International Circulation: What are the differences in the cardio-cerebrovascular disease epidemiology between Asian and Western countries?

    《国际循环》：亚洲的心血管病流行病学与欧美有何差异？这些差异对于降压药物的选择有什么临床指导意义？

    Dr. Kario: There are marked differences in the demographics of cardiovascular disease. Stroke occurs much more frequently in Asia compared to Western countries because we have a salt sensitivity compared to Caucasians. When we have a high salt intake， blood pressure increases and that is a predisposing condition for stroke. The relationship between stroke and blood pressure is stronger than that with coronary artery disease， so it is one of the major problems. I would also like to stress the importance of the blood pressure lowering effect of the calcium antagonists compared to the renin-angiotensin system inhibitors. High salt intake will reduce the renin-angiotensin system， so in the Asian situation， the blood pressure lowering is limited， but the calcium antagonists and particularly amlodipine， have strong blood pressure lowering ability over a 20 hour period because of its long half life. Stroke-prone people need the calcium antagonists

    Kario教授：亚洲和西方的心血管疾病流行病学有很大差异。与西方国家相比，亚洲的卒中发生率更高，因为我们的盐敏感度高于白种人。当盐摄入量高时，血压随之升高，这是卒中的诱发条件。卒中和血压的相关性强于冠心病和血压的相关性。同时，我还想强调CCB与RAS抑制剂相比，其降压疗效的重要性。高盐将抑制RAS系统，因此，在亚洲人群中RAS抑制剂的降压疗效是有限的。但是CCB，尤其是氨氯地平，凭借其长半衰期，可以强效降压达20小时以上。因此，卒中高发人群需要CCB。