<International Circulation>: Contemporary public health emphasizes a community-based approach to health promotion and disease prevention. What can be done to improve a community-based approach to health promotion and cardiovascular disease prevention?

《国际循环》：当前公共卫生领域很重视社区健康促进和疾病预防。我们应如何改进社区健康促进和疾病预防的手段？

　　Dr Ferdinand: The reason why we look at public health approaches from the community base is because if you are going to change chronic diseases， prevention and early treatment is most important.  But treatment I do not mean drug therapy.  Early treatment can mean lifestyle modification， for instance， let’s consider hypertension: that is a field in which I have done a lot of clinical research.  The Institute of Medicine in the United States suggests that hypertension is a ‘neglected disease’; that is a term that comes from infectious disease medicine.  It is for certain that if an infectious disease has a vector， usually related to human waste， and if it is easily identified and removed， the disease would be corrected. Well， hypertension is easy to identify， the main vectors of hypertension are sedentary lifestyle which is inactivity， high salt intake， and obesity， and if those vectors are removed the disease could be corrected.  But once a person develops hypertension or high blood pressure， then often they do require drug therapy， but that is a whole different topic of conversation. The burden of hypertension really can be prevented by environmental changes related to salt or sodium in prepared food and processed food， and tackling physical inactivity and increasing obesity.

Ferdinand博士：我们从社区的角度审视公共卫生方法的原因在于改变慢性疾病流行状况还是要靠预防和早期治疗。治疗并不一定是药物治疗，改变生活方式就是早期治疗很有效的手段。比如说高血压，这个词其实来源于传染病，如果传染病有带菌者的话，这种疾病的传播通常和人类的排泄物有关，识别并消除了病菌，疾病也就得到了治疗。高血压恰恰很容易识别，主要带菌者就是那些不经常运动、高盐饮食和肥胖的人，如果纠正了上述因素，高血压状态也就消失了。美国的医疗机构忽视了这一点。现在的情况是，人们一旦患上高血压，往往要求药物治疗。高血压的疾病负担真的是可以通过环境的改变得到改善的，比如说降低方便食品和加工食品中的含盐量、增加运动量和减肥。

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