Study On The Correlation Between Vascular Remodeling And Blood Pressure Variability In Patients With Essential Hypertension And TCM Syndromes

Background:The incidence of hypertension in our country is high, and the number have been increased in the past five years. According to the statistical data of the National Health and Family Planning Commission, the compound annual growth rate of the number of patients with hypertension discharged from the National Hospital during the period of 2005-2012 was 39.9%. The incidence of hypertension in China increased from 14.5% in 1991 to 21.4% in 2009. It is estimated that there are more than 295million hypertensive patients in China at present. With the changes in the lifestyle of the residents and the ageing of the population, our country hypertension prevalence rates are excpected to rise in the next few years. However, the harm cognition of our country is still lack, and the diagnosis and treatment of hypertension is still staying at the level of change the absolute value of blood pressure after treatment..Objective:From two angles of vascular remodeling and blood pressure variability, we explore the difference between these and TCM syndrome types. In the hope that we can according TCM syndrome to a certain degree of judgment on vascular remodeling and blood pressure variability in the occurrence and development, at the same time, find the relevant factors between them.Methods:102 cases of essential hypertension patients were Selected.TCM syndrome were been evaluated. Carotid artery color Doppler ultrasound were been done and 24h ambulatory blood pressure were been monitored. Carotid artery ultrasound detected patients’ bilateral common carotid artery, carotid artery, internal carotid artery bifurcation and other parts,to capture the value of carotid artery intima media thickness (IMF) and other pulmonary vascular remodeling indexes.24h ambulatory blood pressure monitoring evaluat the blood pressure variability and pulse pressure indexes.Results:1, the basic situations:102 cases of primary hypertension TCM syndrome types distribution as follows:hyperactivity of liver fire syndrome 13 cases (12.7%), phlegm dampness syndrome 20 cases (19.6%), yin deficiency and yang hyperactivity syndrome 45 cases (44.1%),24 cases of deficiency of both Yin and Yang syndrome (23.5%). Yin deficiency and yang hyperactivity syndrome has the largest number. Hyperactivity of liver fire syndrome and hyperactivity of Yang due to yin deficiency syndrome patients are in younger age than others. The weight index of phlegm dampness syndrome was significantly higher than other groups; There was no significant difference in the course of disease and the classification of blood pressure. Vascular remodeling situation:patients of hyperactivity of liver fire syndrome compared with deficiency of both yin and yang syndrome and phlegm dampness syndrome, in 24h average diastolic pressure and average pulse pressure index, had significant difference (p<0.05). Vascular remodeling positiveness of deficiency of both yin and yang group accounted for the highest. there were no significant differences between the IMT values of each group (P>0.05).3 blood pressure variability index comparision:the pulse pressure variability of deficiency of both yin and Yang syndrome people increased significantly than the hyperactivity of liver fire syndrome group and hyperactivity of Yang due to yin deficiency group (P<0.05). In the comparison of abnormal rhythms statistics, hyperactivity of Yang due to yin deficiency syndrome and deficiency of both Yin and yang syndrome of abnormal rhythm was significantly higher than that of hyperactivity of liver fire excess syndrome (P< 0.05).Conclusion:1 patients with Yin deficiency and yang hyperactivity syndrome are the most common syndrome; The age of hyperactivity of liver fire syndrome and yin deficiency and yang hyperactivity patients is younger, which are considered in the early stages of hypertension. The average age of deficiency of the both Yin and Yang group is elder. Phlegm dampness syndrome patients with the highest BMI index, means that obese patients often get phlegm wet.2 Hyperactivity of liver fire syndrome people have less vascular remodeling than phlegm dampness syndrome and deficiency of both Yin and Yang syndrome group. Phlegm dampness syndrome patients in the process of vascular remodeling progress maybe more fast than other groups.3 the primary hypertension patients with blood pressure variability and TCM syndrome type index situation comparison. hyperactivity of liver fire syndrome group are less critical in blood pressure variability compared with deficiency of both Yin and Yang group and Yin deficiency and Yang hyperactivity group.Primary hypertension patients with vascular remodeling and blood pressure variability and TCM syndrome type showed a certain degree of correlation and clinical by the TCM syndrome type. In a certain degree, to guide the clinical treatment, determination of vascular remodeling in patients and blood pressure variability can be made through the TCM Syndromes. At the same time, it can be clinically checked by carotid ultrasound and 24h ambulatory blood pressure monitoring and so on. It can be quantified by the means of judging the TCM Syndromes of hypertension.