Journal of Traditional Chinese Medicine ›› 2024, Vol. 44 ›› Issue (3): 564-571.DOI: 10.19852/j.cnki.jtcm.20240308.003
• Original articles • Previous Articles Next Articles
ZHOU Ying1, LI Ping2, LUAN Jianwei2, SHEN Rui2, WU Yinglan2, XU Qiwen2, WANG Xinyue2, ZHU Yao2, XU Xiangru4, LIU Zitian2, JIANG Yuning2, ZHONG Yong5, HE Yun3(), JIANG Weimin2()
Received:
2023-02-22
Accepted:
2023-05-19
Online:
2024-06-15
Published:
2024-03-08
Contact:
Prof. JIANG Weimin, Department of Cardiology, the Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing 210029, China. Supported by:
ZHOU Ying, LI Ping, LUAN Jianwei, SHEN Rui, WU Yinglan, XU Qiwen, WANG Xinyue, ZHU Yao, XU Xiangru, LIU Zitian, JIANG Yuning, ZHONG Yong, HE Yun, JIANG Weimin. Study on blood pressure rhythm in hypertensive patients with Yin deficiency syndrome and a random forest model for predicting hypertension with Yin deficiency syndrome[J]. Journal of Traditional Chinese Medicine, 2024, 44(3): 564-571.
Characteristic | Total sample (n = 234) | YX (n = 74) | NYX (n = 160) | t/χ2/F value | P value |
---|---|---|---|---|---|
Gender (Male/Female, n) | 154/80 | 39/35 | 115/45 | 8.266 | 0.004 |
Age (years) | 45±11 | 47±12 | 43±11 | -2.804 | 0.005 |
Course (mouth) | 9 (1-24) | 11 (1-36) | 6 (0-24) | -1.171 | 0.242 |
Waist (cm) | 91±9 | 87±9 | 93±9 | 4.712 | <0.001 |
BMI (kg/m2) | 26±3 | 25±3 | 27±3 | 4.075 | <0.001 |
SBP (mm Hg) | 147±16 | 146±15 | 148±16 | 0.927 | 0.355 |
DBP (mm Hg) | 94±12 | 91±14 | 95±12 | 2.358 | 0.019 |
Heart rate (bpm) | 81±10 | 82±11 | 81±10 | -1.026 | 0.306 |
Smoking (yes/no) | 53/181 | 8/66 | 45/115 | 8.658 | 0.003 |
Drinking (yes/no) | 41/193 | 7/67 | 34/126 | 4.867 | 0.027 |
Table 1 General clinical characteristics in tow groups
Characteristic | Total sample (n = 234) | YX (n = 74) | NYX (n = 160) | t/χ2/F value | P value |
---|---|---|---|---|---|
Gender (Male/Female, n) | 154/80 | 39/35 | 115/45 | 8.266 | 0.004 |
Age (years) | 45±11 | 47±12 | 43±11 | -2.804 | 0.005 |
Course (mouth) | 9 (1-24) | 11 (1-36) | 6 (0-24) | -1.171 | 0.242 |
Waist (cm) | 91±9 | 87±9 | 93±9 | 4.712 | <0.001 |
BMI (kg/m2) | 26±3 | 25±3 | 27±3 | 4.075 | <0.001 |
SBP (mm Hg) | 147±16 | 146±15 | 148±16 | 0.927 | 0.355 |
DBP (mm Hg) | 94±12 | 91±14 | 95±12 | 2.358 | 0.019 |
Heart rate (bpm) | 81±10 | 82±11 | 81±10 | -1.026 | 0.306 |
Smoking (yes/no) | 53/181 | 8/66 | 45/115 | 8.658 | 0.003 |
Drinking (yes/no) | 41/193 | 7/67 | 34/126 | 4.867 | 0.027 |
Characteristic | Total sample (n = 234) | YX (n = 74) | NYX (n = 160) | t/χ2/F value | P value |
---|---|---|---|---|---|
