• Title/Summary/Keyword: 24-hour ambulatory blood pressure monitoring

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The Relationship between Anxiety, Depression and 24-hour Ambulatory Blood Pressure in Hotel Employees (호텔 종사자들에서 불안 및 우울과 24시간 활동혈압 관련성)

  • Bae, Jun-Ho;SaKong, Jeong-Kyu;Kim, Sang-Kyu
    • Journal of agricultural medicine and community health
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    • v.36 no.3
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    • pp.157-166
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    • 2011
  • Objectives: Anxiety and depression are known to be associated with hypertension, and blood pressure can vary spontaneously throughout the day. The aim of this study was to evaluate anxiety, depression and 24-hour ambulatory blood pressure (24-h ambulatory BP) in employees at their worksite. Methods: A total of 107 volunteers among 136 employees at a hotel in Gyeongju, Korea were enrolled in this study between December 2009 and March 2010. The Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were used to assess anxiety and depression, respectively. Blood pressure was measured using a 24-h ambulatory BP monitoring system. Results: No significant differences in either BAI or BDI scores were found when hypertensive individuals were compared to normotensive individuals. The frequency of diastolic non-dipper was significantly higher in individuals with depressive symptoms compared to those without (p<0.05). Depression was significantly associated with diastolic non-dipper (OR: 6.85, 95% CI: 1.50-30.01). Conclusions: The results of this study indicate that depression should be considered when deciding upon blood pressure control regimens, and appropriate additive psychotherapy may be beneficial in the treatment of hypertensive patients.

The Effect of Shift Work on the Diurnal Rhythm of Blood Pressure in Nurses (간호사의 야간교대근무로 인한 혈압의 일중 변동 양상)

  • Lee, An-Saeng;Rhee, Sang-Jae;Kim, Nam-Ho
    • Korean Journal of Occupational Health Nursing
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    • v.18 no.1
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    • pp.14-21
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    • 2009
  • Purpose: This study was performed to investigate the effect of shift work on diurnal blood pressure (BP) pattern in nurses. Method: We studied 20 healthy nurses engaged in 3 shift work. 24-hour ambulatory BP monitoring was performed to each nurse two times during the day and night shift. Five nurses were excluded because of inadequate BP measurement. Results: All subjects were female. The mean age was 27.4 years (range: 23-33 years) and mean body mass index was 19.7 Kg/$m^2$ (range: 18.0-21.2 Kg/$m^2$). The changes of systolic BP ($17.8{\pm}9.1$ vs. $13.2{\pm}4.7%$, p=0.031), diastolic BP ($22.3{\pm}8.7$ vs. $17.3{\pm}9.0%$, p=0.061), and heart rate ($25.2{\pm}5.2$ vs. $12.5{\pm}8.7%$, p=0.001) during the sleeping period were decreased after a night shift compared with day shift. The non-dipper group significantly increased from 20% to 40% after a night shift (p=0.018). Conclusion: Working night shift is significantly associated with non-dipper status in nurses.

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The utility of ambulatory blood pressure monitoring in obese children (소아 비만아에서 ambulatory blood pressure monitoring의 유용성)

  • Kim, Myung Jin;Song, Jin Young
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.604-609
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    • 2008
  • Purpose : Obesity in children and adolescence is highly correlated with adult obesity, which can provoke hypertension. Therefore, it is important to evaluate the blood pressure of obese children regularly. In this study, the results of ambulatory blood pressure monitoring (ABPM) in obese children and adolescents were evaluated. Methods : ABPM was conducted for selected patients who visited Handong University Sunlin Hospital from Feb. 1, 2006 to Dec. 1, 2007. The patients were classified into 3 groups: group 1 was normal, group 2 had normal casual blood pressure and a body mass index over the 95th percentile, and group 3 had high casual blood pressure over 120/80 mm Hg and a body mass index over the 95th percentile. Systolic and diastolic 24-hour blood pressure was measured, including both day and night. Results : There were 49 patients in the study. The results showed a significant difference for average systolic blood pressure between the three groups ($105.1{\pm}4.7$, $111.0{\pm}7.1$, $117.8{\pm}6.6mmHg$, P<0.001), but for average diastolic blood pressure only between groups 1 and 3 ($69.1{\pm}5.3$, $77.9{\pm}6.3mmHg$, P=0.001). In the daytime, only groups 1 and 3 showed a statistically significant difference for systolic and diastolic blood pressure. During the night the systolic pressure of group 3 was significantly higher than the other groups, but the diastolic pressure of group 3 was only higher than that group 1. No statistical difference was found in night dips among the groups. Conclusion : Ambulatory blood pressure monitoring in children and adolescents showed statistically higher blood pressure in obese patients with high casual blood pressure.

