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研究生:劉佳欣
研究生(外文):Chia-Hsin Liu
論文名稱:慢速呼吸運動調降血壓之臨床預測因子
論文名稱(外文):Predictors for Responders with Blood Pressure Reduction by Slow Breathing Exercise
指導教授:蔡美文蔡美文引用關係
指導教授(外文):Mei-Wun Tsai
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:物理治療暨輔助科技學系
學門:醫藥衛生學門
學類:復健醫學學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:英文
論文頁數:80
中文關鍵詞:高血壓呼吸運動預測因子
外文關鍵詞:hypertensionslow breathing exercisepredictors
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研究背景:高血壓是一高盛行率的全球性健康問題,近年來的研究更顯示血壓上升即使未達臨床的診斷標準對健康壽命也是具有相當地威脅性,而調降血壓可以顯著降低心血管疾病的發生率與死亡率。有研究顯示簡易的慢速度呼吸運動在一些血壓偏高的族群中可以有效的調降其血壓,及增進其心血管相關的調節功能,不過各研究間之血壓調降效果仍有很大的個別變異甚或有出現負面的成果。本研究目的為比較呼吸運動可以有效調降血壓與無效調降血壓者間的基本資料、臨床特徵、生理數據與呼吸運動執行順應性的差異;並且進一步分析呼吸運動可有效調降血壓的臨床預測因子。
研究方法:本研究共納入54位符合選取條件的受測者,進行為期4週的呼吸運動介入。在介入前會先針對個案的基本資料、臨床生理數據、生活習慣、心血管自律神經功能與壓力狀態進行資料蒐集作為後來成效分析的潛在因子。當受測者在四週的介入後滿足以下三項條件時,即會歸為反應良好者:1) 原始血壓高於130/80毫米汞柱者,血壓調降於其下;2) 收縮壓下降10毫米汞柱以上;3) 舒張壓下降5毫米汞柱以上。另一方面,當受測者不滿足以上任一條件時,則會將其歸納為反應不良的組別。利用獨立t檢定或卡方檢定檢驗兩組之間的差別並找出有潛力的預估因子,再進一步使用多變量羅吉斯回歸分析找出能用慢速度呼吸運動調降血壓的臨床決策因子。
研究結果:54位個案(37%男性,平均年齡54.1±4.6歲,33.3%有使用高血壓藥物治療),平均原始血壓為115.9±15.2/73.9±9.9毫米汞柱,在四週慢速呼吸運動介入之後,血壓改變為-3.9±12.4/-2.4±7.4毫米汞柱 (p<0.05) ,其中25位個案(46.3 %)符合反應良好者的條件,反應良好組在四週介入後血壓平均下降 11.8±9.6/8.2±4.9毫米汞柱,相較於反應不良組的血壓變化為上升3±10.3/2.6±5.4毫米汞柱。經由多變項回歸分析得知,此四週慢速呼吸調降血壓的運動最有助益於年齡高於55歲或是LF%高於49.86%者;對於沒有使用藥物的族群而言,反應良好者大部分屬於年齡偏高、沒有高血壓家族史、LF%大於49.86%或是α-HF高於3.96(毫秒/毫米汞柱);而有用藥或是血壓偏高的族群則是高鹽者與收縮壓血壓浮動高於5毫米汞柱介入反應較為良好。
結論:這是第一個探索利用四週慢速呼吸運動而調降血壓反應良好者與相關因子分析的研究,本研究主要的發現為本族群中血壓有效下降與原始血壓的高低、心率變異度之LF%、個案年齡、高血壓家族史、感壓反射敏感度之α-HF 指標、鹽類攝取與收縮壓血壓浮動有顯著相關,並有族群特異性。另外也發現慢速呼吸運動對具高危險因子者的血壓調降的效益較好。
Background and Purpose: High blood pressure (BP) is a prevalent and life-threatening risk factor over the world. Reducing BP is associated with a significant reduction in cardiovascular morbidity and mortality. Recent studies have shown that slow breathing exercise can be an efficacious way to lower BP in subjects with elevated BP, and there is numbers of beneficial effects on the cardiovascular regulatory functions. However, the efficacy of slow breathing exercise on BP reduction still exist individual variance and controversial findings on lowering blood pressure. The aims of this study were to compare the demographic, clinical, physiological data, and compliance of performing breathing exercise between responders and non-responders of BP reduction, and to identify significant predictors for clinical application on reducing BP by slow breathing exercise.
