Study On The Relationship Between Blood Pressure Variability And Arteriosclerosis In Hypertension With Different Syndromes - Study On Intervention Of Resistance To Blood Vessel Remodeling In SHR Rats

Hypertension is a kind of systemic arterial hypertension as the main features of the clinical syndrome, often accompanied by a variety of target organ damage, blood pressure variability as an independent risk factor can cause target organ damage, more and more attention. In the target organ damage caused by hypertension, a change in arterial structure and function occurs firstly; therefore, prevent atherosclerosis, arteriosclerosis and blood pressure clear correlation characteristic is particularly necessary. This study based on TCM Syndromes of Hypertension characteristics, as well as arteriosclerosis and blood pressure variability and the relevance of animal studies and the combined evaluation of Chinese medicine treatment of blood pressure levels and improves the effectiveness of the degree of atherosclerosis, as provide reference clinical treatment of hypertension. This topic includes the following three parts:1 TheoryThrough access to literature, modern medicine overview of BPV EH patient characteristics and the correlation between AS summarize and generalize TCM Summary explore the relationship between traditional Chinese medicine theory and blood pressure variability, as well as research progress BPV traditional medicine Intervention Methods for clinical study provides a theoretical basis.2 Clinical Study2.1 ObjectiveTo investigate the distribution characteristics of different types of hypertension in clinical, syndromes characteristics, study the relationship between different syndromes of hypertension in patients with blood pressure and differences in variability between arteriosclerosis and for clinical syndrome differentiation, prevent target organ damage provide a reference.2.2 MethodIncorporated in December 2012-in patients with essential hypertension in May 2015 in the Chinese Academy of Traditional Grandmaster comprehensive inpatient 320 cases, retrospective analysis, study includes general (gender, age, height and weight of the patient etc.), illness (duration of hypertension, classification, cardiovascular risk stratification, complications, etc.), clinical indicators, met the inclusion criteria of hypertensive patients based on symptoms and tongue and pulse into anger Kang Sheng, Yin Yang Kang, phlegm dampness, yin and yang four syndromes, post-processing data entry Excel spreadsheet to establish a database, using SPSS 16.0 software to analyze statistical differences in general and each index between research syndromes.2.3 Results320 cases of EH patients, male 155 cases (48.44%), female 165 cases (51.56%), average age 59.82±9.42 years, duration of 10.47+10.40 years.The frequency distribution of the syndrome hyperactivity syndrome> phlegm-dampness> deficiency of both yin and yang> anger hyperactivity, where anger hyperactivity youngest average, relatively low blood pressure grades, relatively short duration, mean diastolic blood pressure, and load the highest level of standard deviation; and syndromes among the relatively normal circadian rhythm to disappear sort order of anger hyperactivity <hyperactivity Syndrome <phlegm-dampness <deficiency of both yin and yang. BaPWV were to prevail difference analysis, the degree of arteriosclerosis is anger hyperactivity <deficiency of both yin and yang <phlegm-dampness <hyperactivity syndrome. baPWV and ambulatory blood pressure monitoring in the correlation of each indicator is more significant, the higher the degree of sensitivity of the diagnosis of arteriosclerosis.2.4 ConclusionThe results of this study show:1 the greater vascular stiffness, higher systolic blood pressure, diastolic pressure, the lower level; the higher the degree of vascular blockage, the higher the diastolic blood pressure.2.ABI nothing to do with ambulatory blood pressure standard deviation, and the larger arterial stiffness, diastolic blood pressure of less volatility.3. The higher the degree of vascular congestion, diastolic blood pressure load is smaller; the larger vascular stiffness, the greater the load systolic and diastolic blood pressure load is smaller.The clinical manifestations of hypertension is different for each type of TCM, there are differences between the level of blood pressure variability and the degree of arteriosclerosis, hypertension early, mostly anger hyperactivity, mean blood pressure, blood pressure variability, blood pressure load of the highest levels of the four syndromes, but the presence of circadian blood pressure, arteriosclerosis degree lightest, heaviest yin permit the extent of atherosclerosis, clinical therapy, the patient’s condition should be combined with the characteristics of the correct syndrome.3 Experimental research3.1 ObjectiveBy observing SHR mesenteric artery sliced, morphological index calculation explore analysis SHR Resistance Vessel Remodeling morphological features observed Liver Blood Circulation improving vascular remodeling its feasibility and effectiveness of the impact of atherosclerosis.3.2 MethodThe 50 SHR rats were randomly divided into five groups:model control group, Chinese medicine large, medium and small dose group and western medicine group, take 10 Wistar rats were used as normal control group, the group was given different doses of medicine Tianma comfortable extract liquid medicine group to losartan potassium, model and normal control group was given equal volume of distilled water, administered continuously for 14 weeks after the end of the experiment the animals were killed, specimens from mesenteric specimens fixed, sliced, HE staining, inverted microscope aberration microscopic changes in vascular morphology, computer image analysis system measured and calculated outside diameter of the lumen, the inner lumen diameter, thickness, cross-sectional area of the membrane, the inner thickness/lumen radius.3.3 ResultsSHR vascular remodeling eutrophication; with respect to the increase in diameter of the inner model control group, traditional Chinese medicine and western medicine group lumen each dose group (P<0.05 or P<0.01), the film thickness, a significant reduction in thickness/ inner radius (P<0.05 or P<0.01), explained under the intervention effect, improve vascular remodeling eutrophication.3.4 ConclusionHypertensive vascular remodeling of resistance morphological features of luminal diameter, diameter reduction, thickness, thickness/inner radius increases, while the film is no significant change in cross sectional area, indicate a eutrophic remodeling. After Liver Blood Circulation intervention, compared with the model group, each dose group improved eutrophic remodeling, indicating Liver Blood Circulation can be improved resistance vessels in hypertensive remodeling eutrophication morphological level, have an impact on atherosclerosis trend.