Study On The Correlation Between Target Organ Damage And Risk Factors In High Normal Blood Pressure And TCM Constitution

ObjectiveTo explore the relationship between high normal pressure and target organ damage and the cardiovascular risk factors,and find sensitive and accurate predictors,we can screen the high-risk patients in time.To study the distribution law of constitution in high-risk high normal pressure,so we can think highly of non-drug intervention,and open up a new way for non-drug intervention in high normal pressure.MethodsTo select the subject from the First Affiliated Hospital of Guangzhou Traditional Chinese Medicine(TCM)University in January 2018 to February 2019,who are in line with the inclusion criteria and exclusion criteria.We have 255 cases,including 96 cases of normal blood pressure group,high normal pressure group with 94 cases,65 cases of hypertension group.They will be tested with some objects,and fill in the questionnaire of TCM constitution criteria.Then we use SPSS20.0 statistical software to conduct multivariate stepwise regression analysis to screen the dangerous TCM constitutions in the early stage of high normal pressure and analyze the relationship between the dangerous constitutions,risk factors and target organ damage.Results1.There was no significant difference in blood pressure between the three groups.There were differences in age composition,the normal blood pressure group and the normal high blood pressure group were dominated by middle-aged people,while the hypertension group was dominated by middle-aged people.The TCM constitutions distribution was dominated by biased body mass(212 cases,accounting for 83.1%),including compound biased constitutions(119 cases),and qi deficiency(70 cases,accounting for 33%).In three groups,the predominance was biased constitution,mostly qi deficiency.Fisher's exact probability method was applied to the constitutions of the three groups,and the P value was>0.05,indicating that there was no significant difference in constitutions of the three groups.2.Chi-square test was conducted on the number of blood pressure groups and risk factors.The three groups were all dominated by the combination of more than 3 risk factors,and the incidence of the combination of more than 3 risk factors was higher with the increase of blood pressure,and the difference was statistically significant(P<0.05).Variance analysis and chi-square test were used to analyze the risk factors of the three groups.Lsd-t test was used between pairwise and pairwise,body mass index was correlated with high normal blood pressure,and age,low-density lipoprotein,apolipoprotein B,cystatin C,total cholesterol was correlated with hypertension,and the difference was statistically significant(P<0.05).The risk factors of the three groups were analyzed by multivariate ordered Logistic regression analysis.Age,apolipoprotein B,low-density lipoprotein,gender(male)was the influencing factor of blood pressure progression.Binary Logistic regression analysis was performed between the two groups,and it was found that the sex(male),low-density lipoprotein was correlated with normal high blood pressure,and the age,body mass index,glycated hemoglobin,apolipoprotein B was correlated with hypertension,and the difference was statistically significant(P<0.05).3.In the normal blood pressure group,Yang deficiency was associated with uric acid,blood stasis was associated with triglycerides,damp-heat was associated with glycosylated hemoglobin,and qi stagnation was associated with apolipoprotein B,low-density lipoprotein.In normal high blood pressure,Yang deficiency is related to homocysteine,and qi stagnation is related to total cholesterol triglyceride and low density lipoprotein(P<0.05).4.Chi-square test was conducted on the number of target organ damage components in the three blood pressure groups,and the three groups were all dominated by no target organ damage(95.8%,92.6%,81.5%).With the increase of blood pressure,the probability of target organ damage was higher,and the difference was statistically significant(P<0.05).Variance analysis and chi-square test were carried out on the composition of target organ damage in the three groups,and there were differences in diastolic function of left ventricular,interventricular septal thickness in fundus lesions,left ventricular posterior wall thickness,left ventricular mass index,carotid artery plaque,urine protein and cardiac diastolic function.LSD-t test was performed between the two groups,the left ventricular posterior wall thickness and E/A was correlated with high normal blood pressure.The left ventricular septal thickness,the inner diameter of the left atrium,the left ventricular posterior wall thickness,left ventricular mass index,carotid artery plaque,E/A,E'/A,E/E' were correlated with hypertension.and the difference was statistically significant(P<0.05).The components of target organ damage in the three groups were analyzed by multiple ordered Logistic regression,E/A,E/E' were the influencing factor of blood pressure progression.Binary Logistic regression analysis was performed between the two groups,and left ventricular mass index,E/A,E/E'were correlated with high normal blood pressure,and left ventricular mass index,E/A,E/E' were correlated with hypertension,and the difference was statistically significant(P<0.05).5.Multiple disordered Logistic regression analysis was carried out to analyze the damage of target organs and the types of body constitution.In the normal blood pressure group,damp-heat constitution was associated with the inner diameter of the left atrium,interventricular septal thickness,left ventricular posterior wall thickness and IVS/LVPW.In normal high blood pressure,yang deficiency was related to ejection fraction,damp-heat constitution was associated with ejection fraction and left ventricular mass index.In hypertension,qi deficiency was related to E/E',qi-stagnation constitution was associated with interventricular septal thickness and left ventricular posterior wall thickness.Conclusion1.The prehypertension group was dominated by biased constitution,suggesting that the body type is complex biased constitution,which indicates that the occurrence and development of blood pressure are complicated with syndrome characteristics.2.The high normal pressure has the risk factors and the early stage of target organ damage,which is closely related to the blood pressure level and TCM constitution.Therefore,from the perspective of constitution theory,it is a new direction in the future to take measures to intervene high-risk patients with normal high blood pressure.