Analysis The Characteristics And Correlative Factors Of Heart Rate Variability And Blood Pressure Variability Of Elderly Patients With Hypertension From Different TCM Syndromes

Objective: To investigate the characteristics and related factors of heart rate variability(HRV)and blood pressure variability(BPV)among elderly hypertensive patients with different syndromes of TCM,so as to provide objective basis for controlling elderly hypertension.Methods: To collect information about 524 inpatients who were from the Affiliated Hospital of Gansu University of Traditional Chinese Medicine's hypertensive sleep disorder,cardiovascular and neurology departments from June 2014 to December 2017,including general demographic data,clinical symptoms,laboratory data and other indicators such as HRV and BPV;according to the "Vertigo disease(primary hypertension)of TCM clinical pathway implementation plan(trial)" the patients were divided into hyperactivity of yang due to yin deficiency,overabundant liver-fire syndrome,turbid phlegm and blood stasis syndrome,deficiency of kidney qi,the deficiency of Qi and blood syndrome,analyzed characteristics of HRV and BPV among different syndromes.Results:1.The 524 elderly patients with hypertension,in which 239 cases were yin deficiency and yang hyperactivity syndrome,were the most.The others were phlegm and blood stasis syndrome in 182 cases,kidney qi deficiency syndrome in 68 cases,hyperactivity of liver fire in 22 cases,deficiency of qi and blood syndrome in 13 cases.2.In 524 elderly patients with hypertension,there was a significant difference in 24 h MPP between different age group(DMSBP)and NMSBP(P<0.05).3.The analysis of HRV and BPV indexes among elderly hypertensive patients with different TCM syndromes showed that there were significant differences in HRV and BPV between senile hypertensive patients with yin deficiency and yang hyperactivity,phlegm and blood stasis syndromes and kidney qi deficiency syndrome(P< 0.05),yin deficiency and yang hyperactivity syndrome,phlegm and blood stasis syndromes.There was significant difference(P < 0.05)between 24 h MSBP and 24 h MDBP of kidney qi deficiency syndrome(P<0.05).4.In this study,the related factors of HRV and BPV in elderly hypertensive patients with different TCM syndromes were analyzed,and the results showed that,There was anegative correlation between HRV Index and HCY in HRV patients with Yin deficiency and Yang hyperactivity.(P<0.05)PNN50 was negatively correlated with CREA(P<0.05)and there was a negative correlation between HDL-C(P<0.05)and HDL-C(P<0.05).There was a positive correlation between NMDBP and HB and LDL-C(P<0.05)and HB(P<0.05)Correlation(P<0.05)was positively correlated with HCT(P<0.05).In the patients with phlegm and blood stasis syndrome,there was a negative correlation between HRV and HB and HCT(P<0.05).There was a negative correlation between Index and HB and HCT(P <0.05).PNN50 was negatively correlated with HCT(P<0.05).There was a positive correlation between MDBP and GLU in patients with phlegm-blood stasis syndrome(P<0.05),between Index and TG(P<0.05).There was a positive relation with HB(P<0.05)and HP(24MPP)with HB(P<0.05).There was a negative correlation between HRV and CREA in patients with deficiency of kidney qi(P<0.05).There was a negative correlation between Index and HB and HCY(P<0.05).There was a positive correlation between NMSBP and HCT(P<0.05)and a negative correlation between NMSBP and HCT(P<0.05).5.In this study,by analyzing the related factors of different TCM syndromes in elderly patients with hypertension,the results showed that insomnia,stroke and HCY were the influencing factors of hypertensive patients with Yin deficiency and Yang hyperactivity syndrome(P<0.05),smoking,drinking alcohol,insomnia,HCY in stroke group was the influencing factor of hypertension in the group of phlegm and blood stasis syndrome(P<0.05).Smoking,drinking and salt intake were the influencing factors of hypertension in the group of deficiency of kidney qi(P<0.05).Conclusion:1.Hyperactivity of Yang due to yin deficiency syndrome,phlegm and blood stasis syndrome were the most common TCM syndromes.2.There was a correlation between the increase of BPV index and age in 524 elderly hypertensive patients among different TCM syndromes.The BPV index during yin deficiency and yang syndrome,phlegm and blood stasis syndrome,kidney qi deficiency syndrome increased in 24hMPP?DMSBP?NMSBP?24MPP.3.Hb?TG?HCT?HCY?GLU?CREA?HDL-C and LDL-C had a relationship between HRV and BPV among different TCM syndromes of elderly hypertensive patients.4.Smoking,drinking,insomnia,intake of salt,stroke and HCY were associated with different TCM syndromes in elderly patients with hypertension.