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[GWICC2007]澳大利亚心血管教授Patel现场访谈----糖尿病患者的降压治疗

作者:国际循环网   日期:2007/11/27 16:06:00

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<International Circulation>: Shall we use the anti-hypertensive therapy in diabetic patients with relatively normal bloodpressure?
我们是否应该对血压相对正常的糖尿病患者采取抗高血压治疗?

Prof. Anushka: What the study trying to do is to get away from some of the ideas of hypertension and normal blood pressure.If we look at the association between the blood pressure and overall heart attack, it continues the association. There is no magic number in blood pressure above which you have hypertension, and below that you don’t have hypertension. No matter what blood pressure is, it does conclude that we should take the blood pressure level as the major reason for blood lowering treatment. We don’t use the term anti-hypertension; we use the term blood pressure lowering. It’s different meaning. And if you use hypertension, that means you believe certain of the people have hypertension, it is a concept we don’t believe.
我们研究的目的之一是要摒弃有关高血压和正常血压的概念。如果我们研究一下血压和心血管事件的总体发生率,它们始终是有关联的。血压没有一个幸运数字,在此之上是高血压,在此之下就不是高血压。不论血压是多少,血压水平是采取降压治疗的关键因素之一。我们不用抗高血压这个名词,我们使用降血压治疗。他们的意义是不同的。如果我们使用高血压,也就意味着我们认为一部分人是高血压的,这和我们的概念是相左的。

<International Circulation>:What do you think the target of the blood pressure control, as for diabetic patients?
对于糖尿病患者,您认为血压控制的目标是多少?

Prof. Anushka:I think we haven’t finished the trial, and we could not answer the question, because we don’t have the target, we choose any level of blood pressure and we just lower it, we just try and get to target. I think it’s providing the different ways to achieve the target, lowering the blood pressure for everyone.
我想我们还没有完成整个试验,现在还不能回答这个问题,因为我们还没有目标,我们选择任何水平的血压并采取降压治疗,使其降到一定数值。我想达到降压目标是有不同途径的,应该为每个患者降压。

<International Circulation>: Should it be a little bit lower?
是否应该将血压降得再低一些吗?

Prof. Anushka:Yeah, exactly, you know, we don’t have the large number of patients whose blood pressure is less than 130/70,but if you look at the group, there is no evidence for patients saying patients’ treatment should have difference if you arebelow 130 or above 130.
是的,我们只有很少的患者血压小于130/70mmHg,但是如果你看看分组,血压高于或低于130 mmHg的患者其治疗并没有什么差异。

<International Circulation>: What’s the meaning of this study for the clinical practice?
此项研究对临床实践有什么意义?

Prof. Anushka:I think the meaning for the clinical practice is that, if a patient in front of you, with diabetes. What’s thefirst step you think, no matter what the treatment they have, and no matter what the blood pressure, you should consider lowering the blood pressure further. And we had put the evidence about balancing of perindopril and indapamide combination.So that should be one of the best regimen for continue using.
我想其临床意义在于,如果患者在你面前,而且合并有糖尿病,你应该采取的措施是什么呢?不管他目前接受什么治疗,不管他的血压是多少,你应该考虑进一步降压。我们已经将培哚普利和吲达帕胺联合应用的数据和证据发布,这应该是目前应用的最佳药物组合。

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