International Circulation:Can you share with us your opinion about the role of prevention of cardiovascular disease， the role of cardiovascular diseas risk extimation in the prevention of cardiovascular disease， and the status in cardiovascular prevention?
    《国际循环》：您能就心血管疾病预防的作用、在心血管疾病预防中心血管疾病风险评估的作用以及心血管疾病预防现状谈谈您的看法吗？

    Dr Philip Greenland: Well，I think the first question of the role of prevention of cardiovascular disease is kind of a major emphasis of cardiology today， and we know so much about the risk factors and the treatment oppertunity. In terms of status unfortunately we are still finding evidence that in many countries the identification of risk factors is still sub-standard and the treatment intensity of risk factors is still sub-standard.   This session spends a lot of time obviously talking about methods of identify risk. One of the things I find at this point in our research as mentioned in my summay is that even though we are able to improve risk estimation and we have some methods which can substantially improve and properly certify people， the problem is that we still end up with a fairly large proportion of the events in people who are predicted to be low risk. If we are really committed to a strategy of high risk prevention which is the drug based approach that means inevitably that all those people who are predicted to be low risk are not going to get much treatment. At the same time when we are doing this risk assessment in clinical practice， we have to be very aware that what we really want to do is also move the entire risk in the population down. That would probably most appropriately be done by broad population based risk and lifestyle interventions even the risk is lower.

    Philip Greenland教授：我认为，第一个问题有关心血管疾病预防的作用是当今心脏病学的一个主要重点。我们对危险因素和治疗时机了解颇多。而谈及预防性努力的情况，不幸的是，我们还在寻找证据，在很多国家中危险因素的定义仍然不合标准，且对危险因素治疗的强度也不合标准。本次会议显然花费了大量时间来讨论识别风险的方法。如同我在本次AHA会议结束时的总结中所提到的那样，在这一点上我在我们研究中的一个发现是，即使我们能够改进风险评估，我们有一些能实质性改善且正确识别人群的方法，问题是在那些被预测为低风险的人群中最终仍然有相当大比例的事件发生。如果我们真的致力于基于药物方法的高风险预防策略，就意味着所有那些被预测为低风险的人群将必然不会得到很多治疗。同时，当我们在临床实践中进行这种风险评估时，我们必须非常清楚，我们真正想要做的还是降低人群的整体风险。这很可能是最恰当的要做的事情，通过基于广泛人群的危险因素和生活方式干预来确保人群整体风险较低。