International Circulation:  What about the incidence of coronary artery disease and cerebral artery disease in Asian countries have been different to those of western countries?  When we look at similar studies conducted in western countries， what do we see the consistency  and differences in the Asian population.  What did we find from KYOTO HEART study?

《国际循环》：那么亚洲国家冠脉疾病和脑血管病的发生率又是如何呢？是否与西方国家不同？当我们比较那些在西方国家进行的类似研究时，与亚洲人群有何异同之处？我们从KYOTO HEART研究中得到了什么？

Dahlof:  I think that stroke is more prevalent in Asian countries and Japan in particular has a very high stroke incidence due to many reasons.  One is their high salt intake. But as you say populations in Asia such as Japan are getting more westernized in their lifestyle which gives increasing incidence to coronary heart disease.  I think the implication of both studies JIKEI and KYOTO HEART is not uniquely an Asian indication because strokes and coronary heart disease are prevalent enough in all the western countries. Therefore， since we have data on stroke of western populations resulted from other trials showing the prevention of stroke， I think it is not unique to Japan in that regard.  So I think that one could reach the results to western countries even though it is easier to show a result on something that is more prevalent like stroke， easier because you have higher numbers to show the benefit.  But you have to remember that some people probably will say that JIKEI and KYOTO HEART study are quite small studies. How can you show such big differences?  It is just the opposite you can say. Just because you have such big differences， ，you can show it in such small studies.  Otherwise you will need big studies where the differences are small. So it can be turned around also.
International Circulation:  One final question.  The trend appears to be towards combination therapy and both JIKEI HEART study and the KYOTO HEART study have shown that some combination therapy including ARBs are effective on hypertensive patients with high risks in Asia.  When we talk about ARBs and antihypertensive treatment especially in Asia， what is your view and where does it fall? What is the position you can say when you look at ARBs?.

Prof. Dahlof：卒中在亚洲国家更普遍，特别是日本，由于多种原因，卒中的发生率非常高。第一，他们盐摄入量较高，但是正如你所指出的，亚洲国家如日本在他们的生活方式越来越西化，导致冠心病和卒中的发生率增高。由于卒中和冠心病在西方国家中也非常普遍，所以说，JIKEI HEART研究和KYOTO HEART研究所带来的启示并非亚洲独有。

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