<International Circulation>: In your opinion， do we have enough evidence for medication treatment for prehypertension patients?

　　Dr Zanchetti: Again， this is part of this revision of the new guidelines from the previous one in terms of what has been shown by trials. The evidence says there is no evidence at the time being whatsoever of benefit from lowering blood pressure in patients with prehypertension. The European Guidelines even try to avoid the term prehypertension because it has too large a range of blood pressure. They call it high normal blood pressure with a value between 130mmHg and 140mmHg， and 85mmHg and 90mmHg diastolic which is a more restricted classification than the American prehypertension concept. But even in this condition of high normal blood pressure there is no evidence of benefit even in patients at high-risk. So there is definitely no recommendation for treating these patients. Admittedly， lack of evidence does not mean evidence against but we need trial evidence before recommending giving drugs to such a huge number of individuals.

　　《国际循环》：在您看来，目前是否有充分的证据支持对高血压前期患者进行药物治疗？

　　Zanchetti教授：对此，新指南根据试验证据进行了修订。目前尚无证据显示对高血压前期患者进行降压治疗能为患者带来获益。欧洲指南甚至避免应用高血压前期这一表述，因为它所涵盖的血压范围实在太大了。新指南将130~140 mmmHg/85~90 mmHg定义为正常血压高值，与美国高血压前期的概念相比，其分类更为严格。但是即使在正常血压高值的人群（甚至是高危人群）中，目前尚缺乏治疗获益的证据。所以对这些患者目前并不推荐进行治疗。当然，缺乏证据并不意味着证据显示不应该进行治疗。在数量庞大的该类人群，只有得到临床试验证据的支持后，我们才能做出进行药物治疗的推荐。

　　<International Circulation>:  How do you think we should promote the application of the new ESH/ESC guidelines?

　　Dr Zanchetti: The application of guidelines is always difficult. It is easier to give advice than follow advice which is part of life. I think we should try to use common sense and as much as possible try to inform physicians who are in charge of these patients what the essence of these guidelines is and for those physicians to follow evidence when treating their patients. As well as through the doctors we need to employ the media (like yourself) to forward this concept and information to the patients as well. Patients today like to be informed and information is readily available via the internet. The information available on the internet is often non-critical information and in very large quantities and the average individual is unable to know what is good and what is not good information. The doctor needs to act as an intermediary with the patients so that they can understand the information from the internet and other sources.

　　《国际循环》：您认为我们应如何在临床实践中推广新版ESH/ESC的应用？

　　Zanchetti教授：指南的应用通常是非常困难的。提出建议要比根据建议来做要简单得多，但后者才是实践所需要的。我认为，我们应该尽可能地告诉患者的治疗医生指南的本质是什么，并让他们在治疗患者时遵循指南。除了医生之外，我们还需要通过媒体来传播这样的理念，并向患者提供相应的信息。当今的患者是乐于接受信息的，而且互联网上已经有了相应的信息。但是互联网上的信息经常是些非关键性的信息，且数量众多，一般人是无法知道哪些是好的信息，哪些是不好的信息。医生则需要充当患者与信息之间的媒介，以使患者能更好地理解来自互联网及其他来源的信息。