International Circulation:  Do you think that hypertension is a novel regulator of adaptive immunity in atherosclerosis and why? 
Prof. Harrison:  Yes I do.  Our evidence suggests that T cells are activated in response to a variety of hypertensive stimuli and while we do not have evidence that this is applicable to atherosclerotic models， there is no reason why it would not be.  Indeed if people have created hypertension in atherosclerotic animals or animals with high cholesterol， the severity of atherosclerosis is remarkably increased.  So I would believe that this adaptive immune response is probably augmented dramatically in the atherosclerotic setting.

《国际循环》：您是否认为高血压是动脉粥样硬化中的一种新型适应性免疫调节因子？为什么？
Prof. Harrison: 我认为是。我们的证据表明，T细胞活化以适应各种高血压的刺激，虽然我们没有证据表明这适用于动脉粥样硬化模型，但没有理由不是。实际上，如果能在动脉粥样硬化动物或高胆固醇动物中制造高血压，动脉粥样硬化的严重度将会显著增加。因此，我相信这种适应性免疫反应可能在动脉粥样硬化环境下显著增加。

International Circulation:  How does hypertension affect atherosclerotic plaque phenotype?
Prof. Harrison:  Well most of this is epidemiological though there are some experimental studies but it is well known that hypertension is a major risk factor for atherosclerosis. They are both direct effects in terms of the shear forces， the mechanical forces that predispose one to rupture and plaques.  And then it is very likely that stimuli like angiotensin or high salt perhaps catecholamines， could effect activation of inflammatory cells but then take up residence in the atherosclerotic plaque and promote the atherosclerotic process. 

《国际循环》：高血压如何影响动脉粥样硬化斑块的表型？
Prof. Harrison：最多的是流行病学研究，虽然也有一些实验研究。众所周知高血压是动脉粥样硬化的一种主要危险因素。高血压通过剪切力和机械力两者的直接作用，可使动脉粥样硬化病变容易破裂和形成斑块。随后，血管紧张素、高盐或者儿茶酚胺等刺激很可能导致炎症细胞活化，并停留在动脉粥样硬化斑块内，促进动脉粥样硬化进展。

International Circulation:  Do you agree with hypertension as a low grade systemic inflammatory condition?
Prof. Harrison:  Yes I do， I think that hypertension causes T cell activation and it causes the accumulation of macrophages in various tissues including the kidney and the vessels.  It can lead to an inflammatory response in those tissues.
《国际循环》：您是否赞同高血压是一种低度全身性炎症状态？
Prof. Harrison：我赞同。我想高血压能够引起T细胞活化，并且使巨噬细胞聚集在肾脏、血管等组织内。这些组织中，高血压会引起一种炎症反应。

International Circulation:  Keeping with the inflammatory response theme here， what is your opinion as to the relationship between hypertension and inflammation? 
Prof. Harrison:  Our data and a lot of other data suggests that hypertension is an inflammatory disease and it promotes inflammation and as I pointed out in my presentation today I think that low levels of inflammation promote hypertension so that it can be kind of a vicious circle.

《国际循环》：继续炎症反应的话题，您如何看待高血压与炎症的关系？
Prof. Harrison：我们的数据和许多其他资料表明，高血压是一种炎症性疾病，其能促进炎症，正如我今天发言中所提，我想低水平的炎症可以促进高血压，以至于形成一种恶性循环。

International Circulation:  Is there any one thing a person can do to reduce the inflammation?
Prof. Harrison:  Well lifestyle is probably going to be very effective， weight loss， exercise， proper diet; the DASH diet for example is very effective in lowering blood pressure.  The mechanisms that are not entirely clear but the DASH diet contains lots of polyphenols which are anti-inflammatory and perhaps play an important role.  We do not have specific anti-inflammatory therapies that are approved or that would be easy to use in the long term with hypertension.  I have often thought that it would be possible in people with malignant hypertension or people with hard to control hypertension.  It might be reasonable to try to treat them， at least begin a study in which we would try to treat them with some potent anti-inflammatory agents like mycophenolate mofetil or perhaps drugs that modify the co-receptors activation like abatacept， the trade names is Orencia and we could use those for short term and that might help bring blood pressure under control and stop some of the untoward effects of acute inflammation.  We learn in medical school about malignant hypertensions associated with an arteritis and glomerulonephritis and cerebritis and myocardial damage and we fail to understand that these are almost like a vasculitis or an immune response and it could very well be that this is very much like you might see in giant cell arteritis or other systemic lupus erythematosus some of these other more classic autoimmune diseases. 

《国际循环》：有无办法减少炎症？
Prof. Harrison：良好的生活方式或许非常有效，如减轻体重、锻炼、适当饮食；例如DASH饮食在降血压方面非常有效，其机制尚未完全清楚，但DASH饮食中含有大量多酚类，具有抗炎作用，或许起着重要作用。目前尚无经批准的或易于长期使用的高血压特定抗炎治疗。我常想，对于恶性高血压或高血压难以控制的患者而言，这种治疗可以接受。尝试进行治疗可能合理，至少应开始一项研究，试用某些特效抗炎药如吗替麦考酚酯、或者调解协同信号激活的药物如阿巴他塞（商品名为Orencia），短期的治疗可能有助于控制血压、阻止某些急性炎症的不良反应。在医学院中，我们已知道恶性高血压与动脉炎、肾小球肾炎、大脑炎和心肌损伤有关，但不知道其很可能是一种血管炎或者是一种免疫反应，并且非常接近于我们在巨细胞动脉炎或其他像系统性红斑狼疮那样经典的自身免疫性疾病所见的改变。

International Circulation:  What is your advice for the use of markers of inflammation to assess the severity of hypertension?
Prof. Harrison:  Right now I think that this is not something that is commonly employed.  I think that markers like CRP (c-reactive protein) markers like IL 6 (interleukin) other cytokine markers are good experimental tools and there are things that can be studied.  But currently we do not use these in the setting of hypertension very often.  I think there are better ways to assess these.  Now as we begin to understand more about the hypertensive milieu which can include an elevated blood pressure it can include atherosclerosis and other risk factors， it might very well be that we will learn that some of these markers of inflammation are important.  One of the things we are studying at our own institute is levels of activated T cells in humans.  You can measure level of T cells that bear surface markers like CCR 5 and CD 44， and CD 44 high cells.  Those cells are activated T cells.  We are trying to understand if they correlate with bad outcome， worsened endothelial function， and other markers of inflammation.  That would give us a little bit more specific insight as to what kind of inflammation is going on in these patients. 

《国际循环》：您对使用炎症标志物评估高血压严重程度有何建议？
Prof. Harrison：我想现在这并不常用。我认为，CRP、IL6或其他细胞因子标志物都是很好的实验室指标，还有许多事情可以研究。但是，目前我们对高血压很少使用这些指标。我想最好能够进行评估。现在随着我们对高血压背景有了更多理解，包括血压升高、动脉粥样硬化和其他危险因素，很有可能知道哪些炎性标记非常重要。我们研究所正在