Guido Grassi  意大利米兰Bicocca大学

  <International Circulation>: You are making a presentation entitled “Weight Loss Influences on Arterial Hypertension: Myth or Reality?” What is the influence of anti-hypertensive drugs on the weight of obesity patients? Are there certain classes of drugs that are preferred and others that might exacerbate the obesity problem?

《国际循环》：您的演讲题目是“减重对动脉高血压的影响：神话还是现实？”降压药物对肥胖患者的体重有何影响？是否某些药物对体重有利，而另一些则加重肥胖问题？

    Prof.Grassi: Anti-hypertensive drugs may have heterogeneous effects in obese hypertensive patients. Some drugs like diuretics or beta-blockers may provide blood pressure reduction but this reduction is associated with unfavorable metabolic effects such as insulin resistance or hyperglycemia. This means that these should be avoided in these patients whereas drugs acting on the renin-angiotensin system (ACE inhibitors， angiotensin II receptor blockers or calcium channel blockers) may be preferred.

    Grassi教授：降压药对肥胖高血压患者的作用有异质性。有些药物如利尿药或β受体阻滞剂虽能降压，但降压的同时带来不良代谢影响如胰岛素抵抗或高血糖，这意味着应该避免将它们用于这些患者。而作用于肾素-血管紧张素系统的药物（ACEI，血管紧张素II受体阻滞剂） 或钙通道阻滞剂是肥胖高血压患者更好的选择。

    <International Circulation>:  We know often when we see these obese patients they may suffer from diabetes because diabetes， obesity and hypertension often all go together. At the moment， the guidelines recommend the goal of 130/80 mmHg for patients with diabetes. What is your view? Is this a level that is appropriate or are there changes likely in the future?

   《国际循环》：我们知道肥胖患者通常患有糖尿病，因为糖尿病、肥胖和高血压通常并行。目前，指南推荐糖尿病患者的降压目标是130/80  mm Hg。您的观点是什么？这个水平合适还是将来可能要修改？

    Prof.Grassi: I think the target of 130/80 mmHg during treatment is something that favors cardiovascular risk protection in these patients. Obviously it is difficult to achieve and this means that the physician should use combination treatment more frequently.

    Grassi教授：我认为治疗中130/80 mmHg的靶目标有利于对这些患者心血管风险的预防。显然要达到这个目标血压很难，这意味着内科医生应该更常应用联合治疗方案。