24SBP (mm Hg) | 131.8±13.8 | 130.2±12.6 | 132.6±14.3 | 1.226 | 0.222 |
dSBP (mm Hg) | 134.7±14.2 | 133.1±13.1 | 135.5±14.7 | 1.179 | 0.240 |
nSBP (mm Hg) | 122.0±14.6 | 120.5±13.1 | 122.7±15.2 | 1.075 | 0.283 |
24DBP (mm Hg) | 83.2±11.4 | 81.2±11.0 | 84.2±11.5 | 1.871 | 0.063 |
dDBP (mm Hg) | 85.6±11.9 | 83.4±11.5 | 86.6±12.0 | 1.882 | 0.061 |
nDBP (mm Hg) | 75.±11.2 | 73.8±10.5 | 76.2±11.5 | 1.515 | 0.131 |
24MAP (mm Hg) | 99.4±11.6 | 97.5±10.9 | 100.3±11.9 | 1.702 | 0.090 |
dMAP (mm Hg) | 102.0±12.1 | 100.0±11.3 | 102.9±12.4 | 1.692 | 0.092 |
nMAP (mm Hg) | 91.0±11.8 | 89.4±10.8 | 91.7±12.2 | 1.399 | 0.163 |
24SBPSD (mm Hg) | 13.7±3.2 | 13.5±3.5 | 13.7±3.1 | 0.610 | 0.543 |
24DBPSD (mm Hg) | 10.7±2.4 | 10.2±2.4 | 11.0±2.5 | 2.171 | 0.031 |
dSBPSD (mm Hg) | 12.4±3.3 | 12.4±3.3 | 12.4±3.3 | -0.055 | 0.956 |
dDBPSD (mm Hg) | 9.7±2.7 | 9.4±2.4 | 9.8±2.8 | 1.129 | 0.260 |
nSBPSD (mm Hg) | 10.8±3.6 | 10.4±3.7 | 11.0±3.6 | 1.254 | 0.211 |
nDBPSD (mm Hg) | 8.7±2.9 | 7.9±2.4 | 9.0±3.0 | 2.648 | 0.009 |
24SBPCV (%) | 10.4±2.4 | 10.4±2.7 | 10.4±2.2 | 0.126 | 0.900 |
24DBPCV (%) | 13.0±3.0 | 12.7±3.2 | 13.1±2.9 | 0.949 | 0.344 |
dSBPCV (%) | 10.1±2.2 | 10.1±2.5 | 10.1±2.1 | 0.185 | 0.853 |
nSBPCV (%) | 12.6±2.8 | 12.4±2.9 | 12.8±2.7 | 1.012 | 0.313 |
dDBPCV (%) | 11.3±3.0 | 11.3±3.6 | 11.32±2.8 | -0.002 | 0.998 |
nDBPCV (%) | 14.5±4.1 | 14.2±4.6 | 14.7±3.8 | 0.794 | 0.428 |
Circadian rhythm of BP | 9.919 | 0.019 | |||
Dipper [n (%)] | 88 (37.6) | 22 (29.7) | 66 (41.3) | 22 | <0.001 |
Non-dipper [n (%)] | 113 (48.3) | 41 (55.4) | 72 (45.0) | 8.504 | 0.004 |
Riser [n (%)] | 21 (9.0) | 4 (5.4) | 17 (10.6) | 8.048 | 0.005 |
Extreme-dipper [n (%)] | 12 (5.1) | 7 (9.5) | 5 (3.1) | 0.333 | 0.564 |
Table 2 ABPM characteristics in two groups
Characteristic | Total sample (n = 234) | YX (n = 74) | NYX (n = 160) | t/χ2/F value | P value |
---|---|---|---|---|---|
24SBP (mm Hg) | 131.8±13.8 | 130.2±12.6 | 132.6±14.3 | 1.226 | 0.222 |
dSBP (mm Hg) | 134.7±14.2 | 133.1±13.1 | 135.5±14.7 | 1.179 | 0.240 |
nSBP (mm Hg) | 122.0±14.6 | 120.5±13.1 | 122.7±15.2 | 1.075 | 0.283 |
24DBP (mm Hg) | 83.2±11.4 | 81.2±11.0 | 84.2±11.5 | 1.871 | 0.063 |
dDBP (mm Hg) | 85.6±11.9 | 83.4±11.5 | 86.6±12.0 | 1.882 | 0.061 |
nDBP (mm Hg) | 75.±11.2 | 73.8±10.5 | 76.2±11.5 | 1.515 | 0.131 |
24MAP (mm Hg) | 99.4±11.6 | 97.5±10.9 | 100.3±11.9 | 1.702 | 0.090 |
dMAP (mm Hg) | 102.0±12.1 | 100.0±11.3 | 102.9±12.4 | 1.692 | 0.092 |
nMAP (mm Hg) | 91.0±11.8 | 89.4±10.8 | 91.7±12.2 | 1.399 | 0.163 |
24SBPSD (mm Hg) | 13.7±3.2 | 13.5±3.5 | 13.7±3.1 | 0.610 | 0.543 |
