Relation of syndrome types to hypertension grades and risk stratification in patients with primary hypertension

Tiansong ZHANG; Lei HAN; Lei WANG

ABSTRACT

BACKGROUND:

Whether antihypertesive remedy is given or not is not only according to the blood pressure grade, but also to its risk stratification. Recently the relation of syndrome types to hypertension grades and risk stratification in primary hypertension has been investigated at home.

OBJECTIVE:

To observe the relation of syndrome types to hypertension grades and risk stratification in primary hypertension by the method of syndrome differentiation in traditional Chinese medicine combining with achievements in modern medicine.

DESIGN:

Descriptive investigation.

SETTING:

Department of Traditional Chinese Medicine, Jing'an District Central Hospital of Shanghai City and Shanghai Dahua Hospital.

PARTICIPANTS:

Sixty-four patients, in different genders and ages, with primary hypertension from Department of Traditional Chinese Medicine of Jing'an District Central Hospital of Shanghai City

METHODS:

The primary hypertension was classified into four types of syndrome up disturbing of wind-yang, up clouding of turbid phlegm, deficiency of qi and blood and yin deficiency of liver and kidney. The relation of syndrome type to hypertension grade and risk stratification in primary hypertension was investigated combining syndrome differentiation in traditional Chinese medicine (TCM) and disease differentiation in Western Medicine. MAIN OUTCOME

MEASURES:

The relation of syndrome types to the age, course, blood pressure grade and risk stratification in primary hypertension

RESULTS:

All 64 patients entered the result analysis. ① Relationship of syndrome type with the age, course and blood pressure grade The age of patients in up-disturbing of wind-yang group was younger than those in both up-clouding of turbid phlegm and yin deficiency of liver and kidney groups [(59.0±10.9), (72.7±9.1), (71.6±10.1)years, P ＜ 0.01]; the disease course of patients in yin deficiency of liver and kidney group was longer than those in up-disturbing of wind-yang group and up-clouding of turbid phlegm group [( 160.50±143.51 ), (64.83±70.77), (80.56±108.69)months,P ＜ 0.05];the difference of systolic pressure among different syndrome types was not significant, but the diastolic pressure in up-disturbing of wind-yang group was higher than those in other groups [(99±8), (92±9),(89±11 ), (89±12)mmHg, P ＜ 0.05]. ② The relationship of syndrome type with blood pressure grade and risk stratification The difference of blood pressure grades among patients with different syndrome types was not significant, but the risk stratification in up-disturbing of wind-yang group was lower than those in up-clouding of turbid phlegm and yin deficiency of liver and kidney groups (There were respectively 3, 7, 5 and 3 cases; 15, 1, 1and 1 cases; 16, 1, 2 and 1 cases at very high risk, high risk, medium risk and low risk, P ＜ 0.05).

CONCLUSION:

Different syndrome types in TCM may present differences in hypertension grade and risk stratification, which can provide basis for determining therapeutic principle.