International circulation:This has been an question as far as I believe Professor Cleveland brought it up. You know， the dosage with ARBs， this category of drugs that we give to many patients， personally have you felt that is a question that was kind of unanswered. Does it really help to answer questions for you?

     《国际循环》：我想是Cleveland教授提出了一个一直存在的关于ARBs 的剂量问题。该种类的药物我们一直给很多病人服用。我个人感觉这个问题没有完全解决。您认为对您而言这真的有助于回答该问题吗? 

    Anker: It is a question that still remains to be answered. Maybe to some degree for Beta blockers is more important than for ARBs. We have good evidence from several different trials that giving ARBs in the context of ACEI intolerant patients is useful. We also have the charm edit study   some indications that giving ARBs on top of ACE inhibitor is useful. And of course there is also that the Valhaft trial that promotes some of that concept. What we have a problem with of course is that in this heal trial there is no placebo group， which makes the overall interpretation a little bit more difficult..

    Anker教授：这是一个仍待解决的问题。或许在某种程度上β受体阻断剂比ARBs 更重要。我们有多个不同试验的的证据表明对于ACE抑制剂不耐受的患者，服用ARBs有用。我们还有研究表明在ACE抑制剂基础上联合服用ARBs也有效 。当然还有促进该概念的Val-Heft试验。当然在HEAAL试验中我们还有一个问题，那就是我们没有安慰剂组，这使得整个试验的解读有些困难。
 

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