[ACC2009]高血压治疗的未来发展方向是什么?—JNC 8指南主席Suzanne Oparil专访
Suzanne Oparil
JNC 8指南委员会主席
美国高血压协会(ASH)前任主席
美国阿拉巴马大学伯明翰分校教授
Dr. Suzanne Oparil: I think number one, we need to establish more firmly what are the appropriate thresholds for treatment are, which patients should have the blood pressure lowered and what the goal of treatment should be. And there are a few clinical trials addressing that now in the US. One called the ACCORD that is for patients with diabetes and asking whether a systolic blood pressure of 120 mmHg is better than 140 mmHg as a treatment goal. The second is a study called SPRINT (Systolic Blood Pressure Intervention Trial) which is just being designed now looking at non-diabetics, to look at different systolic blood pressure goals. Number two, I think we need more research because there are some patients who cannot be well controlled with existing drugs and we need to find new mechanisms so that we can find new pathways to block.
Oparil博士:首先,我们需要进一步明确降压的目标值。哪些患者需要治疗,降压目标值是多少。目前美国有几个临床试验就是探讨这一问题。ACCORD试验纳入的是糖尿病患者,观察目标收缩压为120 mmHg是否优于140 mmHg。SPRINT试验(Systolic Blood Pressure Intervention Trial)则入选非糖尿病患者,目前还处于试验设计阶段,目的是确定收缩压的目标值。其次, 我认为我们需要开展更多的研究。因为应用现有的抗高血压药物,仍然有些患者不能很好地控制血压,我们需要探寻新的降压机制。找到新的阻断途径。