A total of 82 elderly patients with hypertension complicated by heart failure and deficiency of qi-blood, as well as restlessness of the mind were selected from Henan Provincial Veterans' Hospital from January 2022 to January 2024. They were divided into the control group and the treatment group according to the random number table method, with 41 cases in each group. Both groups were given symptomatic treatment. The control group was treated with valsartan, while the treatment group was treated with Yangxin Decoction combined with valsartan. Both groups were given continuous treatment for 8 weeks. The cardiac function indicators, blood pressure, TLR4/Macrophage Differentiation Factor 88 (MyD88)/Nuclear Factor-κB (NF-κB) pathway factors, C1q Tumor Necrosis Factor-related Protein 3 (CTRP3), N-terminal Brain Natriuretic Peptide precursor (NT-proBNP), Troponin I (cTnI), and high-sensitivity C-reactive protein (hs-CRP) levels were compared between the two groups, and the incidence of adverse reactions was statistically analyzed.

There was no significant difference in the pre-treatment cardiac function indicators, blood pressure, CTRP3, BNP, cTnI, and hs-CRP between the two groups (P >0.05). After treatment, the left ventricular ejection fraction (LVEF), CTRP3, and the ratio of early to late diastolic filling velocity (E/A) in both groups increased compared with those before treatment, while blood pressure, BNP, left ventricular end-systolic diameter (LVESD), cTnI, hs-CRP, and left ventricular end-diastolic diameter (LVEDD) decreased (P <0.05). The LVEF and E/A in the treatment group were higher than those in the control group after treatment, while LVESD and LVEDD were lower (P < 0.05). There was no significant difference in the TLR4/MyD88/NF-κB pathway factors before treatment between the two groups (P > 0.05). After treatment, the relative expression levels of TLR4, MyD88, and NF-κB in both groups decreased compared with those before treatment (P < 0. 05). The relative expression levels of TLR4, MyD88, and NF-κB in the treatment group were lower than those in the control group after treatment (P <0.05). There was no significant difference in the cumulative incidence of adverse reactions between the two groups (P > 0.05).

The combination of Yangxin Decoction and Valsartan can regulate the TLR4/MyD88/NF-κB signaling pathway in elderly patients with hypertension, improve cardiac function, lower blood pressure, and does not increase adverse reactions.