<International Circulation>: Prof. Liu， what is your opinion on that？ How would you adjust clinical practices corresponding to the changes for the case of China?
Prof. Liu: I think first because the ACE inhibitor in?the?market earlier has more evidence. In recent years many trials have been working on ARBs so I think now there is evidence of ARBs， I think for different subclinical target organ damage including left ventricle high blood pressure and later atrial fibrillation and also congestive heart failure from ARB use.  For the new situation， microalbuminuria and renal dysfunction and later even worse. My personal recommendation is to avoid clinical aspects metabolic syndrome. For combinations like ARB and CCB， if you add two together especially for a cardiologist or others， they might not， so in our guidelines， there is some help with ACE inhibitors. In our population including one ACE inhibitor and another being a diuretic being a very good medical choice， however in China we are facing the need to get approval from the specialists as well as the policy makers to get those combinations in the Chinese guidelines.

 　　《国际循环》：刘教授，您的观点是什么？您会如何根据新的情况变化来调整中国的临床实践？
刘力生教授：ACEI上市更早，因此证据更多。近年来有很多关于ARB的试验，所以我认为目前ARB也有了证据。ARB能够预防不同的亚临床靶器官损伤，例如左心室高压和随后发生的心房颤动以及心力衰竭；微量蛋白尿、肾功能不全以及更坏的情况；以及代谢综合征、糖尿病。关于ARB和CCB的联合用药，一些医生并不会这样使用，因此在我们的指南中认为ACEI和利尿剂是非常好的选择。在中国，我们还需要得到专家和政策制订者的批准，在中国指南中推荐这些联合用药方案。

<International Circulation>: There have been several clinical trials on ARBs that have demonstrated its efficacy. The vast majority of hypertension patients with complications have shown improvements with long lasting steady pressure lowering and a few side effects. Professor Redon， how would you evaluate the use of ARBs in this drug class in patients with high blood pressure taking into considering any complications?
Prof. Redon: Well as the EU recommends， of course the ARBs are not able to use widespread in patients with hypertension.  In my country， in particular， approximately 45% of the antihypertensive drugs used are ARBs， then it is probably very widely use and all the things because initially one of the risks to try to avoid was the price was very high. But now the same prices for generics than for the brand names， so ARBs are excellent to use. You can use them but especially in those situations that Professor Liu had recommended; patients with hypertension， patients with renal dysfunction， patients with diabetes or even metabolic syndrome， or patients that take benefits to look at other sources of drugs. This has very good tolerance and this is why the ARBs are still on the market as one of the leading groups of antihypertensive drugs.

 　　《国际循环》：有几个关于ARB的临床试验证实了其有效性，可以使大部分有并发症的高血压患者获得持续稳定的血压降低，且不良反应较少。Redon教授，您如何评价ARB在高血压并发症患者中的使用？
Redon教授：正如刘教授所推荐的，ARB可以在高血压患者中广泛应用。在我们国家，大约45%的高血压药物为ARB，使用非常广泛。ARB的价格比较贵，但是目前有了更加便宜的仿制药。因此ARB是非常好的药物。尤其是刘教授推荐的这些情况更适合使用ARB：高血压患者、肾功能不全患者、糖尿病或代谢综合征患者。ARB的耐受性良好，因此是目前领先的降压药之一。

<International Circulation>: Dr. Liu， would you like to comment on valsartan of the ARBs or any of these new treatments?
Prof. Liu:  At least for myself， I use ARBs to manage these patients usually with the cough so lots of people are afraid of intolerance but it is much safer. We are using that， that is a very important thing and I think because right now the price of ARB is still not comparable to ACE inhibitor， so it is not very popular， but later maybe we can use that.

 　　《国际循环》：刘教授，您能介绍缬沙坦以及ARB类药物的新适应证吗？
刘力生教授：至少对于我来说，我会使用ARB治疗ACEI咳嗽及担心不耐受的患者。我认为目前的重要问题是ARB的价格仍然高于ACEI，因此使用率还不够高，但是将来可能能够提高。