Conducting today's lipid clinic requires a surprisingly broad knowledge and understanding of modern medicine. The lipidologist needs to understand the genetics and biochemistry of lipids and lipoproteins, the complexities and pitfalls of the ways we currently measure their circulating concentrations, their apparently arcane classification, and their contribution to the atherogenic process and to a particular patient's cardiovascular risk. He or she has also to keep up to date with the pharmacology of the various lipid modulating drugs, of which the statins are clearly the best known but far from the only option, and to base treatment on familiarity with, and an ability to interpret, a large and growing body of epidemiological evidence. Finally, that lipidologist must integrate all this with a wider understanding of the other factors that affect cardiovascular risk and help educate, encourage and involve the individual patient in implementing and monitoring their own personal management strategy. The third edition of Paul Durrington's Hyperlipidaemia: Diagnosis and Management is an excellent guide to all these areas and more, as might be expected from one who has lived and breathed the research, practice and teaching of clinical lipidology throughout his distinguished career. It is clear, well organised and comprehensive but the style is far from dry or cold: the section on dietary fat restriction in the management of hypertriglyceridaemia exudes particular warmth! It is also well produced, illustrated and referenced. Single author texts can be prone to an over-representation of the writer's opinions; I like Paul Durrington's honesty in highlighting when he is expressing his own view and also his recording of the divergence of colleagues' approaches to the management of complicated dyslipidaemias where the evidence is currently incomplete. In summary, I enjoyed reading this book very much, refer to it frequently, and can whole-heartedly recommend it to all lipidologists. But does is appeal to a wider audience? I think it is such a good account of both normal and disordered lipid and lipoprotein metabolism and its role in cardiovascular disease, that it would be of interest to all who research atherogenesis or who try to prevent or treat its complications. There are briefer and simpler accounts that are perhaps better first introductions to lipidology for the practising cardiologist, but as a mid-range reference text for those who find their interest whetted, Paul Durrington's book has yet to be surpassed.
Dr Paul Flynn, Consultant Physician in Acute and Metabolic Medicine and Clinical Lead for the Lipid Clinic, Addenbrooke's Hospital, Cambridge.