Arterial Elasticity And Endothelial Function In Different TCM Syndromes Of Essential Hypertension:Correlative Analysis

Objective:To investigate the difference of arterial elasticity index like brachial-ankle pulse wave velocity (baPWV), vascular endothelial substances as nitric oxide (NO) and endothelin (ET-1) in essential hypertension (EH) patients in different TCM types, evaluate atherosclerosis and endothelial dysfunction degree in EH patients of different TCM types, and provide theoretical basis for syndrome differenciation in EH patients.Methods:This study observed a total of95cases, including80cases of EH patients and15cases as healthy control group, all of them came from the Jiangsu Provincial Hospital of Cardiology in May2011to December2011out-patient and medical center. By using the clinical questionnaire, EH patients were divided into23cases of hyperactive liver Yang Group, hyperactive liver Yang with Yin deficiency group of20cases, phlegm dampness stagnation group of22cases,15cases of yin and yang deficiency group.Observe all patients’ vital signs and biochemical parameters, and take fasting venous blood. Automatic atherosclerosis tester was used in measuring baPWV of patients and serum NO and ET-1values were determined from the laboratory index.Results:(1)baPWV in EH patients was higher than the healthy control group, the difference was significant (P>0.05), the order between groups was yin and yang deficiency group> phlegm dampness stagnation group> hyperactive yang and yin deficiency group> hyperactive liver yang group, and yin and yang deficiency group was significantly higher than hyperactive liver yang group, the difference was significant (P>0.05);(2)The baPWV related factors including age, pulse pressure, TC, course of disease, and different EH types in TCM;(3)NO in different EH types was obviously higher than control group, which was statistically significant (P <0.05), the order in various EH types was hyperactive liver yang group> hyperactive liver yang with yin deficiency group> phlegm dampness stagnation group> yin and yang deficiency group, and yin and yang deficiency group was significantly lower than hyperactive liver yang group, the difference was significant (P>0.05);(4)the difference of ET-1between EH groups and control group was also statistically significant (P<0.05), and the order of EH types was hyperactive liver yang group<hyperactive liver yang with yin deficiency group<phlegm dampness stagnation group<yin and yang deficiency group, and yin and yang deficiency group was significantly higher than hyperactive liver yang group, the difference was significant (P>0.05).Conclusions:(1)the degree of atherosclerosis of yin and yang deficiency group was more obviously than other groups, which was associated with the course of disease and in coincidence with pathological evolution of EH in TCM;(2)the factors as age, pulse pressure, the TC, duration, group, etc.related to the degree of atherosclerosis;(3)yin and yang deficiency group had reduced NO but increased ET-1, NO/ET imbalance was significantly in this type, which could supply important objective evidence for EH syndrome differentiation.