International Circulation: Professor Kanstam， you just said that we really don’t have that comparison answered but do the results of HEAAL help you to know where to start if you were going to compare it to an ACE inhibitor since we know the optimal dose of Losartan? Could we now have a fairer comparison perhaps?

    《国际循环》：Kanstam教授，根据HEAAL的结果，若要与ACE抑制剂对比应从哪里开始？既然已找到了氯沙坦的合理剂量，现在是否可以公平对比？

    Professor Kanstam:  A logical extension of what has been done and is known at this point， including HEAAL， would be to do a study comparing strategies of an ACE inhibitor versus an ARB or the two in combination. One point I would like to make is to relate these findings to the CHARM study that is a study I’m thinking about a lot in comparison to this. The CHARM study looked at a strategy of incremental renin-angiotensin inhibition but did it by adding an ARB to background therapy that included ACE inhibitors.  We looked at two doses which also provide incremental inhibition of the renin-angiotensin system. If you look at our effects compared to the effects of that strategy in CHARM they are not far apart and are in fact fairly similar.  I take home from that that there are different ways to achieve inhibition of the renin-angiotensin system but if you are going to use an ARB you really need to push it to the dose that has been demonstrated to have the best outcome effect.

    Kanstam教授：对于所做的和已知的包括HEAAL研究进行逻辑延伸，我们应进行一项对比ACE抑制剂和ARB，或两者联合策略的研究。需要强调的一点是，将这些研究与CHARM研究相结合就会发现，后者对此进行了更多的对比。CHARM研究探讨了肾素-血管紧张素抑制剂的递增策略，通过在背景治疗的基础上包括ARB增添了ACE抑制剂。两种剂量的肾素-血管紧张素系统抑制剂同样有递增抑制作用。如果将其效果与CHARM对比，就会发现他们不是独立的，实际上很相似。因此可以通过不同的方式抑制肾素-血管紧张素系统，但若要使用ARB，则需要调整至能产生最佳结果效应的剂量水平。

    Professor Huang: Many of the clinical trials show that ACE inhibitor and ARB are quite useful in treatment of patients with heart failure， especially with the target dosage. I don’t think we need another large scale clin