys,Mike Davies, Michael France, Anthony Heagerty, Ian Laing, Paul Miller, Peter Selby, Colin Short and my many colleagues at the Hyperlipidaemia Education and Research Trust (HEART UK).

Once again I owe a great debt of gratitude to Caroline Price for expert preparation of this manuscript. I also wish to thank the staff at Hodder who have shown great forbearance and provided every encouragement since they first asked me to produce another edition.My family has, as ever, provided the greatest support during this arduous task, something else to add to all their generosity towards me.