Analysis The Characteristics And Influencing Factors Of Heart Rate Variability And Blood Pressure Variability Of Female Patients With Hypertension From Different TCM Syndromes

Objective: To investigate the relationship among heart rate variability(HRV),blood pressure variability(BPV)and TCM syndromes by studing characteristics of HRV and BPV in hypertensive female patients with different TCM syndromes and their related influencing factors,and to provide objective basis for further research or similar research,also it provides theoretical basis for improving HRV and BPV.Methods: A total of 314 women with hypertension included in this study were all admitted to the Affiliated Hospital of Gansu University of Traditional Chinese Medicine from June 2014 to December 2016,and were in line with the inclusion criteria of this study.The general data,clinical symptoms,blood and urine routine tests,arterial blood gas analysis,routine biochemistry,HRV and BPV indexes were collected from the inpatients in hypertensive sleep disorder,cardiovascular and neurology departments.The included patients were divided into overabundant liver-fire syndrome,syndrome of hyperactivity of yang due to yin deficiency,phlegm-damp syndrome and deficiency of both yin and yang according to the "Clinical research guideline of traditional Chinese medicine in treatment of hypertension",characteristics of HRV and BPV in different syndromes were analyzed.Nonparametric tests and stepwise multiple linear regression analysis were used as statistical analysis.Results:1.Among the TCM syndrome distribution in 314 cases of female hypertension,7 cases were deficiency of both yin and yang(2.23%),32 cases were overabundant liver-fire syndrome(10.19%),121 cases were phlegm-damp syndrome(38.54%)and 154 cases were syndrome of hyperactivity of yang due to yin deficiency(49.04%).2.Through analysis of the different age with HRV and BPV in 314 cases of female patients with hypertension,there were significant differences in the of 24 h MDBP,DMDBP,NMDBP,24 hMPP,DPP,NPP of BPV index from different ages,the differences were statistically significant(P < 0.05),there were no significant differences in SDNN,HRV Index,RMSSD,SDANN,and 24 hMSBP,DMSBP,NMSBP of BPV index from different ages(P > 0.05).3.Through the analysis of HRV and BPV in female hypertension patients from different TCM syndromes,the SDANN level in syndrome of hyperactivity of yang due to yin deficiency group was lower than that of the overabundant liver-fire syndrome group and the phlegm-damp syndrome group,the difference was statistically significant(P < 0.05);the level of RMSSD and 24 h MSBP increased more obviously in syndrome of hyperactivity of yang due to yin deficiency group compared with that of the overabundant liver-fire syndrome group and the phlegm-damp syndrome group,the difference was statistically significant(P < 0.05);there were no significant differences in SDNN,24 hMDBP,DMSBP,DMDBP,NMSBP,NMDBP,24 hMPP and DPP in different TCM syndromes groups(P > 0.05).4.In this study,the influencing factors of HRV and BPV in 314 cases of female hypertension with different TCM syndromes were analyzed.The results showed that the HRV index(SDNN)was negatively correlated with serum TG in the syndrome of hyperactivity of yang due to yin deficiency group(P < 0.05),the BPV indexes(24h MDBP,24 h MPP,DPP,NPP)were positively related to age,emotional agitation,COPD,diabetes mellitus and PASP(P < 0.05),the BPV index(24hMDBP)was negatively correlated with the CCB antihypertensive drugs(P < 0.05);the HRV index(RMSSD)in the phlegm-damp syndrome group was negatively correlated with serum TG(P < 0.05),the BPV indexes(24hMSBP,DMSBP,NMSBP index,24 h MPP,NPP)were positively correlated with diabetes mellitus,excessive sodium intake and HHCY(P < 0.05),BPV index(NPP)was negatively correlated with beta blocker drugs(P < 0.05);HRV index was positively correlated with hyperuricemia and excessive sodium intake(P < 0.05),BPV indexes(24hMDBP,DMDBP,NMSBP,NMDBP,24 h MPP,DPP,NPP)were positively correlated with insomnia,hyperuricemia,stroke,diabetes,OASHS and PASP(P < 0.05),the BPV index(NMSBP)was negatively correlated with the CCB antihypertensive drugs(P < 0.05).Conclusion:1.314 cases of female hypertension patients with different TCM syndromes,syndrome of hyperactivity of yang due to yin deficiency is the common syndrome.2.In 314 cases of female hypertension patients with different TCM syndromes,the BPV index was correlated with age.HRV index was decreased and BPV index was increased in the syndrome of hyperactivity of yang due to yin deficiency,phlegm-damp syndrome and overabundant liver-fire syndrome groups.3.Emotional,excessive intake of sodium salt,COPD,hyperuricemia,diabetes and other factors affect the HRV and BPV indexes from different TCM syndromes of female hypertension patients,which leads to decreased HRV and increased BPV.