Correlation Between Different Syndromes Of Hypertension And Cardiovascular Constitution, Function And ACE Polymorphism

Aims: to investigate the correlation between blood pressure rhythm, aorta functionsand left ventricular hypertrophy, ACE I/D polymorphism and circardian varioussyndromes of hypertension. We hope to provide more objective data to supporttraditional Chinese medic, ine differentiation of hypertension. By doing this, we couldprovide new integrated methods to prevent and treat hypertension. As a result, theresearch and therapeutic methods of hypertension will arrive at a new level.Methods: we used a questionnaire, hypertension patient’s registration forms andTCM symptom severity index to record information. Blood pressure and heart ratewere also recorded. Serum chemistry and gene polymorphism were tested in thefast. Ambulatyory blood pressure monitoring devices (Welch Allyn Quie Trak TM5100) were used to measure blood pressure during the day (6am-10pm) and night(10pm-6pm). We also used Sphygmocor (Sydney, Australia) to record PulseWaveform of the radial artery. The Cardiosoft version4.2 (GE Medical Systems) wasused to simultaneously record 12channel electro cardiography with.Echocardiography of HP5500 was used to measure left atrium diameter (LAD), leftventricular internal diameter (LVID), left ventricular end-systolic diameter(LVESD), inter septal (ISV) and posterior wall thickness(PWT). The polymerasechain reaction and agarose gel electrophoresis were used to analyze ACE I/Dgenotype. Observations included TCM differentiation, basic characters (includingrecent drug intake, medical history of hypertension and other cardiovascular diseases,family history, diabetes history, drinking, smoking, height and body weight), clinicblood pressure, heart rate, and 24h ambulatous blood pressure in different syndromes.Large artery elasticity index in different syndromes, such as P-AI, C-SP, C-PH, C-AI,Sokolow -lyon Index (Sv1+Rv5 or Rv6) and echocardiography index, such as Aos,LVEDD, LVESD, PWT were also been studied. The genotype and alleles of ACEpolymorphism were recorded.Results: In the primary hypertension patients, more patients suffered from theLiver fire flare than other types. Among the subjects of this study, there was nosignificant difference between male and female in age, systolic and diastolic pressure,use of medication. However, smoking, drinking, body weight, uric acid and uriccreatinine in women were lower than men(P＜0.05), while total cholesterol washigher than men. The incidence of diabetes in men was higher than women. Theaverage systolic pressure in asymptomatic group was significantly fower than othergroups. Systolic pressure in Phlegm dampness accumulation group and Yindeficiency Yang excess group were significantly higher than other groups (P＜0.05).There was no difference among the Liver fire flare group, group of patients who had symptoms without definite syndrome and Yin and Yang deficiency group. There wasno difference between these groups in regard to heart rate. In the 24h ambulatorsblood pressure measurement, average systolic pressure of Phlegm dampnessaccumulation group and Yin and Yang deficiency group were much higher than othergroups (P＜0.05). 24h arnbulators blood pressure in the group of patients who hadsymptoms without definite syndrome was much lower than other groups (P＜0.05).There was no significant difference between these groups with regard tothe average 24h diastolic: pressure and heart rate. Large artery elasticity indexes inthe asymptomatic group, such as P_AI, C_SP, were obviously lower than Liver fireflare group, Phlegm dampness accumulation group, Yin deficiency Yang excessgroup, Yin and Yang deficiency group and group without definite syndrome (P＜0.05). P_AI, and C_SP, C—AI in the Yin and Yang deficiency group weremuch higher than asymptomatic group, Liver fire flare group, Yin deficiency Yangexcess group, Phlegm dampness accumulation group and the group without definitesyndrome (P＜0.05). Sokolow-lyon Index of electrocardiography in Yin and Yangdeficiency and Phlegm dampness accumulation group were much higher than theasymptomatic group, Liver fire flare group, Yin deficiency Yang excess group andthe group without definite syndrome (P＜0.05) Echocardiography index, such asAos,LVEDD,LVESD, and PWT were not significant differentbetween there groups.The ACEI/D polymorphism genotype frequency in different syndrome group wasnot significanc different.Conclusion: In the primary hypertension patients, more patients suffered fromthe Liver fire flare. The ACEI/D genotype in different syndrome group was notsignificantly different. Among these groups, blood pressure rhythm in the Yin andYang deficiency group was worse than the others and its sclerosis degree of largearteries was also more obvious than others. The incidence of left ventricularhypertrophy in the Phlegm dampness accumulation group and Yin and Yangdeficiency groups was higher than other the groups. The ACE I/D polymorphismwas not correlated to TCM syndromes.