Zangfu zheng (patterns) are associated with clinical manifestations of zang shang (target-organ damage) in arterial hypertension

Abstract

Background: Hypertension is a clinical condition that manifests target-organ damage (TOD) with symptoms. This study investigates the association between Zangfu patterns and symptomatic manifestations of TOD. Methods: Datasets with manifestations of Zangfu patterns (Liver-fire blazing upwards; Kidney-yin deficiency and Liver-yang rising; obstruction of phlegm and dampness of Heart/Liver/Gallbladder; qi and blood deficiency leading to Liver-yang rising; Kidney-yin/yang deficiency) and TODs (cerebrovascular, heart and kidney) were compiled from literature. The Pattern Differentiation Algorithm was used to test and to determine diagnostic accuracy with these datasets. A questionnaire was developed from datasets and applied to 43 subjects newly diagnosed with hypertension. Pattern differentiation was performed and the results were statistically analyzed for association between descriptions of patterns and TOD. Results: The observed diagnostic accuracy, sensitivity and specificity were 98.0%, 96.2% and 99.8% respectively. Similarity between patterns and TOD datasets was mostly negligible. Twelve manifestations demonstrated high prevalence, namely red tongue (81.4%), headache (72.1%), irritability (67.4%), palpitation (60.5%), blurred vision, insomnia and mental fatigue (58.1%), frequent nocturnal urination, numbness in feet and hands, shortness of breath (55.8%), and heavy limbs sensation, wiry pulse (51.2%). No significant association was found between blood pressure variables (systolic, diastolic, mean, pulse pressure) and manifestations. Conclusion: Zangfu patterns are associated with clinical manifestations of TOD. Manifestations associated patterns indicate morbid conditions to be secondary to hypertension rather than simple blood pressure. © 2011 Luiz et al; licensee BioMed Central Ltd.