Method: A cohort of 54 subjects who met selection criteria of this study were recruited. Their baseline data were collected as potential predictors, which included the demographic data, clinical features, lifestyle behaviors, cardiovascular autonomic nerve functions, and stress status. Responders of significant lowering BP was defined as one of the following conditions after 4-week intervention satisfied: 1) BP was controlled below 130/80 mmHg for subjects with higher BP more than 130/80 mmHg at baseline, 2) the reduction of systolic blood pressure was more than 10 mmHg, 3) the reduction of diastolic blood pressure was more than 5 mmHg. In contrast, subjects who fail to achieve the above targets after intervention were categorized as non-responders. Comparisons of the personal and clinical characteristics between responders and non-responders were analyzed by independent t-test or chi-square test to assess potential predictors. Furthermore, multivariate logistic regression was used to determine the significant predictors for responders who could significantly reduce BP by slow breathing exercise.
Results: Fifty-four subjects were recruited (37% male, aged 54.1±4.6 years, baseline BP: 115.9±15.2/73.9±9.9 mmHg, 33.3% medicated). BP significantly lowered from baseline (change, -3.9±12.4/-2.4±7.4 mmHg) after 4-week intervention of slow breathing exercise, and 25 subjects (46.3 %) achieved targets of being a responder. The main reduction of blood pressure within responders and non-responders were -11.8±9.6/-8.2±4.9 mmHg and 3±10.3/2.6±5.4 mmHg after the 4-week intervention. A 4-week slow breathing exercise intervention was generally applicable to subjects aged over 55 years or assessed with a higher LF% (more than 49.86%). For subject without medication, aged over 55 years, family history without hypertension, LF% over 49.86%, α-HF over 3.96 ms/mmHg, these factor were significantly associated with responders. As well, subjects with higher blood pressure or with medication, higher salt intake or higher SBP oscillation (more than 5 mmHg) tended to advantage in the treatment.
Conclusion: This is the first study to investigate predictors for responders with blood pressure reduction via a 4-week intervention of slow breathing exercise. The main findings of presented study were found blood pressure changes to depend on baseline BP, age, family history of hypertension, autonomic activity of LF% and α-HF index, salt intake and SBP oscillation in a group-specific trend, but were found independent of gender and BMI. In addition, there were clinical implications in the practice; subjects at higher risk appear to be benefit more.
TABLE OF CONTENTS i
ACKNOWLEDGEMENTS v
LIST OF TABLES vii
LIST OF FIGURES ix
ABSTRACT x
摘要 xii
CHAPTER ONE INTRODUCTION 1
CHAPTER TWO LITERATURE REVIEW 6
2.1 Classification of Blood Pressure 6
2.1.1 Measurement of blood pressure at home setting 6
2.2 Risk Factors of Hypertension 8
2.2.1 Aging 8
2.2.2 Obesity 9
2.2.3 Poor lifestyle 10
2.2.4 Genetic 11
2.2.5 Psychological stress 11
2.2.6 Autonomic imbalance 12
2.3 Treatment of Hypertension 13
2.3.1 Weight reduction 14
2.3.2 Physical activity 15
2.3.3 Dietary approach and sodium control 16
2.3.4 Slow breathing exercise 16
2.4 Effect of Slow Breathing Exercise 17
2.4.1 Blood pressure reduction 18
2.4.2 Modification on autonomic nervous system 19
2.4.3 Other beneficial effects 20
CHAPTER THREE METHOD 22
3.1 Study Design 22
3.2 Subjects 22
3.3 Study Procedure and Protocol of Slow Breathing Exercise 23
3.4 Data Collection and Management 25
3.4.1 Blood pressure 26
3.4.2 Basic data 27
3.4.3 Lifestyle behavior, Psychological stress, and Personality 28
3.4.4 Physiological data 31
3.5 Definition of Responders of Blood Pressure Reduction 35
3.6 Categorized variables of the potential predictors 36
3.7 Statistical Analysis 36
CHAPTER FOUR RESULTS 39
4.1 Baseline Characteristics 39
4.2 Compliance of Slow Breathing Exercise Intervention 40
4.3 Effectiveness of 4-week slow breathing exercise 40
4.4 Comparison between Responders and Non-responders 41
4.5 Association between Potential Factors and Blood Pressure Reduction 43
4.6 Multivariate Analysis of the Predictors for Responders 44
CHAPTER FIVE DISCUSSION 46
5.1 Predictors for responders with blood pressure reduction 46
5.2 Effect of Slow Breathing Exercise 49
5.3 Limitations 52
5.4 Implication and Further Recommendations 52
5.5 Conclusions 53
REFERENCES 54
APPENDICES 77
Appendix A. Consent form 77
Appendix B. Definition for parameters of HRV and BRS 79
Appendix C. Cutoffs for potential predictors 80
(1) Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr., Jones DW, Materson BJ, Oparil S, Wright JT, Jr., Roccella EJ. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003 December;42(6):1206-52.
