The incidence and mortality rates of coronary heart disease combined with hypertension in China have been steadily rising, posing a significant threat to public health security. Consequently, it is essential to standardize and synthesize the treatment protocols for coronary heart disease combined with hypertension within the framework of traditional Chinese medicine (TCM), thereby providing a robust data foundation for clinical differential diagnosis and management as well as for the development of consensus guidelines.

This study aims to investigate the formulation and compatibility rules of coronary heart disease combined with hypertension utilizing latent structure modeling in conjunction with association rule mining.

The search period for this research extends from the establishment of the database until May 31, 2024, a systematic search was conducted in CNKI, VIP, Wanfang Data and SinoMed databases, the literature on TCM decoction for coronary heart disease complicated with hypertension was screened using EndNote software. Standardized data were imported into Microsoft Excel 2019 to establish a TCM database, lantern 5.0 and Rstudio were used for analyzing the hidden structure model and association rules of high-frequency TCM.

In the end, a total of 122 TCM prescriptions were included, involving 104 medicinals with cumulative use frequency of 1 390, the high-frequency Chinese medicines identified were salvia miltiorrhizomes, Chuanxiong, achyranthus rhizome, red peony root and Yujin, which primarily exerted tonifying effects on deficiencies and promoting blood circulation. Through hidden structure analysis, a total of 19 latent variables, 38 latent categories, 5 comprehensive cluster models and 16 core formulas were obtained, decoctions deduced syndrome types for coronary heart disease complicated with hypertension, common witnessed types included Qi deficiency and blood stasis, Yin deficiency and blood stasis as well as phlegm dampness blocking. Association rule analysis yielded 43 strong association rules with the highest support degree observed between Achyrantha-Chuanxiong and the highest confidence degree between Yujin-Salvia miltiorrhiza.

Coronary heart disease combined with hypertension is a syndrome characterized by deficiency in nature and excess in superficiality, the core pathological mechanism is dominated by blood stasis, followed by deficiency and phlegm, it is closely related to liver, heart and spleen, treatment principles should focus on activating blood circulation while supplementing Qi, clearing phlegm while dispelling dampness, nourishing Yin while strengthening spleen, regulating Qi while soothing liver.