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TCM Diagnosis for Hypertension
In TCM, a disease or a symptom might be caused by one pathogenic factor, even two or three pathogenic factors. When diagnosing a disease or a symptom, TCM doctors must follow the principle of "Syndrome Differentiation", and then "Suit the Remedy to the Case". In order to gain a right and valuable diagnosis, it's important and necessary for the doctor to learn the detailed health information of the patient, including his/her disease duration, age, sex, height, weight, family history, urine, stool, diet, sleep, sweat, energy, mood (emotion), as well as the tongue conditions and the palm conditions, etc. If you would want our expert to create a TCM diagnosis, please fill out the health form as requested.

Hypertension, also called high blood pressure, condition that arises when the blood pressure is abnormally high. Hypertension occurs when the body’s smaller blood vessels narrow, causing the blood to exert excessive pressure against the vessel walls and forcing the heart to work harder to maintain the pressure. Although the heart and blood vessels can tolerate increased blood pressure for months and even years, eventually the heart may enlarge and be weakened to the point of failure. Injury to blood vessels in the kidneys, brain, and eyes also may occur.

Essentials for TCM diagnosis    
(1) Hypertension has a gradual onset often with no symptom at the early stage, manifested as dizziness, headache, blurred vision, tinnitus, insomnia and lassitude in some cases.

(2) Upon physical examination, the aortic second sound is accentuated and in elderly cases, metallic sound may be heard. Besides, there may be the fourth heart sound and aortic early systolic ejection sound. In a case with prolonged hypertension, there appears left ventricular hypertrophy.

(3) According to the 1999 World Health Organization (WHO)/International Society of Hypertention (ISH) Guidelines, hypertension is defined with the systolic pressure (SP) ≥ 18.7 kPa (140 mmHg) and/or diastolic pressure (DP) ≥ 12.0 kPa (90 mmHg) and without taking antihypertensive medication.

(4) Accelerated (malignant) hypertension progresses rapidly with a persistent DP greater than 17.3 kPa (130 mmHg), usually manifested as fundus bleeding or exudation, or edema of the optic disc. There may appear severe damage to the heart, brain and kidneys in a short time and even death.

(5) Routine urine examination: usually normal at the early stage, but when renal function is impaired, protein, erythrocyte, and cast, in occassional cases, may be found in the urine and the concentration of creatinine may increase.

(6) Chest X-ray may reflect the appearance and size of the heart, the change of the width and density (calcification) of the aorta. Echocardiogram is a reliable means to evaluate hypertrophy of the left ventricular. Besides electrocardiogram discloses the involvement of the heart (left ventricular hypertrophy, strain, ischemia and infarction) and arrhythmia, which are caused by high blood pressure.

Five syndromes of hypertension categorized in TCM diagnosis
Syndrome of Hyperactivity of Liver Yang
Syndrome of Yin Deficiency Causing Hyperactivity of Yang
Syndrome of Retention of Phlegm Damp in the Body
Syndrome of Deficiency of Both Yin and Yang
Syndrome of Incoordination of Thoroughfare and Conception Vessels
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