<International Circulation>:Beta-blockers and ARBs are among the drug classes used to treat hypertension. You were involved in a paper where you compared the effects of losartan and atenolol on lipids. What did that study reveal to you and what are the implications in clinical practice?

  《国际循环》：β受体阻滞剂和ARB类药物是常用的2类降压药。您在一篇文章中比较了氯沙坦和阿替洛尔对脂质的影响。研究发现了什么？对临床实践有何意义？

    Prof.Olsen: One has to remember that it was a post hoc analysis. We were a bit surprised because we found that the patients treated with losartan had a better lipid profile than the patients treated with atenolol. It wasn’t clear which mechanism was involved but one possible mechanism was that if you get atenolol for your hypertension then you do not exercise as much because it reduces your heart rate. Some of the people receiving atenolol experienced weakness and tiredness as a side effect. That could be a reason but we did not actually see a change in BMI so it was uncertain as to whether that was a mechanism. We speculated whether losartan in fact could directly influence HDL and changes in HDL but， again， we don’t know the mechanism. As it is important to maintain a high HDL， it was interesting to see that these changes in HDL did actually also have an impact on outcome in the live study so some of the beneficial effect of getting losartan could actually be explained by the changes in HDL but we don’t know the mechanism.

    Olsen教授：必须记住那是一项回顾性分析。我们有些惊奇，因为我们发现服用氯沙坦的患者血脂情况优于服用阿替洛尔的患者。尚不清楚涉及什么机制，很可能的原因是如果服用阿替洛尔降压，你运动比以前少了，因为它降低心率。有些服用阿替洛尔的患者有虚弱和倦怠的副作用。那可能是一个原因，因为我们并没有发现BMI的变化，所以尚不确定那是否是造成该结果的一个原因。我们推测氯沙坦是否直接影响HDL水平但是同样造成HDL水平变化的发生机制我们尚不清楚。因为保持高水平的HDL非常重要，而很有趣的现象是 HDL的这些变化确实对研究结果有影响，所以应用氯沙坦带来的益处可以由HDL水平的变化来解释，但我们不清楚机制。