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[ESC2009]ACCOMPLISH的影响及单片复方制剂(SPC)在临床中的应用--Dahlof教授专访

作者:国际循环网   日期:2009/9/3 19:00:00

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ACCOMPLISH研究是第一个将固定剂量复合制剂(SPC)RAAS/CCB同RAAS/利尿剂用于高血压或高心血管事件风险的患者效果比较的试验,您认为这个研究是否会推动单片复方制剂(single-pill combination,SPC)在临床高血压治疗中的广泛应用呢?您认为ACCOMPLISH研究对JNC8及ESC/ESH高血压指南对于SPC的临床应用将会有何影响?

 


International Circulation:  What impact do you think the ACCOMPLISH study will have or should have?  You are an expert in Europe but with the upcoming JNC 8 guidelines from the United States and also the ESC and ESH hypertension guidelines?  DO you think it should change or will it help change guidelines?

国际循环:您认为ACCOMPLISH研究将会或应该会产生什么样的影响?作为欧洲的专家,您对美国即将颁布的JNC 8指南及ESC/ESH高血压指南有何看法?该研究是否会改变指南内容,或有助于修改指南?

Dahlof:  Already in the guidelines we have strong recommendations that you could start patients on a single pill combination if they are 20/10 from their goal.  It is not stated in figures in the European guidelines, what I quoted was the American guidelines but it is the same general message.  I think that the ACCOMPLISH trial will now make that message even stronger for the coming guidelines.  I think one thing that I can not predict is how the choice of the diuretics in the American guidelines will be phrased this time because they were very diuretic oriented in the JNC 7 and I know behind some scenes there is a huge debate of how to phrase this in the next guidelines.  But I think that the combination story will also appear in the new American guidelines.

Dahlof:我们已对指南提出强烈建议,若想降低血压20/10,最好起始采用单药联合疗法。欧洲指南中并没有类似陈述,我引用的是美国指南中的内容。我认为ACCOMPLISH试验更确信了这一点,为即将颁布的指南提供依据。有一点我无法确定,就是美国指南将如何选择利尿剂,因为JNC 7曾力荐使用利尿剂,据我所知对本次指南将如何选择利尿剂的争议很大。但无论如何,新版美国指南还将纳入联合疗法。

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