International Circulation:  What do you think the most economical approach is in hypertension management?
Prof. Thier:  I think a very good screening program so that you have everybody who is entitled to healthcare – and I think that is the whole population， at least screened on some regular basis.  You do not need to use doctor’s offices to do this， it can be done in lots of settings but I do think that identifying the people with hypertension， that is the awareness piece and treating effectively when necessary. 

《国际循环》： 您认为管理高血压最经济的方法是什么？
Prof. Thier： 我想是一种非常好的筛查程序，能够使健康护理人员对整个人群进行筛查、至少定期进行。不必在医生诊室进行，可以在许多地方开展；但我认为应知道识别高血压患者，并且一旦需要给予有效治疗。

International Circulation:  Almost no one with elevated blood pressure is free of other health problems. According to ACC 2009， polypill could significant cut risk of heart disease and stroke. Do you think this fixed dose combination therapy should be recommended in patients with hypertension?
Prof. Thier:  To be fair I am always nervous about fixed dose.  You can do this as well with two pills and you can titrate one versus the other rather than being fixed into one level of dosing.  I have never been a big fan of combination pills.

《国际循环》： 几乎所有高血压患者同时存在其他健康问题。根据ACC2009会议，polypill能够显著减少心脏病及中风风险，您是否认为这种固定剂量的复合制剂应推荐用于高血压患者？
Prof. Thier： 公平而言，我对固定制剂并不感兴趣。您可以使用2种药物进行治疗，并且能对1种药物相对另一种进行剂量滴定，而不是将两者固定成一种水平的剂量。我从而都不是复合型药品的支持者。

International Circulation:  Your approach would be otherwise?
Prof. Thier:  I would certainly treat the different problems.  If you have hypertension and you have hypercholesterolemia， treat them both.

《国际循环》： 在其他方面，您将会怎样处理？
Prof. Thier： 我宁愿治疗不同的疾病。如果您有高血压并且还有高胆固醇血症，我会同时治疗两者。

International Circulation:  Do you think that hypertension should be regarded as a global cardiovascular risk factor? 
Prof. Thier:  I do not know enough to answer that.  Does it have the same complication rate in China as in the US?  I do not know.  Once you have a certain level if they find that it has the same in terms of potential for stroke and heart disease then I would say yes but that population you are now talking about is a global issue but I do not know the facts on that.

《国际循环》：  您是否认为高血压应看作一个全球性的心血管危险因素？
Prof. Thier： 我不能确切地回答这个问题。美国和中国是否具有相同的并发症发生率？我不知道。一旦发现高血压达到某种程度，发生卒中和心脏病的可能性是相同的，因此我可以说是的。但是您现在谈到的是一个人群的整体话题，我不知道答案是什么。

International Circulation:  Should the major aim of antihypertensive therapy be the significant cardiovascular benefit?
Prof. Thier:  I think that control of hypertension has so many benefits.  By “cardiovascular” if you include stroke and if you include renal disease then sure but I think it is perfectly reasonable to see it as a major systemic disease which has multiple potential complications and I would treat it.

《国际循环》： 降压治疗的主要目标应该是显著心血管获益吗？
Prof. Thier： 我想控制高血压会有许多获益。对于“心血管”而言，如果包括中风和肾病，的确如此。但是我想将高血压看成一种全身性疾病更加合理，因为其具有多种可能的并发症，并且需要治疗。