24DBPSD (mm Hg) | 10.7±2.4 | 10.2±2.4 | 11.0±2.5 | 2.171 | 0.031 |
dSBPSD (mm Hg) | 12.4±3.3 | 12.4±3.3 | 12.4±3.3 | -0.055 | 0.956 |
dDBPSD (mm Hg) | 9.7±2.7 | 9.4±2.4 | 9.8±2.8 | 1.129 | 0.260 |
nSBPSD (mm Hg) | 10.8±3.6 | 10.4±3.7 | 11.0±3.6 | 1.254 | 0.211 |
nDBPSD (mm Hg) | 8.7±2.9 | 7.9±2.4 | 9.0±3.0 | 2.648 | 0.009 |
24SBPCV (%) | 10.4±2.4 | 10.4±2.7 | 10.4±2.2 | 0.126 | 0.900 |
24DBPCV (%) | 13.0±3.0 | 12.7±3.2 | 13.1±2.9 | 0.949 | 0.344 |
dSBPCV (%) | 10.1±2.2 | 10.1±2.5 | 10.1±2.1 | 0.185 | 0.853 |
nSBPCV (%) | 12.6±2.8 | 12.4±2.9 | 12.8±2.7 | 1.012 | 0.313 |
dDBPCV (%) | 11.3±3.0 | 11.3±3.6 | 11.32±2.8 | -0.002 | 0.998 |
nDBPCV (%) | 14.5±4.1 | 14.2±4.6 | 14.7±3.8 | 0.794 | 0.428 |
Circadian rhythm of BP | 9.919 | 0.019 | |||
Dipper [n (%)] | 88 (37.6) | 22 (29.7) | 66 (41.3) | 22 | <0.001 |
Non-dipper [n (%)] | 113 (48.3) | 41 (55.4) | 72 (45.0) | 8.504 | 0.004 |
Riser [n (%)] | 21 (9.0) | 4 (5.4) | 17 (10.6) | 8.048 | 0.005 |
Extreme-dipper [n (%)] | 12 (5.1) | 7 (9.5) | 5 (3.1) | 0.333 | 0.564 |
Characteristic (mm Hg) | YX (n = 74) | NYX (n = 160) | t value | P value |
---|---|---|---|---|
Si-Shi DBP | 88±12.6 | 91±13 | -2.183 | 0.029 |
Si-Shi MAP | 104±12 | 107±13 | -2.105 | 0.035 |
Hai-Shi SBP | 128±16 | 134±18 | -2.644 | 0.008 |
Hai-Shi DBP | 78±14 | 85±15 | -3.079 | 0.002 |
Hai-Shi MAP | 95±14 | 101±15 | 2.978 | 0.003 |
Zi-Shi SBP | 120±15 | 125±18 | 2.188 | 0.030 |
Zi-Shi DBP | 72±12 | 77±13 | 2.424 | 0.016 |
Zi-Shi MAP | 88±12 | 93±14 | 2.588 | 0.011 |
Chou-Shi SSD | 6±4 | 7±4 | -2.423 | 0.015 |
Chou-Shi DSD | 5±3 | 6±3 | -2.214 | 0.027 |
Chou-Shi SCV | 6±5 | 8±5 | -2.207 | 0.027 |
Table 3 ABPM characteristics of 12 two-hour periods in two groups
Characteristic (mm Hg) | YX (n = 74) | NYX (n = 160) | t value | P value |
---|---|---|---|---|
Si-Shi DBP | 88±12.6 | 91±13 | -2.183 | 0.029 |
Si-Shi MAP | 104±12 | 107±13 | -2.105 | 0.035 |
Hai-Shi SBP | 128±16 | 134±18 | -2.644 | 0.008 |
Hai-Shi DBP | 78±14 | 85±15 | -3.079 | 0.002 |
Hai-Shi MAP | 95±14 | 101±15 | 2.978 | 0.003 |
Zi-Shi SBP | 120±15 | 125±18 | 2.188 | 0.030 |
Zi-Shi DBP | 72±12 | 77±13 | 2.424 | 0.016 |
Zi-Shi MAP | 88±12 | 93±14 | 2.588 | 0.011 |
Chou-Shi SSD | 6±4 | 7±4 | -2.423 | 0.015 |
Chou-Shi DSD | 5±3 | 6±3 | -2.214 | 0.027 |
Chou-Shi SCV | 6±5 | 8±5 | -2.207 | 0.027 |
