International Circulation: Presently， hypertension management guidelines put a  lot of stress on total cardiovascular risk and point out that besides the baseline blood pressure level， antihypertensive regimens should be made on the basis of CVD risk evaluation， so what do you think of the relationship between total CVD risk and blood pressure lowering? What is your view of the effect of CCBs (such as amlodipine) in reducing total CVD risk?

   《国际循环》：目前，高血压指南强调总体心血管危险，指出除了基线水压水平之外，还应当在总体心血管危险评估的基础上制定降压方案。您认为总体心血管危险管理和降压治疗之间的关系如何？CCB类药物（例如氨氯地平）在降低总体心血管危险方面的作用如何？

    Dr. Lau: I think it is important for any doctor who is faced with a patient with hypertension to do a global cardiovascular risk assessment for that patient and that is very important because we have to take the global cardiovascular risk in totality into account when we treat any patient. That will include of course the blood pressure itself， the lipid profiles， the weight of the patient， the body mass index， the waist/hip ratio perhaps，  and smoking history. These are all important components in treating a patient and trying to reduce the overall CVD risk factors eventually. What is good today is that we have a lot of available medications that work very effectively in lowering blood pressure such as amlodipine or calcium channel blockers. It does so without causing unwanted side effects. For example， there are some classes of anti-hypertensives that give rise to unfavorable metabolic side effects like hyperglycemia， hypertriglycemia， hyperuricemia. Those things are important to bear in mind when prescribing anti-hypertensives. There is also the availability now of combination therapy， for example， Caduet， which is a combination of amlodipine with a statin， atorvastatin， which works in the sense of reducing blood pressure as well as achieving a better LDL target for patients who require it.

    Dr. Lau：我认为每位医生在面对高血压患者时均应当进行总体心血管危险评估，这是非常重要的。总体心血管危险评估包含血压本身、血脂、体重、体重指数、腰/臀比、吸烟等。这些参数对于高血压患者的治疗以及最终减少总体心血管疾病危险因素均是至关重要的。目前，值得欣慰的是，我们有多种药物可以有效控制血压，例如CCB类药物－氨氯地平。此类药物在降压的同时并未带来明显的不良反应。而某些降压药物在一定的剂量下会引发不良的代谢副反应，例如高血糖、高甘油三酯、高尿酸血症。在选择降压药物时，对上述不良反应进行考虑是非常重要的。此外，还有很多联合治疗方案可供选择，例如Caduet，氨氯地平和阿托伐他汀的复方制剂，它在降压的同时使患者获得更理想的LDL目标水平。因此，这一复方制剂对于控制总体心血管危险来说是非常重要的。