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: The recommended combination therapy in the new version of the ESH/ESC guidelines changed from ‘hexagonal’ to ‘quadrilateral’ – the importance of beta-blockers and alpha-blockers has been reduced. The new JSH guidelines still emphasize that the five classes of antihypertensives are equal. What are your comments on this and will the JNC8 be more like the ESH/ESC’s guidelines?
《国际循环》:在新版的ESH/ESC指南中,联合治疗方案得到推荐,并且药物从之前的“六角形”转变为“四边形”——β受体阻滞剂和α受体阻滞剂的重要性降低。新的JSH指南却还是强调五种降压药的作用是平等的。您对此怎么看呢?JNC 8会更倾向于ESH/ESC指南么?
Prof Oparil: I have no comment as our group is in the process of evaluating the evidence supporting one decision or another and we are taking an evidence based approach, which means a very rigorous evaluation of all the published randomized controlled trials since 1966. So we have a lot of evidence to sift through. We have to weigh the strength of the evidence and then based on the strength of the evidence we will give a recommendation which is either strong, weak or negative. In other words, you must do this, maybe you can do this, or you must not do this. So I have no recommendation with respect to any particular drug or treatment approach, but we hope that once we have finished this process, we will have the best possible advice given the evidence that was evaluated and given our patient population. We don’t have many Asian people in our studies, so we will be looking at Caucasians, Hispanics, who may be either black or white, and African-Americans. So things may be different in Asia versus North America versus UK.
Prof Oparil:目前,我们正在评估从1966年以来所有发布的随机对照试验结果,所以我现在还不便发表评论。我们必须对这些证据进行综合分析,然后我们将在此基础上给出不同级别的建议。所以我对于任何特殊药物或者治疗方案不作评论,但是希望一旦完成这项研究,就将有最好的建议方案出台。我们的研究中亚洲患者人群所占比例不是很大,因此将来我们会更加关注高加索人种、西班牙人种等,无论是黑人或白人,还是非裔美国人。亚洲人群的结果可能会与北美和英国有所不同。