<International Circulation>: Would you say， the periodicity of medication also kind of complicates and makes compliance a little harder?

　　Prof. Mancia: Yes， this is one factor which is recognized to be involved in compliance. Treatment simplification， in a number of studies， has been shown to be associated with better rates of compliance. We’ve known this a long time， and is of course the reason why a fixed dose of single tablet combination has always been given a favorable reception by guidelines， including the European guidelines， including the latest 2013 guidelines， which mention specifically that single tablet combination can favor adherence to treatment.

　　Of course， there are some disadvantages to single tablet combinations， the most important of which is reduced flexibility during the titration phase， because maybe physicians want to increase the dose of one drug only， and they have to increase both. But， nowadays， it is less of a disadvantage than before， because fixed dose combinations have several doses of combination compliance. So， one can switch to another one. So I don’t think this is a real， fundamental disadvantage， and of course， simplification of treatment remains an advantage.

　　《国际循环》：您是否认为复杂的服药周期也是导致依从性差的原因？

　　Mancia教授：是的，复杂的服药周期确实会影响依从性。很多研究显示，简化治疗方案能提高依从性。我们很早就意识到这一点，正因如此，包括最新欧洲指南在内的多个指南都肯定了固定剂量单片复方制剂在高血压治疗中的重要性，并强调单片复方制剂有助于改善治疗的依从性。当然，单片复方制剂也存在一些不足，其中最重要的就是降低了剂量滴定阶段的灵活性，因为有时候医生可能只想增加复方制剂中某一种药物，但却不得不两种药物剂量都增加。但是，与以前相比，其不足之处明显减少，因为固定剂量复方制剂有了多种剂量的组合搭配剂型。这样在需调整剂量时，就可直接由一种剂型换用另一种剂型。所以，我认为一方面剂量调整的灵活性问题并不是复方制剂的缺点，另一方面复方制剂拥有简化治疗的巨大优势。

　　<International Circulation>: What do you think of the superiority of Valsartin Almodipine SPC in the treatment of hypertension?

　　Prof. Mancia: I wouldn’t talk about superiority -- I think it’s an effective combination， because it has clear cut evidence that it can reduce， very effectively， an elevated blood pressure， and can be particularly effective if blood pressure is very high. In this case， it has shown the ability to even reduce blood pressure by 40 mm Hg systolic or even more. So it is， by no question， an effective combination， and the combination of angiotensin receptor antagonists and calcium channel blockers is among the highest prioritized combinations in the guidelines.

　　《国际循环》：您认为缬沙坦-氨氯地平单片复方制剂（SPC）治疗高血压的优势有哪些？

　　Mancia教授：我不想谈论优势。我认为，它是一种有效的联合治疗方案，因为有明确证据证实其能有效降低血压，尤其在血压非常高的情况下疗效非常显着，能使收缩压降低40 mm Hg或甚至更多。正因如此，毫无疑问，缬沙坦-氨氯地平SPC是ARB与钙离子拮抗剂联用的一种非常有效的组合方案，被指南列为最高的优先推荐应用等级。

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