International Circulation: First of all， Professor Volpe， I would like to thank you very much for accepting this interview today with International Circulation. I am sure our readers in China are very anxious to hear your opinions on a few of these subjects.

According to the results of recent anti-hypertensive trials， do you think that calcium channel blockers play an important role in the strategies of anti-hypertensive combination treatment? Also， could you give a brief introduction about the most important advances in calcium channel blockers recently?

《国际循环》：首先，Volpe教授， 非常感谢您接受《国际循环》的采访。我相信我们中国的读者一定非常想知道您对这些主题的看法。根据现有抗高血压试验的结果，您是否认为钙离子通道阻滞剂在抗高血压联合治疗中起到了重要作用？还有，您能否简单介绍一下目前钙离子通道阻滞剂最重要的进展。

Professor Volpe: Actually， calcium channel blockers have represented， for a long time， one of the most important drugs for the treatment of hypertension. They were somehow challenged by some meta-analysis questioning the safety of calcium channel blockers. More recently， studies like the ASCOT study and the CAMELOT study， or the VALUE study have been re-evaluated. There is potential of calcium channel blockers， not only being as effective and safe anti-hypertensive agents， but also being effective in reducing the potential exposure to cardiovascular events. Right now， calcium channel blockers represent first-line therapy in the guidelines and of course they may be extremely important as an add-on therapy in patients who do not respond to monotherapy with RAS blockers or diuretics.

Volpe教授：事实上，钙离子通道阻滞剂在很长一段时间内是高血压治疗中最重要的药物之一。钙离子通道阻滞剂的安全性曾面临荟萃分析的质疑。最近一些研究，像ASCOT研究、CAMELOT研究或VALUE研究被重新评价。钙离子通道阻滞剂不仅仅是安全有效的抗高血压药物，还能减少心血管事件的发生。现在钙离子通道阻滞剂是用药指南的一线药物，当然其作为RAS阻滞剂或利尿剂单一疗法无效患者的附加用药，作用也极其重要。International Circulation: You spoke about ASCOT. I have a question in regards to ACCOMPLISH. There is a high correlation between BP control and clinical endpoint events. The results of ACCOMPLISH were presented in 2007. Antihypertensive combination therapy-calcium channel blocker amlodipine plus ACE inhibitor benazepril got excellent results in blood pressure control. What do you think about these findings and the future of anti-hypertensive treatment?

《国际循环》：您就ASCOT 发表了演说，我有一个关于ACCOMPLISH的问题想请教您。血压控制和临床终末点事件有着密切联系。ACCOMPLISH结果在2007年公布。抗高血压联合治疗－钙离子通道阻滞剂氨氯地平加上血管紧张素转化酶抑制剂贝那普利能够很好地控制血压。您怎样看待这些发现？抗高血压治疗的前景如何？

Professor Volpe: We have to regard ACCOMPLISH as the only available study for a long time directly comparing combination strategies on major outcomes. However， it has to be said that in spite of the more beneficial influence of the combination of benazepril with amlodipine compared to the combination of the ACE inhibitor with a diuretic， the endpoint was somehow in favor of this combination because it included angina， whereas congestive heart failure was excluded. So， I think that ACCOMPLISH is an important piece of information. It can not definitely say that the combination with ACE inhibitors and a calcium channel blocker is better than the combination with a diuretic， but it is interesting. I think it goes in the line of other studies， such as the ASCOT study， or even other smaller studies that have shown that the combination with calcium channel blockers is an important way to potentiate anti-hypertensive therapy.

Volpe教授：我们不得不承认ACCOMPLISH是长时间以来直接比较联合疗法主要成果的唯一有效研究。然而，虽然贝那普利与氨氯地平联合比血管紧张素转化酶抑制剂与利尿剂联合更具优势，但终末点支持这一联合是因为它包括心绞痛，而将充血性心力衰竭除外。所以，我认为ACCOMPLISH是一组重要信息。血管紧张素转化酶抑制剂和钙离子通道阻滞剂联合并不是绝对比与利尿剂联合更有效，但是这些发现很有趣。我想它和其它表明与钙离子通道阻滞剂联合是抗高血压治疗一个重要手段的研究一致，如ASCOT研究，或甚至其它更小的研究

International Circulation:  What are the advantages of amlodipine used alone and in combination therapy?
《国际循环》：氨氯地平单独使用和联合治疗的优点是什么？

Professor Volpe: I think that amlodipin in monotherapy has the advantage of being one of the most powerful anti-hypertensive treatments， but on the other hand， is related to some frequent side-effects， especially ankle edema. In combination therapy， especially with RAS blocking agents， the risk of ankle edema is largely reduced so amlodipine appears to be even more interesting as an add-on therapy than as an initial therapy in hypertension.

Volpe教授：氨氯地平单一疗法有作为最有力的抗高血压疗法之一的优势，但另一方面，也有频繁的不良效应，特别是踝部浮肿。在联合治疗时，特别是和RAS阻滞剂联合，踝部浮肿发生风险大大降低，所以氨氯地平作为附加治疗比作为高血压初始治疗更加有趣。

International Circulation:  In your editorial “Reduction in Estimated Stroke Risk Associated with Practice-Based stroke-Risk Assessment and Awareness in a Large， Representative Population of Hypertensive Patients: Results from the ForLife Study in Italy”， which was published in the Journal of Hypertension in December， 2007， you mentioned that the assessment of stroke risk and increased awareness of stroke risk factors by GPs is associated with improved blood pressure control， reduced cardiovascular risk profile and a prompt reduction in the 10-year estimated risk of stroke. Can you briefly talk about the management of stroke prevention in hypertensive patients?

《国际循环》： 2007年11月您在《Journal of Hypertension》上发表的“Reduction in Estimated Stroke Risk Associated with Practice-Based stroke-Risk Assessment and Awareness in a Large， Representative Population of Hypertensive Patients: Results from the ForLife Study in Italy”一文中，您提到卒中风险的评价和卒中风险因素意识的增加，与血压控制改善、心血管风险减少和卒中十年预期风险的显著降低有关。您能否简单谈谈高血压患者预防卒中的手段？

Professor Volpe: Stroke is the most frequently associated event that one can find in hypertensive individuals and it’s preventable. So， it’s extremely important to manage hypertension properly to reduce the risk of stroke. In the ForLife study， we were able to show that by just making the doctors aware that it was important to estimate the risk of stroke without making any specific changes or recommendations in the therapy， there was a significant reduction in the estimated risk of stroke within 6 months. This means that doctors should really be aware of the possibility that they can reduce the risk of stroke in hypertensive individuals， especially by properly treating blood pressure and by controlling associated risk factors.

Volpe教授：卒中是高血压人群中最常见的相关事件，它是可以预防的。所以，将血压控制在适当水平以减少卒中风险是非常重要的。在ForLife研究中，我们发现只要医生意识到评价卒中风险的重要性，在治疗不做任何特殊变动或推荐的情况下，就能够明显降低6个月内的预期卒中风险。这表示医生应该真正认识到他们降低高血压患者卒中风险的可能性，特别是通过良好控制血压和控制相关风险因素。

International Circulation: So it was just really just an awareness issue?
《国际循环》：所以“意识到”就是非常重要的？

Professor Volpe: Yes， they just calculated with a calculation tool based on the Framingham a