<International Circulation>: Prof. Nilsson， could you please give a brief summary of the most important updates of the new guidelines?
　　Prof. Nilsson: I am the secretary of the European Society of Hypertension， and also one of the co-authors of the new guidelines. Please remember that these new guidelines are joint guidelines of the European Society of Hypertension and the European Society of Cardiology. We are very proud of the new guidelines， the first in six years. So the bottom line is that hypertension is really important and we should go for risk factor control in addressing all risk factors. First thing is to evaluate target organ damage and then to go for blood pressure goals. The position of our society is that it is very important to go below 140/90 mm Hg in most patients. For patients with diabetes type 2， less than 140/85 mm Hg， of course this is in newly detected patients， in younger patients you can go lower， for example around 130 or 135 mm Hg this is compatible below 140 mm Hg but in the elderly or fragile patients you should be cautious not to introduce any harm.  According to the drugs， we think that there are so many patients with hypertension， so there is a need for many different drugs to be used in monotherapy or in combination therapy. We do not exclude any kind of drugs because there are so many patients， so eventually some patients will need some drugs and other patients will need other drugs.  Of course we understand that there are different important mechanisms including the renin angiotensin system that should be addressed by treatment often in combination.

　　《国际循环》：Nilsson教授，请您简要总结一下新指南最重要的更新是什么？
　　Nilsson教授：我是ESH的秘书，也是新指南的合作撰写者。新指南是由欧洲高血压学会和欧洲心脏病学学会联合发布的。我们为自己所出台的新指南感到自豪。新指南认为高血压非常重要，我们应该关注并控制所有危险因素。首先要评估靶器官损害，然后设定降压目标。我们学会认为大多数患者应将血压控制在140/90 mm Hg以下。2型糖尿病患者的降压目标应小于140/85 mm Hg，新发糖尿病及年轻糖尿病患者可进一步将血压降得更低至130 mm Hg或135 mm Hg。而在老年及体弱患者中，则应审慎降压，关注其不良反应。就药物选择而言，我们认为高血压患者数量众多，需要多种不同的药物来进行单药或联合治疗。我们不排除任何一种药物，因为高血压患者太多，终究会有一些患者需应用某些药物，另一些患者需选择其他药物。当然我们也意识到联合治疗应选择能针对肾素-血管紧张素系统等不同重要机制的方案。

　　<International Circulation>: Prof. Zhang， we publish new guidelines in order to guide clinical practice better. What impacts do you think the new guideline will have on the daily clinical practice?

　　Prof. Zhang: It is very impressive for the new guidelines in several aspects that I think that one impression is cardiovascular risk assessment and stratification， there have been some changes. Not only the office blood pressure but also the point of official blood pressure included CV risk assessment， so that is very important. Hypertension can be routinely treated by drugs that have never been mentioned before in the 2007 guidelines so that is a new idea. Of course the evidence is excellent， on the evidence level and intensity you see， so I think this should do some clinical trial to confirm that masked hypertension should be treated for some benefit. Second， I think that as Dr. Nilsson has said， the preferred combination should be main therapeutic in the patient because 70% of the hypertention is a high risk or very high risk， so that is very important to the idea because the initial preferred combinations can rapidly achieve blood pressure targets and of course reduce the cardiovascular events. So combination may be in the most hypertensive in initial treatment.

　　Prof. Nilsson: If I may comment， especially in patients with diabetes， we see this masked hypertension during nighttime for example because there is no eating， there is sleep apnea， and some people think that it would be good to prescribe antihypertensive drugs also in the evening. What is your opinion?

　　Prof. Zhang: I noticed that in the new guideline， morning hypetension or the morning surge and isolated the nocturnal blood pressure elevation and did not included， but I think that should belong to the masked hypertension.

　　Prof. Nilsson: I agree with you.

　　《国际循环》：张教授，指南的公布是为了更好地指导临床实践，您认为新指南将对临床实践产生怎样的影响？

　　张教授：新指南在几个方面的更新令人印象深刻。我印象最深的几点第一是心血管风险评估及分层方面的改变。新指南强调，进行心血管风险评估时不仅需要应用诊室血压，还需要关注非诊室血压。这一点非常重要。此外，新指南认为高血压常规治疗时可选用2007版指南未提及的药物，这是一种新的理念。当然这些都是有大量水平及力度均较强的证据支持的。此外，我认为还需要进行一些临床试验来证实治疗隐匿性高血压的获益。第二我认为就像Nilsson教授所说的，联合治疗是首选的主要治疗方法，因为70%的高血压患者是高危或极高危患者，而起始联合治疗能够实现快速降压达标，并降低心血管事件。因此，大多数高血压患者起始治疗时应选用联合治疗。

　　Nilsson教授：如果让我评论的话，我认为患者尤其是糖尿病患者常因夜间不进食或睡眠呼吸暂停，隐匿性高血压更易发生于夜间。有人认为对患者处方高血压药物，让其夜间应用。您对此有何意见？

　　张教授：我注意到新指南提到了清晨高血压、晨峰血压以及单独的夜间血压增高，但并未将其归入隐匿性高血压之中。我认为这些都属于隐匿性高血压。

　　Nilsson教授：我同意您的观点。