To investigate the differences in ocular collateral features among patients with hypertension and those with hypertension complicated by coronary heart disease based on traditional Chinese medicine (TCM) ocular diagnostic theory and scleral image analysis, and provide evidence for the application of objective TCM ocular diagnostic technology in the early screening of cardiovascular diseases.

Patients with hypertension who attended the Department of Cardiology at Dongzhimen Hospital of Beijing University of Chinese Medicine between June and December 2024 were enrolled as the hypertension group (n = 222). In contrast, patients with hypertension complicated by coronary heart disease were enrolled as the combined group (n = 176). Healthy individuals recruited during the same period served as the control group (n= 162). An ocular diagnostic instrument was used to collect scleral images of both eyes from five orientations (upward, downward, leftward, rightward, and frontal gaze). Morphological, color, and regional features of ocular collaterals were digitally extracted and analyzed.

Morphological feature analysis showed that the prevalence of "Dots" and "Vessels" was lower, whereas that of "Hills" was higher in both the hypertension and hypertension with coronary heart disease groups than in the control group (P<0.05). The prevalence of "Hills" was higher in the hypertension with coronary heart disease group than in the hypertension group and showed an increasing trend among the three groups (P<0.01). In color features, both disease groups showed lower proportions of "Dusky pink", and higher proportions of "Yellow" than control group (P < 0.05). The hypertension group showed higher proportions of "Dark reddish" and lower proportions of "Purple" (P < 0.05). The combined group showed lower proportions of "Pink" and "Light yellow" and higher proportions of "Dusky brown" (P<0.05), whereas "Light yellow" was lower than that in the hypertension group (P< 0.05). Regional feature analysis showed lower prevalence of "R7 (Lung)" "R8 (Kidney)" and "R10 (Kidney)" in both disease groups than in the control group, whereas "R6 (Lung)" was more prevalent in the hypertension group than in the hypertension with coronary heart disease and control groups (P< 0.05).

Significant differences were observed in the morphological, color, and regional distribution characteristics of ocular collaterals among the hypertension, the combined and control groups. Ocular collateral features exhibited distinct distribution patterns among the three groups suggesting that objective ocular-diagnosis technology may have value in the early screening of hypertension and hypertension complicated with coronary heart disease.

To explore the objective facial color characteristics of patients with coronary heart disease (CHD).

From August 2023 to June 2024, patients with CHD who were admitted to the Department of Cardiovascular Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, were enrolled as the CHD group (n = 147). Healthy individuals recruited during the same period served as the non-CHD control group (n = 147). Facial images of both groups were collected using the M3 Intelligent Traditional Chinese Medicine Diagnostic System under standardized conditions. The facial region was divided into seven subregions: the entire face, forehead, bilateral cheeks, infraorbital regions, nose, lips, and chin. For each subregion, nine color parameters from three color spaces were extracted and analyzed, including red (R), green (G), blue (B), hue (H), saturation (S), value (V), lightness (L), red-green axis (a), and yellow-blue axis (b).

Compared with the non-CHD group, the CHD group showed decreased R, G, and L values and increased a and b values in overall facial color (P<0. 05). Local facial color analysis revealed that, in the CHD group, the forehead exhibited decreased R, G, B, V, and L values and increased S and a values (P<0. 05); the cheeks showed decreased R, G, and L values and increased S, a, and b values (P<0. 05); the infraorbital regions showed decreased R, G, and L values but increased S and a values (P<0. 05); the nose exhibited decreased R, G, B, V, and L values and increased S and a values (P<0. 05); and the lips showed increased S and a values (P<0. 05).

Compared with healthy individuals, patients with CHD exhibited an overall darker and less bright facial complexion with significantly increased red saturation. Local features such as a dull forehead, reddish cheeks, and a discolored nose align with the traditional Chinese medicine pathogenesis of qi-blood deficiency and blood stasis with internal heat.