Relationship Between Blood Pressure Circadian Rhythm and Heart Rate Variability in Primary Hypertensive Patients with Liver Yin Deficiency Pattern and Hyperactive Liver Yang Pattern

Objective To discuss the influence of blood pressure circadian rhythm pattern on the heart rate variability(HRV) of primary hypertensive patients with liver yin deficiency pattern and hyperactive liver yang pattern,and to evaluate the clinical significance.Methods Based on the primary-symptom syndrome differentiation,87 primary hypertensive patients were divided into hyperactive liver yang group and liver yin deficiency group,and ambulatory blood pressure monitoring and dynamic electrocardiogram HRV analysis were carried out in all of the patients simultaneously.Results Normal blood pressure circadian rhythm was presented in hyperactive liver yang group while the blood pressure circadian rhythm disappeared in liver yin deficiency group.There were no significant differences of the 24-hour systolic blood pressure and diastolic blood pressure,or the day mean systolic blood pressure and diastolic blood pressure between the two groups(P0.05).However,the differences of the night systolic blood pressure and diastolic blood pressure were significant(P0.05),and the values of liver yin deficiency group were higher than those of hyperactive liver yang group.The results of dynamic electrocardiogram HRV analysis showed that most of heart rate variability indexes in liver yin deficiency group were decreased within 24 h through the day,in the day time and at night time(P0.01 compared with those in hyperactive liver yang group).The 24-h mean arterial pressure in liver yin deficiency patients was negatively correlated with the standard deviation of normal-to-normal intervals(SDNN),and the correlation coefficient was-0.408(P0.01).Conclusion The abnormality of blood pressure circadian rhythm in primary hypertensive patients is closely related with the decrease of HRV and the disappearance of circadian rhythm,and the disappearance of circadian rhythm is probably related with the serious injury of autonomic nerve function.The blood pressure circadian rhythm disappears in liver yin deficiency hypertensive patients,and the patients have certain autonomic nerve function damage.It is indicated that dynamic blood pressure and HRV value can be used as the objective indexes for the syndrome differentiation of primary hypertension.