| Background The increase of peripheral resistance is currently considered to be one of the main mechanisms of hypertension.Microcirculation makes the main contribution to regulating peripheral resistance.The functional and structural abnormalities of microcirculation are considered to be the cause and effect of hypertension.The pathological manifestation of hypertension microcirculation disorder is very similar to that of blood stasis in traditional medicine.Thus blood stasis may be common in hypertension.At present,the research on microcirculation and hypertension blood stasis syndrome mainly involves patients with whole layer of hypertension,the patients of high risk stratification may contain more mixed factors,and the combination of diabetes mellitus and other diseases or the occurrence of target organ damage may affect the degree of blood stasis syndrome,leading to the bias of the performance,There has been no study on the correlation between microcirculation and blood stasis syndrome in patients with hypertension of low and medium risk stratification.Family history of cardiovascular disease,smoking,obesity,dyslipidemia,anxiety have been cTonfirmed to be the main risk factors of hypertension,there is no evidence on whether these risk factors are also associated with microcirculation disorders.Objective To investigate the correlation between microcirculation disorder and blood stasis syndrome of stage 1 hypertension of low to medium risk stratification.To explore whether blood stasis has been present in the early stage of hypertension To explore the correlation between blood stasis integral and the variation of 24-hour dynamic blood pressure.To explore the correlation between nail fold microcirculation integral and the variation of 24-hour dynamic blood pressure.To identify whether the common risk factors of hypertension such as family history of cardiovascular disease,smoking,obesity,dyslipidemia,anxiety are correlated with microcirculation disorder.Methods This study is observational that contains two group which are subjects of stage 1 hypertension with low to medium risk stratification and subjects of health.We recruited subjects of stage 1 hypertension with low to medium risk stratification in the outpatient of Xiyuan Hospital.And we recruited subjects of health in the outpatient of Xiyuan hospital,Guobin Medical Examination Center,Beijing University of Chinese Medicine.Both groups of participants signed the informed consent form.The subjects of hypertensive group took three times blood pressure tests on the same mercury column sphygmomanometer not on the same day.If the measurement of blood pressure meets the standard of stage 1 hypertension,the subjects would take examinations of electrocardiogram,complete blood count,blood biochemistry,urinalysis test.If in line with the standard of inclusion and exclusion criteria,the subjects were not allowed to take medicine of antihypertensive,anticoagulant,antiplatelet aggregation,drugs that affects cardiovascular function in two weeks.Then they would receive examinations of 24h dynamic blood pressure monitoring,electrocardiogram,complete blood count,blood biochemistry,urinalysis test.Subjects from both group that were in line with the standard of inclusion and exclusion criteria would receive examinations of the test on microcirculation of nail fold,assessment of blood stasis syndrome score and anxiety scale.Results? linear regression analysis showed a positive correlation between microcirculation assessment of hypertensive nail fold and blood stasis syndrome(P<0.05).?The difference between cases of normal/abnormal of nail fold microcirculation in hypertension Group and healthy Group was analyzed by card square test,and the result of difference was statistically significant(P<0.05).And two independent sample T tests suggested that there were statistical differences between the score of the two groups of nail fold microcirculation(P<0.05).?The difference between cases of blood stasis syndrome/non-blood stasis syndrome was statistically significant(P<0.05)according to card square test.And two independent sample T tests suggested that there was a statistical difference between the score of the two groups of blood stasis syndrome(P<0.05).?The correlation between blood stasis syndrome score and 24-hour blood pressure variability was analyzed by linear regression equation,and the results showed that blood stasis syndrome score was positively correlated with 24-hour blood pressure variability(P<0.05).?We assigned the results of microcirculation assessment as the cause variable,we named the normal as 0,the mild anomaly as 1,the moderate anomaly as 2,and the severe anomaly as 3.And we assigned risk factors such as the family history of cardiovascular disease,smoking,obesity,dyslipidemia,anxiety as independent variable given 1/0 in accordance with yes/no for multivariate logistic regression analysis.The result showed that the family history of cardiovascular disease,dyslipidemia,obesity were related to microcirculation disorder(P<0.05).,smoking history,anxiety were not related to microcirculation disorder(P>0.05)..Conclusion The degree of microcirculation of nail folds was positively correlated with the degree of blood stasis syndrome,and the microcirculation score of nail folds could reflect the degree of blood stasis syndrome.The degrees of microcirculation of nail folds and the degree of blood stasis were higher than those in hypertensive subjects,which manifested that microcirculation disorder and blood stasis syndrome were present in the early stage of hypertension.And the blood stasis resistance is common in the early pathogenesis of hypertension.Thicker tube diameter,more deformed blood vessels,slower blood flow rate,more significant erythrocyte aggregation and darker blood color are found in the group of hypertension significantly compared to the group of health,which meet the feature of blood stasis in traditional Chinese medicine.The degree of blood stasis was positively correlated with 24-hour blood pressure variability.According to multivariate logistic regression analysis,it is found that the common risk factors of hypertension,such as family history of cardiovascular disease,dyslipidemia,anxiety are related to microcirculation disorder,but smoking,,obesity are not.These risk factors may contribute the occurrence and development of hypertension by affecting microcirculation. |
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