Figure 1 Mean blood pressure of 12 two-hour periods in two groups A: comparison of systolic blood pressure of 12 two-hour periods between Yin deficiency group and non-Yin deficiency group. B: comparison of diastolic blood pressure of 12 two-hour periods between Yin deficiency group and non-Yin deficiency group. Participants were grouped into Yin deficiency group (YX, n = 74) and non-Yin deficiency group (NYX, n = 140) by three experienced chief TCM physicians according to four examinations. YX: Yin deficiency; NYX: non-Yin deficiency; SBP: systolic blood pressure; DBP: diastolic blood pressure. Independent sample t-test was used for comparison between groups. Significant differences were designated as aP < 0.05.
Characteristic | b | SE | Wald | P value | OR | 95% CI |
---|---|---|---|---|---|---|
Szxr | 0.156 | 0.049 | 10.159 | 0.001 | 1.169 | 1.062-1.287 |
Ty | 0.095 | 0.052 | 3.302 | 0.069 | 1.100 | 0.993-1.219 |
Lmgs | - | - | - | 0.124 | - | - |
Mxx | 0.189 | 0.036 | 27.279 | <0.001 | 1.208 | 1.125-1.297 |
Ystr | 0.268 | 0.102 | 6.919 | 0.009 | 1.307 | 1.071-1.595 |
Mx | - | - | - | 0.477 | - | - |
Xj | - | - | - | 0.213 | - | - |
Qh | 0.176 | 0.050 | 12.233 | <0.001 | 1.192 | 1.080-1.315 |
Em | - | - | - | 0.219 | - | - |
Md | - | - | - | 0.125 | - | - |
Table 4 Binary logistic regression of TCM symptoms and diagnosis of Yin deficiency syndrome
Characteristic | b | SE | Wald | P value | OR | 95% CI |
---|---|---|---|---|---|---|
Szxr | 0.156 | 0.049 | 10.159 | 0.001 | 1.169 | 1.062-1.287 |
Ty | 0.095 | 0.052 | 3.302 | 0.069 | 1.100 | 0.993-1.219 |
Lmgs | - | - | - | 0.124 | - | - |
Mxx | 0.189 | 0.036 | 27.279 | <0.001 | 1.208 | 1.125-1.297 |
Ystr | 0.268 | 0.102 | 6.919 | 0.009 | 1.307 | 1.071-1.595 |
Mx | - | - | - | 0.477 | - | - |
Xj | - | - | - | 0.213 | - | - |
Qh | 0.176 | 0.050 | 12.233 | <0.001 | 1.192 | 1.080-1.315 |
Em | - | - | - | 0.219 | - | - |
Md | - | - | - | 0.125 | - | - |
Characteristic | b | SE | Wald | P | OR | 95% CI |
---|---|---|---|---|---|---|
24SBPCV | -1.587 | 0.685 | 5.360 | 0.021 | 0.205 | 0.053-0.784 |
dSBPSD | 0.529 | 0.177 | 8.916 | 0.003 | 1.697 | 1.199-2.402 |
dDBPSD | -0.190 | 0.09 | 4.506 | 0.034 | 0.827 | 0.693-0.986 |
nSBPSD | 0.147 | 0.072 | 4.156 | 0.041 | 1.158 | 1.006-1.334 |
nSBPCV | 0.993 | 0.434 | 5.238 | 0.022 | 2.699 | 1.153-6.317 |
nDBPSD | -0.204 | 0.077 | 7.002 | 0.008 | 0.815 | 0.701-0.948 |
Hai-Shi DBP | -0.051 | 0.025 | 4.262 | 0.039 | 0.950 | 0.906-0.997 |
Hai-Shi SCV | 0.104 | 0.052 | 3.941 | 0.047 | 1.109 | 1.001-1.229 |
Table 5 Binary Logistic Regression of BPV and diagnosis of Yin Deficiency Syndrome
Characteristic | b | SE | Wald | P | OR | 95% CI |
---|---|---|---|---|---|---|
24SBPCV | -1.587 | 0.685 | 5.360 | 0.021 | 0.205 | 0.053-0.784 |
dSBPSD | 0.529 | 0.177 | 8.916 | 0.003 | 1.697 | 1.199-2.402 |