(2) Messerli FH, Williams B, Ritz E. Essential hypertension. Lancet 2007 August 18;370(9587):591-603.
(3) Vasan RS, Beiser A, Seshadri S, Larson MG, Kannel WB, D'Agostino RB, Levy D. Residual lifetime risk for developing hypertension in middle-aged women and men: The Framingham Heart Study. JAMA 2002 February 27;287(8):1003-10.
(4) Hansson L, Zanchetti A, Carruthers SG, Dahlof B, Elmfeldt D, Julius S, Menard J, Rahn KH, Wedel H, Westerling S. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group.[see comment]. Lancet 1998 June 13;351(9118):1755-62.
(5) Stamler R. Implications of the INTERSALT study. Hypertension 1991 January;17(1 Suppl):I16-I20.
(6) Cook NR, Cohen J, Hebert PR, Taylor JO, Hennekens CH. Implications of small reductions in diastolic blood pressure for primary prevention. Arch Intern Med 1995 April 10;155(7):701-9.
(7) Mancia G, De BG, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, Narkiewicz K, Ruilope L, Rynkiewicz A, Schmieder RE, Boudier HA, Zanchetti A, Vahanian A, Camm J, De CR, Dean V, Dickstein K, Filippatos G, Funck-Brentano C, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL, Erdine S, Kiowski W, gabiti-Rosei E, Ambrosioni E, Lindholm LH, Viigimaa M, Adamopoulos S, gabiti-Rosei E, Ambrosioni E, Bertomeu V, Clement D, Erdine S, Farsang C, Gaita D, Lip G, Mallion JM, Manolis AJ, Nilsson PM, O'Brien E, Ponikowski P, Redon J, Ruschitzka F, Tamargo J, van ZP, Waeber B, Williams B. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007 June;25(6):1105-87.
(8) He J, Whelton PK, Appel LJ, Charleston J, Klag MJ. Long-term effects of weight loss and dietary sodium reduction on incidence of hypertension. Hypertension 2000 February;35(2):544-9.
(9) Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller ER, III, Simons-Morton DG, Karanja N, Lin PH. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med 2001 January 4;344(1):3-10.
(10) Kelley GA, Kelley KS. Progressive resistance exercise and resting blood pressure : A meta-analysis of randomized controlled trials. Hypertension 2000 March;35(3):838-43.
(11) Chobanian AV, Hill M. National Heart, Lung, and Blood Institute Workshop on Sodium and Blood Pressure : a critical review of current scientific evidence. Hypertension 2000 April;35(4):858-63.
(12) Xin X, He J, Frontini MG, Ogden LG, Motsamai OI, Whelton PK. Effects of alcohol reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension 2001 November;38(5):1112-7.
(13) 高血壓防治手冊-高血壓偵測、控制與治療流程指引. 陳明豐 ed. 行政院衛生署國民健康局; 2004.
(14) Bernardi L, Porta C, Spicuzza L, Bellwon J, Spadacini G, Frey AW, Yeung LY, Sanderson JE, Pedretti R, Tramarin R. Slow breathing increases arterial baroreflex sensitivity in patients with chronic heart failure. Circulation 2002 January 15;105(2):143-5.
(15) Joseph CN, Porta C, Casucci G, Casiraghi N, Maffeis M, Rossi M, Bernardi L. Slow breathing improves arterial baroreflex sensitivity and decreases blood pressure in essential hypertension. Hypertension 2005 October;46(4):714-8.
