Prof. Sverre E. Kjeldsen :ESH/ESC高血压指南编委
<International Circulation>: Compared with 2003 ESH-ESC guidelines， the 2007 guidelines paid more attention to the total cardiovascular risk， emphasized that diagnosis and management of hypertension should be based on the classification of cardiovascular risk， and update the major diagnostic elements of high/very high risk subjects. What update have you do? Why did these update?
《国际循环》:  2007年欧洲高血压指南对比2003年指南，更加重视总体心血管危险，强调应根据危险分层诊断和治疗高血压，在高危/极高危患者的入选标准方面做了一些更新，这些更新主要有哪些？
Prof. Kjeldson: Most important change from 2003 to 2007 is that ”metabolic syndrome” has come in at the level of 3 or more risk factors， organ damage and diabetes， also in people with high normal blood pressure. It implies that drug treatment maybe recommended in many of these people because of the high added total cardiovascular risk.
Prof. Kjeldson:与2003年相比，2007年欧洲高血压指南最重要的变化是，将“代谢综合征”列入与≥3个危险因素、器官损害和糖尿病等同的危险水平，其中也包括正常高值血压的患者。这样，很多患者将由于总体心血管风险较高而推荐使用药物治疗。

<International Circulation>: In the assessment of cardiovascular risk influencing prognosis， the new guidelines place particular emphasis on identification of subclinical organ damage， some new measurements added to the list of subclinical organ damage ，  although this technology is not widely available， what is your opinion about these markers?  How to popularize?
《国际循环》: 新指南中在评估影响预后的心血管危险因素时增加了一些亚临床器官损害的评定指标，新指标目前的临床应用如何？。

Prof. Kjeldson:We list a number of markers/methods for detection of organ damage， but also the overall picture with availability， predictive value and cost for each marker or method. In fact， organ damage needs only to be proven with one method in order to indicate careful drug treatment and follow-up. But the list gives options because the interest various from one site to the other and it is important to detect organ damage. Many of the markers/methods are still mostly used for research though， and have been put into clinical practice in few large hypertension centers only.
Prof. Kjeldson:指南中列出了许多检测器官损害的指标或方法，并对每种指标或方法的有效性、预测值及其价值都做了全面描述。事实上，为了指导谨慎用药，只需要一种器官损害指标就可以了。但是，由于每个指标的侧重点不同，而对于器官损害的检测又很重要，所以在指南中列出了多种可供选择的方法。然而，许多指标或方法目前还主要用于研究，只有少数大型的高血压中心将其用于临床实践中。

<International Circulation>:  In the treatment of cardiovascular risk factors influencing prognosis， the new guidelines notes that we shoul reduce the serum total chlesterol level from 6.5 to 5 mmol/L，the LDL-c level from 4 to 3mmol/L，Why did we control the chlesterol level so strictly?What effect can they bring to access the total cardiovascular risk factors?
《国际循环》:  新指南在影响预后的心血管危险因子中将TC的目标值由原来的6.5 mmol/L降至5mmol/L，LDL-c由原来的4 mmol/L降至3mmol/L，血脂指标的控制要求越来越严格，哪些高血压患者应该给予降脂治疗？

Prof. Kjeldson:Regarding additional treatment with cholesterol lowering and aspirin， our general rule is unchanged from 2003– we recommend add on treatment with statin if total risk at baseline is about 20% over 10 years or higher. For aspirin the same， but only in people with controlled hypertension. Beyond that we mostly refer to the general preventive guidelines regarding how aggressive the cholesterol lowering therapy should be (new 2007 ESC General Preventive Guidelines).
Prof. Kjeldson:从2003年以来，指南关于强化降胆固醇治疗和阿司匹林应用的总的原则未变，即如果高血压患者10年总体心血管风险的基线值达到20％或更高时就建议给予他汀治疗。对于阿司匹林也是如此，但只是用于血压得到控制的人。除此之外，我们主要参考了2007年ESC心血管病综合预防指南中有关如何强化降脂治疗的建议。