Michael O’Rourke教授   澳大利亚圣文森医院

　　<International Circulation>:  Which has a greater predictive value for hypertension and cardiovascular risk， central aortic pressure or arterial stiffness indexes?

　　Dr. O’Rourke:  At the moment， the atrial stiffness indexes would have the best predictive value， particularly pulse wave velocity carotid- femoralbut other indices and central pressure， pulse pressure， and indices of reflection also， now， are showing predictive value as well.

　　《国际循环》：中心动脉压与动脉僵硬度指标何者对高血压及心血管风险的预测价值更大？

　　O’Rourke博士：目前，动脉僵硬度指标的预测价值最好，尤其是颈动脉-股动脉脉搏波速度。但是其他指标如中心动脉压、脉压及反射指数也具有较好的预测价值。

　　<International Circulation>: What are the current situation and future research directions about the relationship between central aortic pressure， arterial stiffness and cardiovascular risk?

　　Dr. O’Rourke:  The research directions are aimed at seeking a better research connection between central aortic pressure， arterial stiffness and cardiovascular risk that is incremental to the pressure inflammation that we get from thecathe-sphygmomanometer. There is good reason to believe that with appropriate measures of indices of central pressure that we can get more accurate information with fewer patients in research studies and also it is pointing in the direction of giving small information of the effects on the heart and the effects on the cerebral vessels.  The cerebral vessels being particularly important because its vessel damage to the small blood vessels which result from arterial stiffening with age， which are probably responsible for the epidemic of dementia which we have now and also for the complication which follow head injury and stroke and even neurosurgical operations and this is of great and increasing interest in this and other studies being undertaken at the moment.

　　《国际循环》：目前有关中心动脉压及动脉僵硬度与心血管风险的研究现状如何，其未来的研究方向何在？

　　O’Rourke博士：其研究方向主要是旨在寻求能更好地研究中心动脉压、动脉僵硬度及心血管风险的方法。我们有很好的理由相信通过采取适宜的措施测量中心动脉压可以在科学研究中用更少的患者获得更精确的信息，并能为研究对心脏及脑血管的效应提供信息。脑血管是特别重要的，因为随着年龄的增加动脉不断硬化，脑部小血管会受损，容易导致老年痴呆症的流行及头部受损、卒中甚至是神经外科手术并发生的发生。目前很多正在开展的研究都对在关注这些。

　　<International Circulation>:  The isolated systolic hypertension (ISH) in youth is mainly caused by amplification of the central pressure wave， which is different from elderly patients whose hypertension is usually contributed in aortic stiffening.  What are the differences between the treatments of the two groups?

　　Dr. O’Rourke:  For elderly people with isolated systolic hypertension there is definitely a benefit and an established mortality benefit for treating， but only in people over the age of 60 years is that information available.  Under the age of 60 years we do not have that information available but under the age of 40 years it certainly seems that systolic pressure is not related to cardio vascular events.  Diastolic pressure certainly is， but systolic pressure certainly is not and we have an explanation for this phenomenon which can separate between the mechanisms causing systolic pressure to be high in brachial artery in youth as compared to systolic pressure being high in the central pressures of older people and we can readily determine what people should have treatment by measuring central pressure.

　　《国际循环》：老年人单纯收缩期高血压（ISH）主要由动脉僵硬引起不同，年轻人的ISH多由中心动脉压增高所致。与老年人群相比，您认为年轻ISH患者的治疗有何不同之处？

　　O’Rourke博士：对老年单纯收缩期高血压而言，治疗能为其带来明确的获益，降低其死亡率，但这仅适用于60岁以上的老年人。在60岁以下的老年人中，我们未发现上述益处。在40岁以下的人群中收缩压则似乎与心血管事件并无相关性，与心血管事件相关的是舒张压。对此现象我们是这样解释的，导致年轻人与老年人肱动脉收缩压增高的机制不同，前者是由中心动脉压所致，后者是由动脉僵硬引起。所以通过测量中心动脉压，我们能够很容易地确定哪些人应该接受治疗。