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The Atlas of Heart Disease and Stroke, 1st Edition by Judith Mackay and George A Mensah. Soft cover, 7" x 9.5".
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An increasing burden of cardiovascular diseases especially heart disease and stroke, both in the developed and developing countries, has generated a need for comprehensive information in the minds of both the scientific community and the general population for the same. While the former can satisfy their needs by accessing scientific literature published in journals and books, the same may not hold true for the general population. To satiate the needs of the general population, information needs to be presented in a simple and lucid manner without abstruse scientific jargon. The present publication by presenting scientific facts and data on various aspects of heart disease and stroke in the form of colorful pictures and graphs supported by write ups in a simple and easily understandable language is definitely an excellent attempt is meet this unmet information need.
The use of bright and colorful pictures, graphs, pictograms and maps in the atlas builds upon the adage viz. "A picture can speak a thousand words". The bright and vibrant pages of the atlas are a pleasant change from the usual WHO publications, which although contain useful information may get monotonous to read at times. The combination of colours used in various graphs and pictograms is soothing to look at and the colours come out well on the thick and glossy pages of the atlas. But, at the same time I feel that the size of the atlas should have been increased so as to improve its readability with a larger font size and bigger maps and make it less cluttered. The cover of the book could have been more symbolic of its contents as at first look, the atlas appears to be a book related to children or pediatrics given the photograph of a smiling child used on its front cover.
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The atlas has been divided into six parts containing 25 chapters and runs into 112 pages. Each part begins with a photograph spread over 2 pages along with an epigraph. While the proverbs and quotes quoted in the epigraphs are relevant to the contents of the part in all the parts, some of the photographs could have made more representative of the contents of the chapters in the part. Each chapter also begins with an epigraph and provides basic information about the aspect or disease being covered in form of a short text along with colorful graphs or pictograms or pictorial representations or world maps. Some in addition have inserts providing interesting trivia about the topic being covered. The graphs and pictograms get the message across although some statisticians may protest considering that the scales of the axis's and axis's of the graphs have generally not been given.
 ...The use of bright and colorful pictures, graphs, pictograms and maps in the atlas builds upon the adage viz. "A picture can speak a thousand words". The bright and vibrant pages of the atlas are a pleasant change from the usual WHO publications...
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The first part is titled "Cardiovascular Diseases" and contains 2 chapters. The first chapter gives important facts about the heart and cardiovascular system and graphical representation of the number of deaths attributable to Cardiovascular Diseases (CVD), overall and by age-wise stratification. It also has a pictorial representation of the human body depicting the sites of the common CVDs along with their brief description. The second chapter offers information related to Rheumatic Fever and Rheumatic Heart Disease (RHD). Along with basic information on the cause, epidemiology and treatment of RF/RHD, it contains a global map with countries stratified on basis of mortality attributable to RHD and a bar diagram of the prevalence of RHD among children in various parts of the world.
The second part titled "Risk Factors" has 10 chapters. The first chapter provides an overview of the leading risk factors for CVDs highlighting their importance in relation to other risk factors. The second chapter presents data to support the fact that the risk factors for CVDs have begin early during childhood and youth, thereby making a point for targeting these age groups for primordial and primary prevention of the risk factors. Over the next 8 chapters, individual risk factors including blood pressure, lipids, tobacco, physical inactivity, obesity, diabetes, socio-economic status and female gender are covered in detail.
The third part titled "The Burden" presents information over 5 chapters. The first four chapters give the global burden of coronary heart disease and stroke in terms of Disability Adjusted Life Years (DALYs) and the global figures for mortality attributable to these two diseases. In all the 4 chapters global maps stratifying countries on basis of their contribution to the global burden and mortality are provided. The 5th chapter presents information about the economic costs of the CVDs and their risk factors, cost of medication and lifetime costs of coronary heart disease. It helps one to realize the potential savings if the epidemic of CVDs is controlled.
...The first four chapters give the global burden of coronary heart disease and stroke in terms of Disability Adjusted Life Years (DALYs) and the global figures for mortality attributable to these two diseases. In all the 4 chapters global maps stratifying countries on basis of their contribution to the global burden and mortality are provided....
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The fourth part containing 7 chapters provides an overview of the "Action" that has been and is being taken at the global, regional and country level to counter the threat posed by CVDs and their lethal risk factors. The first chapter on 'Research' provides information about the contribution of various countries world over to the pool of CVD publications, contribution of clinical trails on coronary heart disease to the pool of clinical trials world over and a comparison of the research funding for CVDs and stroke with other diseases by the National Institute of Health, USA. It brings forwards the need for promotion of research on CVDs especially in the developing countries which have an abysmal contribution to research on CVDs. The next chapter contains a list of the major world conferences on CVDs that have been held till date and a map showing the major global, regional and country level organizations working in the field of CVD prevention and control. The third chapter in this part gives the reader a comprehensive list of actions to be taken and healthy choices to be adopted for preventing development of CVDs. The next chapter portrays the population and system level approaches that can be and have been undertaken for countering CVDs as well the shortfall of equipment and trained manpower required for the same. Health education activities and events that have targeted CVDs and their risk factors the world over are given in the next chapter. It also gives a list of the themes of the World Heart Day and lays emphasis on inclusion of schools as important partners in health education activities. The penultimate chapter of the part provides a look at the legislations, laws and treaties that have been enacted and enforced in various countries against risk factors such as tobacco and foodstuffs having high fat content. The final chapter of this part gives an overview of the various treatment options available for treatment of CVDs, their utility in reducing the risk of re-development of CVD and the fact that a large proportion of those being treated are in fact being under treated and need more stringent treatment to reduce their risk of developing CVDs.
...Overall, we feel that the atlas provides an excellent overview of the present status of CVDs along with the efforts being undertaken for their prevention and control and also offers a glimpse into the past and future of CVDs. It would be useful for both lay persons and medical professionals seeking information on various aspects of Cardiovascular Diseases....
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The fifth part covers the future and the past of CVDs. In the first chapter of this part, the projected DALYs attributable to CVDs and deaths attributable to CVDs as a whole, coronary heart disease, stroke are depicted. In addition, projections regarding prevalence of selected risk factors, economic costs and advances in research & development and treatment modalities are given. In the second chapter a chronological list of milestones in knowledge of heart and vascular diseases is provided, starting from BCE period till 2004.
The sixth and final part of the atlas viz. "World Data Tables" tabulates important information about various countries including their population, DALYs lost and deaths due to heart disease and stroke, deaths due to RHD, prevalence of smoking among adults segregated by gender, prevalence of diabetes, contribution to CVD research and polices and legislations in them. It is followed by a glossary of the technical terms used in the atlas which would help a casual reader to better understand the information given in the atlas and the sources used as reference in individual chapters. The atlas ends by providing a list websites that a reader may refer to for more detailed information on specific topics, followed by an index of the atlas.
Overall, we feel that the atlas provides an excellent overview of the present status of CVDs along with the efforts being undertaken for their prevention and control and also offers a glimpse into the past and future of CVDs. It would be useful for both lay persons and medical professionals seeking information on various aspects of Cardiovascular Diseases.
-Rahul Malhotra and Chetna Malhotra
Senior Residents,
Department of Community Medicine,
Maulana Azad Medical College,
New Delhi, India
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