Research The Characteristics Influencing Factors Of Heart Rate Variability Time-domain Index Of Hypertensive Patients From Different TCM Syndromes

Objective: Based on the investigation of the variation characteristics of HRV time domain parameters and its influence factors on hypertensive patients of different TCM syndromes, our study provide the proof for the treatment of hypertension by traditional Chinese medicine and improvement of autonomic nervous function, also provide the reference for the prevention of cardiovascular and cerebrovascular events.Method: From june 2014 to December 2015, the data of 380 hypertensive patients including general data, clinical symptoms, HRV time-domain index and synchronous heart rate were collected for cross-sectional study from department of sleep disorder of hypertension and department of cardiology of the Affiliated Hospital of Gansu University of TCM. The patients were divided to 7 groups according to CLINICAL RESEARCH INSTRUCTION PRINCIPLE OF TREATING HYPERTENSIVE DISEASE WITH NEW DRUG AND TRADITIONAL CHINESE MEDICINES and Vertigo disease(primary hypertension) of TCM clinical pathway implementation plan(trial) like hyperactivity of Yang due to Yin deficiency syndrome, turbid phlegm and blood stasis syndrome, abundant phlegm-dampness syndrome, deficiency of kidney qi, the deficiency of Qi and blood syndrome, overabundant liver-fire syndrome and deficiency of both yin and yang. For statistical analyses, nonparametric test and multiple linear stepwise regression analysis were used.Results: 1. The different TCM syndromes of 380 patients with hypertension were distributed as follow: The distribution of TCM syndromes of 380 hypertensive patients was: 146 cases with hyperactivity of Yang due to Yin deficiency syndrome(38.42%), 122 cases with turbid phlegm and blood stasis syndrome(32.11%), 36 cases with abundant phlegm-dampness syndrome(9.47%), 30 cases with deficiency of kidney qi(7.89%), 20 cases with the deficiency of Qi and blood syndrome(5.26%), 14 cases with overabundant liver-fire syndrome(3.68%) and 12 cases with deficiency of both yin and yang(3.16%). 2. HRV time domain parameters of 380 hypertensive patients were analysed according to age and gender. Compared to the group of 50 to 72 years old, level of Mean RR decreased significantly in the group of 30 to 49 years old and the difference was statistically significant(P < 0.05); level of Mean RR, RMSSD, SDSD in male patients were significantly decreased, and the difference was statistically significant(P < 0.05) compared with female patients.3. Compared between different TCM syndromes, the level of SDNN was significantly reduced in the groups of hyperactivity of Yang due to Yin deficiency syndrome, turbid phlegm and deficiency of kidney qi, the difference statistically significant(P < 0.05) compared to abundant phlegm-dampness syndrome and the deficiency of Qi and blood syndrome. HRV Index, TINN, SDANN were significantly decreased in the patients of deficiency of kidney qi, and the difference was statistically significant(P < 0.05). SDNN Index、PNN50、Mean RR、RMSSD、SDSD had no significant difference between different TCM syndromes(P > 0.05).4. The study on analysis of the 23 factors like gender, age, smoking, drinking, coronary heart disease, hyperlipidemia, stroke, diabetes that affect the HRV time domain parameters of different TCM Syndromes of hypertensive patients through multiple linear stepwise regression analysis, and the results show that HRV time domain(SDNN、SDNN Index、PNN50、HRV Index、Mean RR、SDANN)parameters of patients in hyperactivity of Yang due to Yin deficiency syndrome was negatively correlated with hyperlipidemia, family history of hypertension, diabetes, sleep apnea, high LDL- C, gender, age(P < 0.05), and HRV time domain(SDNN、SDNN Index、HRV Index、Mean RR、RMSSD)parameters of patients in turbid phlegm and blood stasis syndrome was negatively correlated with hyperlipidemia, hyperuricemia, sleep apnea, high HCY and risk stratification of hypertension, insomnia, gender(P < 0.05). In the group of abundant phlegm-dampness syndrome, HRV time domain(SDNN、PNN50)parameters was negatively correlated with hyperlipidemia and high HCY(P < 0.05), and in(SDNN、Mean RR、RMSSD)patients of deficiency of kidney qi syndrome was negatively correlated with smoking, drinking, insomnia, excessive intake of sodium salt, high HCY and emotion(P < 0.05), in addition, HRV time domain(HRV Index、RMSSD)parameters of patients in the deficiency of Qi and blood syndrome was negatively correlated with insomnia and emotional agitation(P < 0.05).Conclusion: 1. Hyperactivity of Yang due to yin deficiency syndrome, phlegm and blood stasis syndrome is the most common TCM syndromes that need attention among the 380 patients with essential hypertension.2. The reduction of the HRV time domain parameters in 380 hypertension patients with different TCM syndrome was related to gender, age and other factors. HRV time domain parameters significantly reduced in the group of Hyperactivity of Yang due to yin deficiency, phlegm and blood stasis syndrome, deficiency of kidney qi syndrome.3 Smoking, drinking, insomnia, HCY, diabetes, hyperlipidemia and other factors can affect HRV time domain parameters among different TCM syndromes of hypertension patients, which can lead to HRV time domain parameters decreased.