《国际循环》： 高血压合并糖尿病患者控制血压的治疗策略还存在一些争议。在高血压合并糖尿病的患者中，有效降低心血管风险的适当策略有哪些？

    <International Circulation>:The treatment strategy for blood pressure control in hypertensive diabetes patients has been somewhat controversial. What is the appropriate strategy for tackling cardiovascular risk in patients with hypertension and diabetes?

    Williams教授：我认为高血压合并糖尿病数据的问题在于，我们只有一项称为ACCORD的研究，该研究提示治疗获得的非常低的血压水平在终点上并无益处。但这是一个单项研究。他们将血压降至非常低的水平。其他研究均已提示血压降得越低越好，但可能不应低至120/80 mm Hg。首先我们应该做的是将血压降至低于140/90 mm Hg，然后再较年轻的患者中，如果他们能够耐受，我会尝试把血压降得更低，因为证实血压在糖尿病心血管和微血管并发症中起如此重要作用的证据是压倒性的。

    Prof.  Williams：I think the problem with the data with hypertension and diabetes is we have just one study called ACCORD which suggested that very low level of blood pressure on treatments were not beneficial in terms of outcome. But that’s a single study. They took the blood pressure to a very low level. And I think the other studies have all suggested that the lower the blood pressure the better， but maybe not as low as 120/80. What we should be doing is to get the blood pressure below 140/90 in the first instance， and then in younger patients， if they will tolerate it， I would try and get the blood pressure even lower; because the evidence is overwhelming that blood pressure plays such an important role in the cardiovascular and microvascular complications of diabetes.

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