International Circulation: International Circulation is honored to speak to Professor Suzanne Oparil on the occasion of WHC2009 in Beijing and this Chinese guidelines preparatory meeting.
We know the ESH/ESC and the Japanese JSH just updated their guidelines for hypertension management, and China and the United States are also in the process of updating their hypertension guidelines. From your perspective, why are organizations updating their hypertension guidelines now in the last couple of years?
《国际循环》:我们知道ESH/ESC和日本JSH刚刚更新了高血压治疗指南,现在,中国和美国也正在更新高血压指南。在您看来,为什么这些年来,这些组织都在不断地更新指南?
International Circulation: In your opinion, what’s the role of guidelines in the prevention, treatment and control of hypertension – the world’s major cardiovascular disease, and how can we maximize the value of the guidelines?
《国际循环》:在您看来,指南在高血压(世界主要的心血管疾病)的预防和治疗中发挥着什么作用?我们怎样才能最有效地发挥指南的这些作用?
Prof Oparil: Guidelines, in fact, are only guidelines. We do respect the judgment of physicians who are well-trained and concerned about the welfare of their patients, and patient A is not the same as patient B. I am not the same as you with respect to my cardiovascular system. But primary care physicians and family physicians, certainly in the United States, and it is these physicians who take care of most patients with hypertension, are very busy. They see many patients every day, maybe forty, fifty, sixty patients. They cannot think through a long series of papers or clinical studies, they can’t digest a hundred pages of advice. They have to have simple advice about the things that work best at lowering blood pressure and protecting the patient. So we are trying to construct simple guidance for them about what is effective and what is safe in, firstly, lowering blood pressure, and secondly, preventing cardiovascular disease and preventing cardiovascular disease death. It is simple but it is complicated.
Prof Oparil:实际上,指南仅仅是指南。我们尊重接受过良好训练并且关心患者利益的临床医生的判断,同时我们也明白患者存在个体差异。但是初级内科医生和家庭医生是非常忙碌的,尤其是在美国,因为他们需要面对很多高血压患者,每天接诊40、50甚至60位患者。他们没有时间阅读长篇大论的文献、临床研究报告,以及长达100多页的建议,他们需要的是关于降低血压和保护患者的简单的建议方案。所以我们试图为他们制定简单的指南,例如哪些药物更有效,哪些方案更安全;首先降低血压,然后预防心血管事件的发生和由此导致的死亡等。因此,指南是简单的但同时又是复杂的 。