Interview with George L. Bakris, MD

How has Hypertension, 4th Edition evolved since the previous edition? How has it evolved since the first edition?  

Since the previous edition, we have trimmed some chapters and deleted others that were not well accessed. This while expanding the database of the existing chapters and yet keeping it within acceptable limits for a quick read. 

What is the most exciting aspect of the new edition? What chapter or topic covered in the new edition are you most excited about?  

The chapters that are the most important and interesting from my standpoint are the Pathophysiology chapter, Immuno basis for hypertension, use of combinations therapies to reduce pill count and improve adherence, management of diabetic kidney disease and the review of all clinical trials including metanalyses which covers over 50 years of hypertension research. 

Who will find the greatest value from Hypertension, 4th Edition and why? Has the audience changed since the book was first published? 

The people who I feel should have this book as a MUST-read reference book are the following specialties: Internal Medicine, Cardiology, Nephrology, and Endocrinology. These are the fields that see more than 95% of patients with hypertension and yet it is not being taught well in most institutions without a focus on physiology and just getting the numbers down. This book will show the reader the way in terms of applying proper physiology and pharmacology to the treatment of a known Cardiorenal risk factor. 

What new ideas, practices, or procedures would you like to highlight for the new edition?  

Initial use of single-pill combination therapy and maintaining maximal dosing of blockers of the renin-angiotensin system. Also to assess spot urine albumin creatinine ratios in people with hypertension with or without diabetes as a marker of heart failure risk. Finally, understand that proper measurement of blood pressure is critical to diagnosis of white coat hypertension and treat properly. 

What problem do you hope the future generation of your specialty will be able to solve? 

Have a better understanding of identifying resistant hypertension from apparent resistant hypertension. The importance of proper and adequate sleep in treating hypertension as well as anxiety disorders in older people. Tailoring therapy to those with salt-sensitive hypertension after identifying it and having a good understanding and identifying orthostatic hypotension secondary to common causes like diabetes, neck radiation, and Parkinson’s disease.  

About the Author

George L Bakris, MD, M.A., F.A.S.N., F.A.C.P. Professor of Medicine, Director, Am Heart Assoc Comprehensive Hypertension Center University of Chicago Medicine 

Purchase your copy of Hypertension: A Companion to Braunwald’s Heart Disease, 4th Edition here!