(16) Spicuzza L, Gabutti A, Porta C, Montano N, Bernardi L. Yoga and chemoreflex response to hypoxia and hypercapnia.[see comment][erratum appears in Lancet 2000 Nov 4;356(9241):1612]. Lancet 2000 October 28;356(9240):1495-6.
(17) Goso Y, Asanoi H, Ishise H, Kameyama T, Hirai T, Nozawa T, Takashima S, Umeno K, Inoue H. Respiratory modulation of muscle sympathetic nerve activity in patients with chronic heart failure. Circulation 2001 July 24;104(4):418-23.
(18) Patel C, North WRS. Randomized controlled trial of yoga and bio-feedback in management of hypertension. The Lancet 1975 July 19;306(7925):93-5.
(19) Lee MS, Pittler MH, Guo R, Ernst E. Qigong for hypertension: a systematic review of randomized clinical trials. J Hypertens 2007 August;25(8):1525-32.
(20) Goldstein DS, Pechnik S, Holmes C, Eldadah B, Sharabi Y. Association between supine hypertension and orthostatic hypotension in autonomic failure. Hypertension 2003 August;42(2):136-42.
(21) Schein MH, Gavish B, Herz M, Rosner-Kahana D, Naveh P, Knishkowy B, Zlotnikov E, Ben-Zvi N, Melmed RN. Treating hypertension with a device that slows and regularises breathing: a randomised, double-blind controlled study. Journal of Human Hypertension 2001 April;15(4):271-8.
(22) Meles E, Giannattasio C, Failla M, Gentile G, Capra A, Mancia G. Nonpharmacologic treatment of hypertension by respiratory exercise in the home setting. Am J Hypertens 2004 April;17(4):370-4.
(23) Reyes del Paso GA, Cea JI, Gonzalez-Pinto A, Cabo OM, Caso R, Brazal J, Martinez B, Hernandez JA, Gonzalez MI. Short-term effects of a brief respiratory training on baroreceptor cardiac reflex function in normotensive and mild hypertensive subjects. Appl Psychophysiol Biofeedback 2006 March;31(1):37-49.
(24) Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002 December 17;106(25):3143-421.
(25) Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, Jr., Spertus JA, Costa F. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Curr Opin Cardiol 2006 January;21(1):1-6.
(26) O'Brien E, Asmar R, Beilin L, Imai Y, Mallion JM, Mancia G, Mengden T, Myers M, Padfield P, Palatini P, Parati G, Pickering T, Redon J, Staessen J, Stergiou G, Verdecchia P. European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement. J Hypertens 2003 May;21(5):821-48.
(27) Ayman D, Goldshine AD. Blood pressure determination by patients with essential hypertension. I. The difference between clinic and home readings before treatment. Am J Med Sci 1940;200:465-74.
(28) Reims H, Fossum E, Kjeldsen SE, Julius S. Home blood pressure monitoring. Current knowledge and directions for future research. Blood Press 2001;10(5-6):271-87.
(29) Mejia AD, Julius S, Jones KA, Schork NJ, Kneisley J. The Tecumseh Blood Pressure Study. Normative data on blood pressure self-determination. Arch Intern Med 1990 June;150(6):1209-13.
(30) Kjeldsen SE, Hedner T, Jamerson K, Julius S, Haley WE, Zabalgoitia M, Butt AR, Rahman SN, Hansson L. Hypertension optimal treatment (HOT) study: home blood pressure in treated hypertensive subjects. Hypertension 1998 April;31(4):1014-20.
(31) Stergiou GS, Thomopoulou GC, Skeva II, Mountokalakis TD. Home blood pressure normalcy: the Didima study. Am J Hypertens 2000 June;13(6 Pt 1):678-85.
(32) Ducher M, Fauvel JP, Cerutti C. Risk profile in hypertension genesis: A five-year follow-up study. Am J Hypertens 2006 August;19(8):775-80.
(33) Oparil S, Zaman MA, Calhoun DA. Pathogenesis of hypertension. Ann Intern Med 2003 November 4;139(9):761-76.
