Reascher:In my opinion， at this time Losartan 150 mg is much better than 50 mg in terms of the edendpoints. There is a 10% decrease with 150 mg of Losartan in terms of reducing death or heart failure hospitalization. The HEAALstudy is the first to verify that 150 mg of Losartan has a therapeutic effect in the treatment of heart failure. Also， in Chinathe first time RAS blockade used to treat heart failure were ACE inhibitors but we have about 20% of patients with coughafter…

Reascher:I’d like to talk today about heart failure specifically. We have seen several lead breaking heart failure trials presented here at AHA 2009 and one of those trials was the HEAAL study. Can you give us your brief opinion on the HEAAL study as well as any comments about how we can evaluate it? Additionally， what do you think the contribution is to the progress regarding how we can treat heart failure?

 Prof. Nissen：We don’t use Losartan very…

Reascher:What about in those patients with AF?

Prof. Jessup : Physicians often times use the wrong drugs to slow heart rate or they may combine a calcium antagonist drug in someone who has a poor ejection fraction and that is the wrong thing to do. I think that the guidelines that came out today are very helpful.

Reascher:What is the most efficient or best way to screen out patients who are at high risk for heart failure?

Prof. Jessup : In general physicians do understand who is at high risk. High-risk patients include patients in the hospital frequently， those with an elevated BUN and creatinine， patients with low blood pressure， or multiple comorbidities， which this session was about. Most physicians will understand those patients to be high risk but do not necessarily act on that…