<International Circulation>: You spoke this evening about the SHARE survey about how many patients who are receiving treatment for hypertension have less than optimal control rates. Other lecturers spoke this evening about ARBs and in particular olmesartan. Are there differences between the different ARBs? Is olmesartan superior to other ARBs or diuretics?
　　《国际循环》：您今晚就SHARE调查发表了演讲，谈及接受高血压治疗的患者有多少未达到最佳控制。今晚的其他演讲谈及ARBs，尤其是奥美沙坦。不同的ARBs之间是否存在差异？奥美沙坦是否优于其他ARBs或利尿剂？
　　Prof. Redon: One important point is that in order to reduce the cardiovascular burden we must keep blood pressure on goal because if we do not then risk will stay high. We have a lot of drugs for hypertension and one group that we have a lot of experience with is the ARBs. The ARBs are very excellent antihypertensive drugs， are very well tolerated， and are also able to be combined with all kinds of other drugs， especially diuretics or calcium channel blockers. When we try to look at which group is the best then we must consider that although all the antihypertensive drugs that we use have the potential to lower blood pressure， there are some drugs such as ARBs that are very well tolerated so we can give an even higher dose than usual in order to reduce blood pressure much better. Therefore， ARBs are very well positioned in the field of hypertension treatment.
　　The next question is what the differences are between drugs of the same group—in this case ARBs. In terms of effects beyond blood pressure effect it is not clear if there are differences or not. Of course， the pharmacokinetic and pharmacodynamic characteristics differ between drugs. Olmesartan is one of the most potent drugs in the group of ARBs and also a long lasting drug. This is reflected in a study we published two years ago in which we did a meta-analysis of all the studies that have been published and compared ARBs with ARBs or other drugs using 24-hour ambulatory blood pressure. In this meta-analysis we can see that the highest activity during the 24 hours was for olmesartan. The most important thing is that at night the reduction of blood pressure was higher and also during the last four hours of the interdose period. It is clear that olmesartan has a very good position in the armamentarium to control blood pressure.
　　Josep Redon教授：重要的一点是，为降低心血管负担，我们必须使血压降至目标水平，因为如果血压未能达标，那么风险将维持在高水平。有很多治疗高血压的药物，其中我们积累了丰富经验的一类就是ARBs。ARBs是非常优秀的抗高血压药物，且耐受性非常好，此外还能与几乎所有其他药物联合，尤其是利尿剂或钙通道阻滞剂。当我们试图找出哪类药物是最好的，我们必须考虑到，尽管我们应用的所有抗高血压药物均有降低血压的效力，但有一些药物例如ARBs有非常好的耐受性，因此我们可以使用比常规更高的剂量以更好地降低血压。因此，ARBs在高血压治疗领域中的地位非常重要。
　　下一个问题是同类药物（在此指ARBs）之间有何差异。在血压效应之外的作用方面，尚不清楚是否存在差异。当然，药物之间药代动力学和药效动力学特点不同。在ARBs类药物中，奥美沙坦是作用最强的药物之一，且是一种长效药物。在我们2年前发表的一项研究中，我们对所有已经发表的采用24小时动态血压监测比较ARBs与ARBs或其他药物的研究进行了荟萃分析。在这项荟萃分析中，我们可以看到24小时期间活性最高的是奥美沙坦；最重要的是，奥美沙坦使夜间血压降低较多，且在两次服药中间的最后4小时内亦然。显然，在全部药物中，奥美沙坦在控制血压方面有非常重要的地位。

　　<International Circulation>:  It was noted this evening that a large amount of patients will require more than one drug to control blood pressure. Which patients might be particularly suitable for olmesartan-based combination therapy?
　　《国际循环》：会议再次提到，大量患者将需要不只一种药物来控制血压。哪些患者可能尤其适合基于奥美沙坦的联合治疗？
　　Prof. Redon: In general， if you want to control blood pressure to goal then you need to use more than one drug. Taking into account the potent antihypertensive activity， the good tolerance， and the fact that it combines very well with diuretics and calcium channel blockers， olmesartan is in a very good position to be combined with these other drugs. If we are going to select a diuretic or calcium channel blocker for combination then we need to think of what kind of patient that we have in front of us. Of course， if the patient has metabolic syndrome or a higher risk of developing diabetes it is much better to combine with a calcium channel blocker but there are other patients who may have benefits from the combination of olmesartan with a diuretic.
　　Josep Redon教授：通常，如果你想要控制血压至达标，那么你需要应用不只一种药物。考虑到其强大的抗高血压活性、良好的耐受性以及其与利尿剂和钙通道阻滞剂组合良好的事实，奥美沙坦与其他这些药物的联合具有重要地位。如果要选择一种利尿剂或钙通道阻滞剂来进行联合治疗，那么我们需要考虑我们面对的是什么类型的患者。当然，如果患者有代谢综合征或较高的糖尿病发生风险，则与钙通道阻滞剂联合更佳；但其他患者有可能从奥美沙坦和利尿剂的联合中获益。