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[ESC2009]ACCOMPLISH的影响及单片复方制剂(SPC)在临床中的应用--Dahlof教授专访

作者:国际循环网   日期:2009/9/3 19:00:00

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ACCOMPLISH研究是第一个将固定剂量复合制剂(SPC)RAAS/CCB同RAAS/利尿剂用于高血压或高心血管事件风险的患者效果比较的试验,您认为这个研究是否会推动单片复方制剂(single-pill combination,SPC)在临床高血压治疗中的广泛应用呢?您认为ACCOMPLISH研究对JNC8及ESC/ESH高血压指南对于SPC的临床应用将会有何影响?

International Circulation:  The ACCOMPLISH study is the first study comparing the effect of a single pill combination (SPC) of a RAAS and CCB and RAAS and diuretic in patients with hypertension and high cardiovascular risk. Do you feel that the results encourage the general application of the SPC in antihypertensive therapy?

国际循环:ACCOMPLISH研究首次对比了RAAS与CCB、RAAS与利尿剂单药联合(SPC)疗法对高血压及心血管高危患者的疗效。您认为该结果是否有助于SPC在降压疗法中的普及?

Dahlof:  I think that they are very applicable for more general patient population because the high risk is one thing but the difference in outcome is another thing but I think that the most important message actually is that by using a single pill combination you can improve on blood pressure control in such a substantial way.  One third of the patients were controlled at the beginning of the study and at the end of the study where they were using fewer pills because one was a combination, three quarters were controlled in blood pressure.  We know that high risk patients are usually more difficult to control and in this population we have 60% diabetics and they are also known to be difficult to control so I think that this improvement in control is an underestimate of what would happen in a milder or less severe population so I definitely think these results are applicable for a more broader population.

Dahlof:我认为它可以推广到更多患者当中,高风险并不代表临床结局不好,重要的是单药联合疗法可以更好的控制血压。研究开始时,仅1/3的患者血压控制良好,联合疗法后患者使用的药物数量有所减少,3/4的患者血压控制良好。众所周知,高危患者的血压很难控制,其中60%合并糖尿病,而目前得出的这种改善程度还没有估算轻-中度患者的情况,因此我可以确信联合疗法可普及到更多患者身上。


International Circulation:  Perhaps with a severe population, often compliance can often be a real factor as well so the single pill might even improve compliance as an additional benefit.

国际循环:高度危险人群常并发其他疾病,这也是需要解决的危险因素,而单药更能改善并发病获得额外受益。

Dahlof:  I agree.

Dahlof:我同意。

 

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