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[ESC 2010巅峰对话]强效降压,全面保护——造就心血管获益
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作者:HermannHallervs.孙宁玲 编辑:国际循环网 时间:2010/11/18 19:16:14    加入收藏
 关键字:降压 奥美沙坦 2型糖尿病 

  <International Circulation>: Some studies have shown the efficacy of olmesartan in lowering inflammatory factor levels and increasing circulatory endothelial progenitor cells leading to endothelial function improvement, as well as reversion of atherosclerotic progression. In addition, data from ROADMAP proved that olmesartan can reduce risk of microalbuminuria (MAU) in Type 2 diabetes (T2DM) patients. According to these findings can we conclude that treatment with olmesartan will bring us more promising benefits in reducing CVD risk?
  《国际循环》:多项研究显示奥美沙坦可降低炎症因子水平、增加循环中内皮祖细胞,从而改善内皮功能、逆转动脉粥样硬化。此外,ROADMAP数据证明奥美沙坦可预防2型糖尿病患者发生微量白蛋白尿(MAU)。基于这些发现,我们是否可以得出奥美沙坦可显著降低心血管疾病风险的结论?
  Prof Hermann Haller: Olmesartan has been shown over the last couple of years to have some interesting features for organ protection. The ROADMAP Study has been finished and unfortunately we cannot yet discuss openly the data because its publication is still under review, but there are other studies which have shown that olmesartan has a very beneficial effect. We first commenced studies with olmesartan to demonstrate anti inflammatory effects of olmesartan in diabetic patients and it was very striking that olmesartan reduces inflammation and there have been studies which have also shown that olmesartan reduces oxidative stress. This in addition to very exciting data that olmesartan influences circulatory progenitor cells in patients with CVD and so along with the blood pressure lowering efficacy of olmesartan, it is a very promising drug for cardiovascular protection.
  Hermann Haller教授:过去几年中,奥美沙坦已被证明有某些令人感兴趣的器官保护特征。ROADMAP研究已经完成,不幸的是,我们还不能公开讨论这一数据,因其发表尚处于审查过程中,但有其他研究证明奥美沙坦有极有益的作用。我们首先进行的研究证实在糖尿病患者中奥美沙坦具有抗炎作用,奥美沙坦降低炎症的效益非常引人注目;还有研究显示,奥美沙坦降低氧化应激。另外,令人非常兴奋的数据显示,在CVD患者中奥美沙坦增加循环中的内皮祖细胞,因此,加上奥美沙坦的降压效果,它是一种非常有前景的心血管保护药物。

  <International Circulation>:What’s the difference between olmesartan-based combination therapy and other angiotensin II receptor blockers (ARBs)-based combination therapies? And what are the special benefits of olmesartan-based combination compared with other ARBs-based combinations?
  《国际循环》:基于奥美沙坦的联合治疗与以其他ARB为基础的联合治疗相比有何不同?有何特别益处?
  Prof Hermann Haller: First of all combination therapy is becoming the main treatment strategy of choice right from the start. We now have a lot of evidence that using one blood pressure pill when you have established hypertension is not enough. You need two and sometimes three drugs to keep the blood pressure under control; we have seen this in the ROADMAP Study. Combination therapy is a mainstay of anti hypertensive therapy. In terms of which combination, one component is to block the rennin-angiotensin-system and since “sartans” have less side effects they would be the first choice for long term treatment. The combination partner could be: thiazide diuretics because you have a very good blood pressure lowering component and there are several studies suggesting now that for organ protection the combination of rennin-angiotensin-system blockade and calcium antagonists is very beneficial.
  Hermann Haller教授:首先,联合治疗正在成为从初始治疗开始主要的治疗策略选择。你需要两种有时是三种药物以有效控制血压;我们在ROADMAP研究中观察到了这一现象。联合治疗是抗高血压治疗的中流砥柱。谈及哪种药物联合,一个组分应阻断肾素-血管紧张素系统,且因为“沙坦”类药物不良反应较少,他们将成为长期治疗的首选。联合对象可以是噻嗪类利尿剂,因为你有一个非常好的降压组分;目前有数项研究提示,就器官保护而言,肾素-血管紧张素系统阻滞剂与钙拮抗剂的联合非常有益。

  <International Circulation>:It has been proven that olmesartan is superior to placebo, diuretics, and other ARBs in lowering BP. What are the determinants making olmesartan the strongest anti-hypertensive ARB?
  《国际循环》:已证实奥美沙坦降压作用优于安慰剂、利尿剂和其他ARB。使奥美沙坦成为最强效抗高血压ARB的决定因素是什么?
  Prof Hermann Haller: Number one is the anti-hypertensive efficacy, we have now several studies were different ARBs were compared and with olmesartan with the dosages used at 10.20 and 40mg was always better, not dramatically better but better compared to other agents. Number two: we have data for olmesartan that it can confer organ protection and with its combination of good blood pressure control, anti inflammatory, antioxidative effects make it not only a strong antihypertensive but also organ protective antihypertensive drug.
  Hermann Haller教授: 第一是降压效果,我们现在已经有数项对比不同ARBs的研究,奥美沙坦以10、20和40 mg剂量应用总是更好,虽然不是显著较好但优于其他药物。第二,我们有显示奥美沙坦器官保护作用的数据,因其有良好的血压控制、抗炎和抗氧化作用,所以它不仅是一种强有力的抗高血压药物,而且还是有器官保护作用的抗高血压药物。
  Prof Sun Ning Ling: I think olmesartan is very effective at reducing blood pressure with similar side effects with other ARBs.
  孙宁玲教授:我认为奥美沙坦降压非常有效,且不良反应与其他ARBs相似。

 
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