dDBPSD | -0.190 | 0.09 | 4.506 | 0.034 | 0.827 | 0.693-0.986 |
nSBPSD | 0.147 | 0.072 | 4.156 | 0.041 | 1.158 | 1.006-1.334 |
nSBPCV | 0.993 | 0.434 | 5.238 | 0.022 | 2.699 | 1.153-6.317 |
nDBPSD | -0.204 | 0.077 | 7.002 | 0.008 | 0.815 | 0.701-0.948 |
Hai-Shi DBP | -0.051 | 0.025 | 4.262 | 0.039 | 0.950 | 0.906-0.997 |
Hai-Shi SCV | 0.104 | 0.052 | 3.941 | 0.047 | 1.109 | 1.001-1.229 |
Figure 2 Mean decrease in accuracy and mean decrease in Gini A: the influencing indicators of Yin deficiency syndrome of hypertension were ordered according to the mean decrease accuracy index. B: the influencing indicators of Yin deficiency syndrome of hypertension were ordered according to the mean decrease Gini index. It refers to the degree of decrease in accuracy without the presence of this diagnostic indicator in the random forest model, which is equivalent to the concept of classification contribution. The higher the value, the more important the contribution. Scores: scores of Yin deficiency syndrome of hypertension rating scale; BMI: body mass index; SBP: systolic blood pressure; DBP: diastolic blood pressure; MBP: mean arterial pressure; Zi MBP: Zi-Shi mean arterial pressure; Mxx: string-like and fine pulse; Zi DBP: Zi-Shi diastolic blood pressure; Hai SCV: Hai-Shi SBP coefficient of variation; Waist: waist circumference; Shen HR: Shen-Shi heart rate; Zi HR: Zi-Shi heart rate; Chou SSD: Chou-Shi SBP standard deviation; nDBPCV: nighttime DBP coefficient of variation; Ty: dizziness; Hai MBP: Hai-Shi mean arterial pressure; Hai SBP: Hai-Shi systolic blood pressure; Wu DCV: Wu-Shi DBP coefficient of variation; 24DBPCV: 24 h DBP coefficient of variation; 24DBPSD: 24 h DBP standard deviation; 24SBPSD: 24 h SBP standard deviation; Chou SCV: Chou-Shi SBP coefficient of variation; dSBP: daytime SBP; Hai SSD: Hai-Shi SBP standard deviation; Wu SSD: Wu-Shi SBP standard deviation; Em: tinnitus; Chou DCV: Chou-Shi DBP coefficient of variation; Chou MBP: Chou-Shi mean arterial pressure; Lmgs: dry eyes; nDBPSD: nighttime DBP standard deviation; Ystr: soreness and weakness of lumbus and knees; Wei DBP: Wei-Shi diastolic blood pressure; Hai DBP: Hai-Shi diastolic blood pressure; Yin SSD: Yin-Shi SBP standard deviation; Si DBP: Si-Shi diastolic blood pressure; Course: course of hypertension; Chen SBP: Chen-Shi systolic blood pressure; Chou DSD: Chou-Shi DBP standard deviation; Chou HR: Chou-Shi heart rate; Mao HR: Mao-Shi heart rate; Yin DSD: Yin-Shi DBP standard deviation.
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