AHA的主要任务是让人们构建更健康的生活方式,从而远离心血管疾病和脑卒中。对自己的健康负责,对每个人来说都很重要。我们要做的事情很多。80%的心血管疾病和脑卒中都是可以预防的。从我的观点来看,我们需要人们和患者能够明白,他们为自己的健康能做些什么事情,也需要医生明白使每个人设法保持个体身体的健康与对疾病的治疗同样重要。
International Circulation: Will genetics be a significant part of your time as president of the AHA?
《国际循环》:在您任AHA主席期间,会将基因检测作为治疗高血压的重要部分吗?
Prof. Arnett: I am a genetic epidemiologist and my research will continue in the area of genetic epidemiology, but I do believe in the intersection with the environment. When you think about 8000 generations of humans evolving in a low sodium, high physical activity environment to just four generations of this extremely sedentary environment and high sodium intake. It is easy to imagine why hypertension is affecting 1 billion people worldwide.
Arnett教授:我是一个遗传流行病学家,我的研究范围也将在遗传流行病学领域,但是我相信,会因为大环境的不同而有所交集。当你想到人类约 8000 代人在低钠,高体力活动环境中不断进化,来适应四代人极端久坐的环境和高钠摄入量所造成的后果。很容易想象,为什么高血压影响着世界上近10亿人口。
International Circulation: How much does genetics change approach to these disease. Yes, we can see other causes that we couldn’t see before, other ways in which we are maladapted, but the ways we have been treating hypertension involved having knowledge of the sympathetic nervous system monitoring sodium that have since become maladaptive. Does genetics represent a shift in the way we look at this?
《国际循环》:在方法上,遗传学将在多大程度上影响对这些疾病的治疗?我们可以看到之前我们不曾看到的许多其他的原因,在没有发现其他的治疗方法之前,我们无所适从,但我们的有些治疗高血压的方法,比如利用交感神经系统监控钠的有关知识治疗高血压,效果并不理想。遗传学会改变我们看待这个问题的方式吗?
Prof. Arnett: The hope of genetics research, from the work that I am doing, is that the new methodologies, like Genome Wide Association Studies (GWAS) and exome sequencing, are about agnostically identifying novel genes, which in turn to lead to identifying novel pathways and new forms of treatment.
Arnett教授:从我现在所做的事情,我看到遗传学研究的希望是新技术,如全基因组关联性研究(GWAS)和外显子组测序,都是在形变上识别异常基因,反过来去发现和认识治疗的新途径和新形式。
International Circulation: What do mean by agnostic?
《国际循环》:遗传学不可知是什么意思?
Prof. Arnett: In a GWAS, one is testing genes across the entire genome. You are asking a specific question about an ACE receptor or any other sympathetic pathways like renin or aldosterone. We know those are involved in hypertension. Instead, you are looking for genetic signals of statistical association across the genome that can point to a gene that may be relevant. Then you can do further testing to understand that affect.
Arnett教授:在全基因组关联性研究(GWAS)中,是要在一个是整个基因组中测试一个基因。你问一个关于ACE 受体或任何其他交感神经通路比如肾素或醛固酮的具体问题。我们知道那些都与高血压有关。相反,你正在寻找可以指向一个可能有关的基因的基因组遗传信号统计学关联度。然后你可以做进一步的测试,了解它的实际效果。
International Circulation: Much of your research is in looking for new pathways for treatment?
《国际循环》:你的研究大部分是在寻找新的治疗途径吗?
Prof. Arnett: My research also evaluates the treatments to see if there are pathways that respond to those treatments and identifies variants that could either be screening or pointing to new genes and targets.
Arnett教授:我的研究也是对这些治疗方法进行评估,以查看是否有回应那些治疗的途径, 并标识可以进行筛选或指向新的基因和靶位的变异。