<International Circulation>: What are some of the emerging areas in the treatment of hypertension as related to cardiovascular disease risk?

  《国际循环》：与心血管疾病风险有关的高血压治疗出现了哪些新领域？

    Prof. Jennings: Probably the biggest thing happening in hypertension at the moment is the fact that we have aging communities around the world and hypertension is inherently associated with aging. There are 50% more elderly hypertensive people in the past ten years than in the previous ten years and that is going to be a huge disease burden. It is the biggest modifiable risk factor for atherosclerosis， stroke， AF， and all of the things we associate with old age. The second major area is the question of appropriate targets. We have settled on some quite aggressive targets for diabetes and people with chronic kidney disease (CKD) and that probably warrants further testing. Thirdly， the big move in antihypertensive drug therapy in recent years has been towards combination therapy， particularly in a single preparation. We are now seeing 2 or 3 different drug classes in one tablet and that is to address the problem that we have faced around the world of very low success rates in achieving target levels for hypertension. In a more cutting edge area， we now have some treatments for resistant hypertension that we did not have before. At Baker IDI， we have been particularly associated with the development of renal denervation therapy， which seems to be enormously successful in people who have not responded to two or more drugs. There have been very few new drug classes developed in recent years but direct renin inhibitors are the main example of one new class that has hit the market.

    Jennings教授：此刻关于高血压治疗最重要的事情也许是，世界范围内的老龄化和与老年龄伴发的高血压。比起前一个10年，在过去的10年中，老年高血压患者增加了50%，这将成为一个巨大的疾病负担。高血压成为动脉粥样硬化、中风、房颤、以及与老年相关的所有问题的最大的危险因素。第二个主要领域是制定适当目标。我们已经对合并糖尿病及慢性肾脏病（CKD）的患者制定了目标，并可能需要进一步研究。第三，近几年抗高血压药物治疗的大动作是转向联合治疗，尤其是在单一制剂中。我们现在看到一粒药物中含有2或3种不同类别的降压药物，这是针对解决在世界范围内高血压治疗达标率低的问题。在一个更尖端的领域，我们现在有对于顽固性高血压的降压治疗，而从前我们没有。在Baker IDI，，有与肾神经相关的治疗进展，这看起来是一个巨大的成功，而并不是开发两个或更多药物。近几年除了直接肾素抑制剂这类药物，几乎没有新的降压药物投入市场。