An Effect of the Self-Regulation Program for Hypertensives -Synthesis & testing of Orem and Bandura's theory- (본태성 고혈압 환자의 자가간호증진을 위한 자기조절 프로그램 효과 -Orem이론과 Bandura이론의 합성과 검증-)

  • Park, Young-Im;Hong, Yeo-Shin
    • Research in Community and Public Health Nursing
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    • v.5 no.2
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    • pp.109-129
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    • 1994
  • Chronic health problems has become a major concern and challenge to the health care professionals today. Especially hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Self-care is an essential factor that keeps chronic patients in control of their health and wellness. Thus this study was conducted to identify the effect of the comprehensive self-regulation program as a nursing intervention on the promotion self-care performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi-experimental research with pre and post test design was used. The subjects of the study was consisted of thirty persons with mild or moderate essential hypertension from two companies in Cheong-ju city. The whole program was carried out from October, 1993 to February, 1994. The self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The instruments used for data collection in this study were as follows : 1) Instruments used for measuring the knowledge about hypertension, multiple health locus of control, and perceived benifits and barriers were adapted from previous studies and modified by author to be fit for the subjects. 2) Self-efficacy scale and self-care performance record were developed by the author. 3) Physiological parameters included systolic / diastolic blood pressure, body weight, level of blood cholesterol, and 24hour ambulatory blood pressure. The post-experimental Cronbach's Alpha as the reliability test of scales were 0.703-0.897, an appropriate level of confidence. The effect of the program was analyzed by experimental stages ; the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t-test and t-test, repeated measure ANOVA, and pearson's correlation to de termine the effect of program. The results were as follows : 1) After the self-regulation program, scores on knowledge(t=-2.41, p=.011), perceived self-efficacy (F=5.60, p=.001), self-care performance(F=22.31, p=.0001) were significantly higher than those before the program. 2) After the program, both systolic and diastolic blood pressure were significantly lower than those before the program(F=10.89 -13.11, p=.0001). However in 24hour ambulatory blood pressure, systolic mean pressure was nearly significantly lower, but not in diastolic mean pressure. 3) After the program, the body weight was significant decresed(t=5.53, p=.0001), but the blood cholesterol level was not decreased significantly except in those cases with higher cholesterol level. 4) There were significant relationships between changes in self-care performance and diastolic pressure at 1st week (r=.3389, p=.033) and changes in self-care performance and systolic pressure at 9th week(r=.3651, p=.024). 5) There were significant relationship between perceived self-efficacy and self-care performance at 5th week(r=.5313, p=.001) and 9th week (r=.3026, p=.052). 6) After the program, internal health locus of control and perceived benefits did not show significant change, but perceived barriers was significantly lower than those before the program (t=3.57, p=.0001). From the above results, it can be concluded that 1) The self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives and to lower the blood pressure. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings. 2) The synthesis of Orem's self-care theory and Bandura's self-regulation & self-efficacy theory in this study was proved to enhance explanation and prediction of the change of self-care behavior. Thus the result of the study would contribute in development of the self-care theory and an expansion of practice-theory.

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Antihypertensive effect of Chunghyul-dan(Qingxue-dan) on stage 1 hypertensive patients with stroke (중풍환자 1기 고혈압에 청혈단(淸血丹)의 항고혈압 효과)

  • Kim, Lee-Dong;Lee, Sang-Ho;Kim, Eun-Ju;Kim, Tai-Hun;Park, Young-Min;Jung, Dong-Won;Shin, Won-Jun;Jung, Woo-Sang;Bae, Hyung-Sup;Yun, Sang-Pil
    • The Journal of Internal Korean Medicine
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    • v.25 no.2
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    • pp.195-201
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    • 2004
  • Background and Purpose : Hypertension is one of the modifiable risk factors for stroke. Lowering blood pressure is a primary or secondary preventative measure for stroke. This study aims to assess the efficacy of Chunghyul-dan(Qingxue-dan) in stage 1 hypertensive patients who have suffered a stroke by 24 hour ambulatory blood pressure monitoring(24ABPM). Subjects& Methods : We enrolled 40 hospitalized stroke patients with stage 1 hypertension and divided them into 2 groups by stratified randomization; group A took 1200mg of Chunghyul-dan(Qingxue-dan) at 8:00 a.m. for two weeks without changing herbal medicine, and group B was the control group. 28 patients were included in the final analysis(15 in group A. 13 in group B). Blood pressure is monitored from 8:00 am to 7:30 am every 30 minutes for 24 hours. Blood pressure was monitored two times at baseline and again two weeks later. We used 3 parameters for evaluating the efficacy of Chunghyul-dan(Qingxue-dan); The first parameter is change from baseline to two weeks later in blood pressure and pulse rate. The second parameter is the trough/peak ratio(TPR) and smoothness index(SI). The third parameter is antihypertensive rate by antihypertensive efficacy guideline. Results : There is no significant difference in the baseline assessment hetween the two groups. Systolic blood pressure $(141.37{\pm}8.96\;mmHg\;vs\;132.28{\pm}9.46\;mmHg)$ decreased after two weeks of 1200mg(P=0.03) intake of Chunghyul-dan(Qingxue-dan). Systolic TPR and SI was 0.87 and 1.04 in group A. Antihypertensive rate was higher in group A. Conclusion: These results suggest that 1200mg doses of Clunghyul-dan(Qingxue-dan) is an effective antihypertensive agent on stage 1 hypertension patients who have suffered a stroke.

