我想我们都知道所谓的“白大衣高血压”,这是应激诱导的血压升高。有人认为血糖存在相似的反应。如果你在不同的血糖状态下重复血压测量,他们会发生改变,以及其他影响它的状态如寒冷、发烧、休息水平等。对您正在做这方面的研究,我表示祝贺,因为这将增加我们这方面的知识。
Internation Circulation: Professor Nilsson,during this meeting hypertension,type 2 diabetes,hyperlipidemia and obesity are some hot topics in the meeting.I understand there are also some joint sessions with the European Association for Obesity.Do you think there are common pathological foundation in hypertension and metabolic syndrome? In your opinion, what factors are important in choosing hypotensive drugs for patients with metabolic syndrome complicated by hypertension?
《国际循环》: Nilsson教授,高血压、2型糖尿病、高血脂及肥胖等是本次大会的热点议题。我了解到还有一些与欧洲肥胖协会联合的论坛。您认为高血压与代谢综合征是否有相同的病理基础? 您认为在为高血压合并代谢综合征的患者选用降压药物时哪些因素是重要的?
Peter Nilsson: In the future we will know much more about the genetic background, with the dream being to tailor the optimal drug therapy to the right patient.However, we are not yet at a point where we can do this. We have to simply make the best choice of drug therapy.Many of these patients have insulin resistance, that is, associated with treatment resistance.That is why we need combination treatment.Many of us think that agents that block the rennin-angiotensin system are very beneficial, however not single handed and maybe should be combined with other drugs. If we would really like to push for tight blood pressure control in these patients we should go for the combination. There may be differences between patients, between patients of ethnic groups according to which blood pressure lowering drugs are most preferred. The wise clinician will test and retest,and most importantly ask the patient how well they are tolerating the drug therapy.If not it would be most wise to try to find a better solution.On the one hand you have the physician thinking about clinically, on the other hand you have the patient who must tolerate the treatment. A clinician must always be prepared to ask the patient if he or she is happy with a drug or medication regimen and addressing issues with compliance and side-effects. In the end it is not only a theoretical thing but also a very practical thing that must be communicated with the patient.
Peter Nilsson教授:将来,我们将会对遗传背景