<International Circulation>: There is a large difference between the control rates in different countries. For instance， the control rate in Canada is quite high compared to the control rate in China. What can ISH do to improve the control rate in some of these other countries?

  《国际循环》：是的，当发现各国的心血管疾病控制率存在很大的差异时，我很惊讶。正如有人提到，希望这些将成为过去。相比于我们杂志报道的一些国家，如中国的控制率，西方国家的控制率是非常高的。那么，您认为ISH将如何进一步改善这些发展中国家的心血管疾病控制率？

    Prof. Heagerty: It is an interesting problem. Firstly， we must identify all of the patients and people are getting better at doing that. We now know that between 30~40% of adults in most countries are going to have hypertension. Then， we must make patients aware that there is a problem and we can do something about it and then we have to treat them properly and we have to then re-measure the blood pressure and be sure that it goes down. Various countries are at different stages in their detection， awareness， and treatment programs. Canada has had a wonderful screening program and an awareness program over the last ten years. As you rightly pointed out， the prevalence of hypertension in Canada remains about 1 in 5 adults but the treatment levels are above 2/3， which is outstanding. Other countries have different health care systems， do not have such good awareness programs， and do not have such stringent checks on management. Until the last few years， the U.K. for example， had very poor adequate treatment levels but that has risen quite dramatically as a result of primary care centers receiving some of their salary as a result of their performance in primary care prevention programs. So we have a number of issues. We must start programs in developing countries where we actually measure blood pressure. To a certain extent， we must do that in order to find out how many people have the disease. Then， we have the problem of how to treat it because drugs cost a lot of money. Therefore， our society is working hard to try to influence health care budget levels with various ministries and WHO agencies， we want to improve detection rates， and we want to ensure these people are properly and adequately managed. We can have a two-pronged attack. We can have a zero money option because if we can influence dietary changes and reduce the sodium content of peoples’ diets then their blood pressure will fall and that is something we can do without any drugs. There are also some extremely cheap drugs and if we can persuade health care systems to purchase them， many patients will be properly treated. As a result， we are working hard with the WHO and through the WHO to government policy makers on health to try to influence this agenda. 

    Heagerty 教授：这个观点非常有意思，也是个有趣的问题。首先，我们必须确定高血压患者，然后给予治疗，患者的病征得到好转。此外，我们发现在许多国家，约有30-40%的成年人将成高血压患者。
我们必须让患者意识到疾病的存在，并且我们可以治疗它。然后给予患者适当的治疗，重新测量血压以确定血压下降。各个国家高血压的检测，防治意识和治疗计划均处在不同阶段。
    
    在过去的10年工作基础上，加拿大已经有一套完善的高血压筛查和预防宣传程序。而且，正如你所说的，加拿大的高血压患病率仍旧为1/5个成年人，但其治疗水平超过了三分之二，也就是说，有2/3的患者获得了妥善的治疗。
    
    其它国家的卫生保健系统不尽相同，他们并没有这么好的防治宣传方案，所以他们未能对防治工作进行严格审查。有些国家，如英国，直到几年前，他们的高血压防治水平非常的差，但随着初级保健中心的工作人员因其在初级保健预防程序的工作而获得一定薪水后，防治水平获得极其惊人的提高。
    
    因此，我们有一堆事务要处理。一，我们必须在发展中国家开展上述工作，落实人们血压的测量。从某种程度上，我们也可以观察有多少人患有高血压。然后，我们将面临着如何进行治疗的问题，因为得花费不少药费。因此，ISH协会正努力和各部委机构及WHO部门协商试着提高医疗保健的预算水平。然后，我们想尝试着提高高血压的检测率，并确保患者得到妥善的治疗。

        我们有一个双管齐下的解决方案。 我们可以在金钱上采取零点方案，如果能真正改变人们的饮食习惯和减少饮食中的钠摄入量，他们的血压就会下降。而且未服用任何药物。此外，若我们能说服医疗保健系统购买一些非常廉价的药物，许多患者将得到妥善的治疗。我们正努力和WHO一起，通过WHO劝说政府机构通过这一方案。