本届ESH大会主席、格丹斯克医科大学Krzysztof Narkiewicz教授与上海第二医科大学附属瑞金医院张维忠教授就ESH大会亮点、高血压的变异、高危高血压患者降压目标和治疗方案、睡眠呼吸暂停综合征进行了深入交流。
International Circulation: Professor Zhang, you have attended many international meetings yourself and also chaired many important domestic conferences in China. This 2010 ESH meeting here in Oslo is an important meeting for you as well.There are many hot topics here including endothelial dysfunction in atherosclerosis secondary prevention and other topics like hypertension related renal syndromes.Which topic or session have you attended that you have found is of particular interest to you or especially important to clinicians in China?
《国际循环》:张维忠教授,您出席了很多国内外的高血压会议,在国内也主持过多次会议。我想,在挪威奥斯陆召开的这一届ESH大会对于您来讲也很重要。本届年会有很多热点议题,例如动脉粥样硬化的二级预防和高血压相关肾脏疾病等。本次大会您最感兴趣的议题有哪些?哪些议题对于中国的临床医生来讲尤为重要?
Zhang: There are many aspects I’m interested in but of particular note there are three that I think are exceptionally important. The first is that the meeting revealed the importance of blood pressure variability.The emerging results of blood pressure variability is important for the prognosis of hypertension, particularly related to stroke. There are many therapies related to the improvement of prognosis. The second is related to combined therapy strategies and the presentation of clinical trials, like the TALENT trial, comparing which drug treatment strategy is better. For a long time many pharmacologic strategies were viewed similarly to control blood pressure but now we are seeing some drug combinations emerging as leading to better outcomes. This is very important for the treatment of hypertension and for clinical practice.The third is hypertension with diabetes. How to start treatment? What blood pressure target should be used to guide treatment? What methodology or preferred drug regimen should be used to reduce blood pressure? These are some very important questions be addressed at this year’s meeting. More than 70% of diabetes patients also have hypertension so treatment of hypertension is important for renal function outcomes. So not only lowering blood pressure but also protection against other organ damage. These three aspects are very important for us in China.
张维忠教授:本次年会上,我感兴趣的讲题很多。但是,我比较关注的有三个,这三个讲题尤其重要。首先,在本次大会上讲到了血压变异性的重要意义。目前,不断有血压变异性方面的研究结果发表。血压变异性对高血压患者的预后具有重要意义,尤其是卒中。有很多治疗手段被证实能够改善高血压患者的预后。其次是抗高血压药物的联合治疗。在本次年会上,将有很多观察联合治疗的试验揭晓,比如TALENT试验,比较了哪种药物治疗更好。长期以来,我们认为很多抗高血压药物的降压作用相近。但是,目前我们发现某些联合治疗方案能够改善预后。这对于高血压的治疗和临床实践是非常重要的。第三是糖尿病患者的降压治疗。起始治疗怎么用药?降压目标值是多少?降压应当优先选择哪种药物?本届ESH年会将讨论这一系列重要问题。70%以上的糖尿病患者合并高血压,控制血压对糖尿病患者的肾功能转归意义重大。因此,降压药物不但能够把血压降下来,还能保护靶器官。我刚才提到的这三个方面对中国的临床医生非常重要。