| Objective:To study the correlation between blood pressure fluctuation and carotid atherosclerosis in patients with hypertension,analyze the influence of blood pressure fluctuation on carotid atherosclerosis,and summarize the rules between them.To study the distribution characteristics of blood pressure fluctuation in patients with hypertension among different TCM syndromes,clarify the different prognosis development among different hypertension patients,reduce the incidence of carotid atherosclerosis,and provide objective scientific basis for clinical practice.Methods:215 inpatients(2019.10-2020.10)were selected from the Department of Cardiology of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine and met the inclusion criteria.The clinical retrospective study was used to collect the data of patients,including general conditions,disease-related indicators(such as 24 hour ambulatory blood pressure monitoring indicators,carotid ultrasound,blood lipids,etc.),TCM four diagnostic information.All the collected data were first used Excel software to establish a database,and then SPSS22.0 statistical software was used for statistical analysis.The measurement data were expressed as mean±standard deviation,and the count data were expressed as frequency,frequency and composition ratio.X~2 test was used as statistical method.Variance analysis was used to compare the measurement data with normal distribution,and non-parametric test was used to compare the data with non-normal distribution.P>0.05indicated that the difference was not statistically significant,P<0.05 indicated that the difference was statistically significant,and P<0.01 indicated that the difference was statistically significant.Results:1.215 patients with hypertension were mostly over 60 years old.2.The distribution of TCM syndromes in patients with hypertension is:yin deficiency and yang hyperactivity syndrome>phlegm dampness internal resistance syndrome>blood stasis internal resistance syndrome>qi and blood deficiency syndrome>hepatitis syndrome.3.215 cases of hypertension in different age incidence of gender differences were statistically significant(P=0.000),that is,50 years old before male patients,50 years old after female patients.4.215 cases of hypertension patients with different TCM syndromes in terms of TG by pairwise comparison,liver fire inflammation syndrome and the rest of the syndromes were different,P values were:0.02,0.02,0.04,0.01,liver fire inflammation syndrome TG levels higher than the rest of the syndromes.5.215 cases of hypertension patients with different age stratification in plaque formation difference was statistically significant(P=0.04),the elderly carotid plaque formation more.6.215 patients with hypertension have significant differences in blood pressure variability among different TCM syndromes(P=0.001).Specifically,the syndrome of liver fire inflammation is non-dipper and anti-dipper>super-dipper>dipper;the syndrome of yin deficiency and yang hyperactivity is non-dipper>anti-dipper>dipper>super-dipper;the syndrome of qi and blood deficiency is non-dipper>anti-dipper>dipper and super-dipper;the syndrome of phlegm-dampness internal resistance is non-dipper>anti-dipper>dipper>super-dipper;the syndrome of blood stasis internal resistance is non-dipper>anti-dipper>super-dipper>dipper.In general,the blood pressure variability was increased in patients with yin deficiency and yang hyperactivity syndrome and phlegm-dampness internal resistance syndrome,and the proportion of non-dipper type and anti-dipper type was relatively large.7.215 cases of hypertension patients,different syndromes in 24h DWA,n DWA,24h minimum systolic blood pressure,24h minimum diastolic blood pressure,the difference was statistically significant(P<0.01).Specifically:24h DWA,n DWA,24h minimum diastolic blood pressure of yin deficiency and yang hyperactivity syndrome,qi and blood deficiency syndrome and phlegm-dampness internal resistance syndrome were higher than that of blood stasis internal resistance syndrome;24h minimum systolic blood pressure of phlegm-dampness internal resistance syndrome was higher than that of yin deficiency and yang hyperactivity syndrome;24h minimum systolic blood pressure of qi and blood deficiency syndrome and phlegm-dampness internal resistance syndrome was higher than that of blood stasis internal resistance syndrome;24h minimum diastolic blood pressure of phlegm-dampness internal resistance syndrome was higher than that of liver fire inflammation syndrome and yin deficiency and yang hyperactivity syndrome(all P<0.05).8.215 patients with hypertension had significant gender differences in 24h DWA,d DWA,n DWA,24h maximum diastolic blood pressure and 24h minimum diastolic blood pressure(P<0.01).The 24h DWA,d DWA,n DWA,24h maximum diastolic blood pressure and 24h minimum diastolic blood pressure in males were higher than those in females.9.215 patients with hypertension,different age stratification in24h SWA,24h DWA,d DWA,n SWA,n DWA,24h maximum diastolic blood pressure,24h minimum systolic blood pressure,24h minimum diastolic blood pressure,the difference was statistically significant(P<0.05).Specifically:24h SWA,n SWA,24h minimum systolic blood pressure of young and old people were higher than middle-aged people;24h DWA,d DWA,n DWA,24h maximum diastolic blood pressure,24h minimum diastolic blood pressure of young people were higher than middle-aged and old people;24h DWA,d DWA,n DWA,24h maximum diastolic blood pressure,24h minimum diastolic blood pressure of middle-aged people were higher than old people;24h pulse pressure difference of old people was higher than middle-aged and young people(all P<0.05).10.215 patients with hypertension had significant differences in blood pressure variability in carotid atherosclerosis(P=0.000).The specific distribution was IMT thickening:non-dipper type>dipper type>reverse dipper type>super dipper type,and carotid plaque:non-dipper type>dipper type>reverse dipper type and super dipper type.In terms of blood pressure rhythm,d SWA and n SWA are independent risk factors for IMT thickening.d SWA is positively correlated with IMT,and n SWA is negatively correlated with IMT.Compared with normal IMT,the risk of IMT thickening increases to 1.144 times for every 1 mm Hg increase in d SWA(95%CI:1.090–1.196).Conclusion:1.Hypertension is gender,50-year-old male is more likely to suffer from hypertension,and women patients in 50 are more likely to suffer from hypertension.Male diastolic pressure is generally higher than women.2.Hypertension patients are more likely to form a carotid plaque in middle-aged and elderly people.At the level of blood pressure,young people in hypertensive patients,middle-aged,and older people,the elderly will decrease,but the older persons are more differential.3.TCM programs in patients with hypertension are more prone to abnormalities in blood pressure variants in blood pressure fluctuations,and the sputum variability of phlegm and humidity.4.Hypertensive patients have higher blood pressure levels in Chinese medicine,in general,the blood pressure level,yin deficiency privileges,qi and blood passage,is more common High,qi and blood two failures and sputum injection blogs are higher.5.Blood pressure variability in patients with hypertension is more likely to have a neckhaft in patients with hemoroscopy.And on blood pressure rhythm,DSWA is an independent risk factor of IMT thickening. |
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