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Frequency and Related Factors of Masked Hypertension at a Worksite in Korea

  • Kim, Sang-Kyu;Bae, Jun-Ho;Nah, Dung-Young;Lee, Dong-Wook;Hwang, Tae-Yoon;Lee, Kyeong-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.44 no.3
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    • pp.131-139
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    • 2011
  • Objectives: Masked hypertension is associated with metabolic risks and increased risk of cardiovascular disease. The purpose of this study was to identify the frequency of and risk factors of masked hypertension in Korean workers. Methods: The study was conducted among 121 employees at a hotel in Gyeongju, Korea, from December 2008 to February 2009. We measured blood pressure (BP) both in the clinic and using 24-hour ambulatory BP monitors for all subjects. Hypertension was defined independently by both methods, and subjects were classified into four groups: true normotension, masked hypertension, white coat hypertension, and sustained hypertension. Results: The frequency of masked hypertension in our study group was 25.6%. Compared with true normotension, the factors related to masked hypertension were male gender (odds ratio [OR], 10.7; 95% confidence interval [CI], 1.41 to 81.09), aging one year (OR, 0.88; 95% CI, 0.78 to 0.99), clinic BP 120-129 /80-84 mmHg (OR, 8.42; 95% CI, 1.51 to 46.82), clinic BP 130-139 / 85-89 mmHg (OR, 12.14; 95% CI, 1.80 to 81.85), smoking (OR, 5.51; 95% CI, 1.15 to 26.54), and increase of total cholesterol 1 mg / dL (OR, 1.05; 95% CI, 1.02 to 1.08). In males only, these factors were clinic BP 120-129/ 80-84 mmHg (OR, 15.07; 95% CI, 1.55 to 146.19), clinic BP 130-139/ 85-89 mmHg (OR, 17.16; 95% CI, 1.56 to 189.45), smoking (OR, 11.61; 95% CI, 1.52 to 88.62), and increase of total cholesterol 1 mg/dL (OR, 1.05; 95% CI, 1.01 to 1.09). Conclusions: The frequency of masked hypertension was high in our study sample. Detection and management of masked hypertension, a known strong predictor of cardiovascular risk, could improve prognosis for at-risk populations.

The Influence of Obstructive Sleep Apnea on Systemic Blood Pressure, Cardiac Rhythm and the Changes of Urinary (폐쇄성 수면 무호흡이 전신성 혈압, 심조율 및 요 Catecholamines 농도 변화에 미치는 영향)

  • Lo, Dae-Keun;Choi, Young-Mee;Song, Jeong-Sup;Park, Sung-Hak;Moon, Hwa-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.153-168
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    • 1998
  • Background: The existing data indicate that obstructive sleep apnea syndrome contributes to the development of cardiovascular dysfunction such as systemic hypertension and cardiac arrhythmias, and the cardiovascular dysfunction has a major effect on high long-term mortality rate in obstructive sleep apnea syndrome patients. To a large extent the various studies have helped to clarify the pathophysiology of obstructive sleep apnea, but many basic questions still remain unanswered. Methods: In this study, the influence of obstructive sleep apnea on systemic blood pressure, cardiac rhythm and urinary catecholamines concentration was evaluated. Over-night polysomnography, 24-hour ambulatory blood pressure and ECG monitoring, and measurement of urinary catecholamines, norepinephrine (UNE) and epinephrine (UEP), during waking and sleep were undertaken in obstructive sleep apnea syndrome patients group (OSAS, n=29) and control group (Control, n=25). Results: 1) In OSAS and Control, UNE and UEP concentrations during sleep were significantly lower than during waking (P<0.01). In UNE concentrations during sleep, OSAS showed higher levels compare to Control (P<0.05). 2) In OSAS, there was a increasing tendency of the number of non-dipper of nocturnal blood pressure compare to Control (P=0.089). 3) In both group (n=54), mean systolic blood pressure during waking and sleep showed significant correlation with polysomnographic data including apnea index (AI), apnea-hypopnea index (AHI), arterial oxygen saturation nadir ($SaO_2$ nadir) and degree of oxygen desaturation (DOD). And UNE concentrations during sleep were correlated with AI, AHI, $SaO_2$ nadir, DOD and mean diastolic blood pressure during sleep. 4) In OSAS with AI>20 (n==14), there was a significant difference of heart rates before, during and after apneic events (P<0.01), and these changes of heart rates were correlated with the duration of apnea (P<0.01). The difference of heart rates between apneic and postapneic period (${\Delta}HR$) was significantly correlated with the difference of arterial oxygen saturation between before and after apneic event (${\Delta}SaO_2$) (r=0.223, P<0.001). 5) There was no significant difference in the incidence of cardiac arrhythmias between OSAS and Control In Control, the incidence of ventricular ectopy during sleep was significantly lower than during waking. But in OSAS, there was no difference between during waking and sleep. Conclusion : These results suggested that recurrent hypoxia and arousals from sleep in patients with obstructive sleep apnea syndrome may increase sympathetic nervous system activity, and recurrent hypoxia and increased sympathetic nervous system activity could contribute to the development of cardiovascular dysfunction including the changes of systemic blood pressure and cardiac function.

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