关键词: 高血压, 血管功能, 中医证候, 危险因素

Abstract: Background　Essential hypertension has a high incidence in the world，and it is also a common complication of heart，brain，kidney and other target organ damage. Among them，cardiovascular diseases are the most common ones. Objective　To Screen the risk factors of cardiovascular diseases in patients with essential hypertension，in order to provide a basis for the prevention and intervention of cardiovascular risks. Methods　A retrospective cohort study was conducted to follow up patients with essential hypertension treated by traditional Chinese medicine（TCM） in Henan Province Chinese Medicine Research Institute from 2001 to 2013. The follow-up period was from January 2015 to December 2016. General data，medical history characteristics，laboratory indicators，vascular function and cardiac function examination indicators，and TCM syndromes，as well as the incidence of cardiovascular risk were collected. The COX proportional hazard regression model was used to screen the risk factors of cardiovascular disease in patients with essential hypertension. Results　A total of 985 patients entered the statistical analysis in this study with the age of （55.8±5.8） and the disease duration of （10.6±4.2） years，of which 284 patients had cardiovascular events. COX regression univariate analysis and collinearity diagnostics showed that there were significant difference in age，gender，course of disease，body mass index（BMI），family history of early cardiovascular disease，smoking history，mood，dietary habits，homocysteine（Hcy），Na+，average ankle-brachial blood pressure index（ABI），average arterial pressure，flow-mediated dilatation（FMD），headache，edema，Qi deficiency and blood stasis syndrome，Yin deficiency and Yang hyperactivity syndrome，liver-kidney Yin deficiency syndrome，and Yin and Yang deficiency syndrome in the prognosis of patients with essential hypertension（P<0.05）. The COX regression multivariate analysis suggested that gender〔HR（95%CI）=2.719（1.619，4.566）〕，the course of disease〔HR（95%CI）=1.282（1.131，1.322）〕，family history of early onset cardiovascular disease〔HR（95%CI）=1.547（1.214，1.970）〕，BMI〔HR（95%CI）=1.023（1.003，1.993）〕 and dietary habits〔HR（95%CI）=1.625（1.160，2.278）〕，Hcy〔HR（95%CI）=1.022（1.008，1.037）〕，mean ABI〔HR（95%CI）=0.058（0.015，0.223）〕， mean arterial pressure〔HR（95%CI）=1.204（1.064，1.987）〕，FMD〔HR（95%CI）=0.959（0.909，0.994）〕，headache〔HR（95%CI） =1.344（1.055，1.712）〕，edema〔HR（95%CI） =39.079（4.716，323.841）〕，syndrome of Qi deficiency and blood stasis〔HR（95%CI）=1.327（1.171，1.870）〕，syndrome of Yin deficiency and Yang hyperactivity〔HR（95%CI）=1.085（1.063，1.880）〕，syndrome of liver and kidney Yin deficiency 〔HR（95%CI）=1.172（1.086，1.595）〕，syndrome of Yin and Yang deficiency〔HR（95%CI）=1.204（1.143，2.439）〕 was closely associated with cardiovascular risk of essential hypertension（P<0.05）. Conclusion　Course of disease，gender，family history of early cardiovascular disease，BMI，dietary habits，Hcy，average ABI，average arterial pressure，FMD，headache，edema，Qi deficiency and blood stasis，Yin deficiency and Yang hyperactivity syndrome，liver-kidney Yin deficiency syndrome and Yin and Yang deficiency syndrome are the risk factors of cardiovascular risk in patients with essential hypertension. Clinically，prevention and intervention of cardiovascular risk in patients with essential hypertension should be strengthened according to these risk factors.

Key words: Hypertension, Vascular function, TCM syndrome, Risk factors