Old Age Hypertension Blood Pressure Variability Correlation Between Tcm Syndrome Type And Discussed

Essential hypertension (EH) is widely prevalent and important risk factor for cardiovascular diseases that increases with aging. Blood pressure variability (BPV) is a measure of blood pressure fluctuations and a strong indicator to assess the severity, prognosis and controlling efficacy. There were few reports about differentiation of syndromes of elderly patients with hypertension. And relationship between blood pressure variability and syndromes were rarely involved. The objective of this study is to discuss the distribution regularity of traditional Chinese medicine (TCM) syndrome patterns of EH in elderly patients and the correlation between syndrome patterns and blood pressure variability. It is expected to provide some objective evidences of differentiation of syndromes and to improve the clinical efficacy.Objective:To explore the distribution regularity of TCM syndrome patterns of elderly patients with EH and the correlation between syndrome patterns and BPV.Methods:1018hospitalized cases of the elderly patients (age>60) whose first diagnoses were EH in Xiyuan hospital in the recent5years were included in the research. They are classified into five patterns as liver-fire hyperactivity, excessive phlegm-dampness, blood stasis, yin deficiency and yang hyperactivity and yin-yang deficiency. The data of patients such as general conditions, blood lipid, correlated biochemical indicators and automatic blood pressure parameters were collected and analyzed by SPSS17.0statistical analysis software packet.Result:1.Yin deficiency and yang hyperactivity takes up26.2%,excessive phlegm-dampness takes up22.7%,blood stasis takes up20.8%,liver-fire hyperactivity takes up15.1%and yin-yang deficiency takes up15.1%.2.There is a significant statistical difference in the age, gender, courses of disease, grades of EH and whether or not combined with heart failure over the distribution of syndrome patterns(P<0.05).3.There is a significant statistical difference in the daytime mean diastolic blood pressure (DMDBP) and the distribution of syndrome patterns(P<0.05). Significant difference is not found between the other mean blood pressures and the syndrome patterns.4.There is no significant statistical difference in the indicators of BPV and syndrome patterns (P>0.05).5.In the subgroup analysis of age, no significant difference is found. While in the subgroup analysis of gender, weighted standard deviation of systolic blood pressure (WSD-sbp) is found significant difference in the different syndrome patterns in male patients(P<0.05).In the blood pressure grades subgroup analysis, daytime systolic blood pressure standard deviation (DSD-sbp) and WSD-sbp are significantly different in the distribution of syndrome patterns(P<0.05).6.TCM syndrome patterns of elderly patients with EH have something to do with some factors including age, gender, grades of blood pressure, course of disease, co-morbidities of coronary heart disease, DSD-sbp and24hMDBP.Conclusion:1.Yin deficiency and yang hyperactivity syndrome is the primary syndrome patterns of EH.2. The distribution of syndrome patterns is significantly affected by factors such as age, gender, grades and course of disease. The increasing age, the extension of the course, and the elevated grades of blood pressure result in the transform of syndrome patterns from liver-fire hyperactivity, excessive phlegm-dampness and blood stasis to yin deficiency-yang hyperactivity and yin-yang deficiency.3. Blood stasis syndrome is one of the most important TCM syndrome patterns.4. DMDBP is related to the distribution of syndrome patterns. DMDBP value of excessive phlegm-dampness type is significantly higher than that of yin deficiency-yang hyperactivity type and yin-yang deficiency type.5.There is a certain correlation between BPV and syndrome patterns. In male and grade2blood pressure elderly patients, BPV of yin-yang deficiency syndrome is significantly higher. BPV of liver-fire hyperactivity syndrome is significantly lower in grade2blood pressure elderly patients.6. There is an increased risk of being classified as the yin-yang deficiency syndrome as DSD-sbp increases or24hMDBP decreases.