(34) Ong KL, Cheung BM, Man YB, Lau CP, Lam KS. Prevalence, awareness, treatment, and control of hypertension among United States adults 1999-2004. Hypertension 2007 January;49(1):69-75.
(35) Nakanishi N, Suzuki K. Daily life activity and the risk of developing hypertension in middle-aged Japanese men. Arch Intern Med 2005 January 24;165(2):214-20.
(36) This pronouncement was written for the American College of Sports Medicine by, Pescatello LSPh, Franklin BAP, Fagard RMD, Farquhar WBP, Kelley GAD, Ray CAP. Exercise and Hypertension. [Article]. Medicine & Science in Sports & Exercise 2004 March;36(3):533-53.
(37) Paffenbarger RS, Jr., Wing AL, Hyde RT, Jung DL. Physical activity and incidence of hypertension in college alumni. Am J Epidemiol 1983 March;117(3):245-57.
(38) Groppelli A, Giorgi DM, Omboni S, Parati G, Mancia G. Persistent blood pressure increase induced by heavy smoking. J Hypertens 1992 May;10(5):495-9.
(39) Narkiewicz K, van de Borne PJ, Hausberg M, Cooley RL, Winniford MD, Davison DE, Somers VK. Cigarette smoking increases sympathetic outflow in humans. Circulation 1998 August 11;98(6):528-34.
(40) Rosenberg L, Kaufman DW, Helmrich SP, Shapiro S. The risk of myocardial infarction after quitting smoking in men under 55 years of age. N Engl J Med 1985 December 12;313(24):1511-4.
(41) Wilson K, Gibson N, Willan A, Cook D. Effect of smoking cessation on mortality after myocardial infarction: meta-analysis of cohort studies. Arch Intern Med 2000 April 10;160(7):939-44.
(42) Williams RR, Hunt SC, Hopkins PN, Wu LL, Hasstedt SJ, Berry TD, Barlow GK, Stults BM, Schumacher MC, Ludwig EH, . Genetic basis of familial dyslipidemia and hypertension: 15-year results from Utah. Am J Hypertens 1993 November;6(11 Pt 2):319S-27S.
(43) Tseng CH. Effect of parental hypertension and/or parental diabetes on hypertension in Taiwanese diabetic patients. Eur J Clin Invest 2007 November;37(11):870-7.
(44) Jonas BS, Franks P, Ingram DD. Are symptoms of anxiety and depression risk factors for hypertension? Longitudinal evidence from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Arch Fam Med 1997 January;6(1):43-9.
(45) Bonnet F, Irving K, Terra JL, Nony P, Berthezene F, Moulin P. Anxiety and depression are associated with unhealthy lifestyle in patients at risk of cardiovascular disease. Atherosclerosis 2005 February;178(2):339-44.
(46) Brotman DJ, Golden SH, Wittstein IS. The cardiovascular toll of stress. Lancet 2007 September 22;370(9592):1089-100.
(47) Langewitz W, Ruddel H, Schachinger H. Reduced parasympathetic cardiac control in patients with hypertension at rest and under mental stress. Am Heart J 1994 January;127(1):122-8.
(48) Mussalo H, Vanninen E, Ikaheimo R, Laitinen T, Laakso M, Lansimies E, Hartikainen J. Heart rate variability and its determinants in patients with severe or mild essential hypertension. Clin Physiol 2001 September;21(5):594-604.
(49) Cowley AW, Jr., Liard JF, Guyton AC. Role of baroreceptor reflex in daily control of arterial blood pressure and other variables in dogs. Circ Res 1973 May;32(5):564-76.
(50) Grassi G, Cattaneo BM, Seravalle G, Lanfranchi A, Mancia G. Baroreflex control of sympathetic nerve activity in essential and secondary hypertension. Hypertension 1998 January;31(1):68-72.
(51) Sevre K, Lefrandt JD, Nordby G, Os I, Mulder M, Gans RO, Rostrup M, Smit AJ. Autonomic function in hypertensive and normotensive subjects: the importance of gender. Hypertension 2001 June;37(6):1351-6.
(52) Laterza MC, de Matos LD, Trombetta IC, Braga AM, Roveda F, Alves MJ, Krieger EM, Negrao CE, Rondon MU. Exercise training restores baroreflex sensitivity in never-treated hypertensive patients. Hypertension 2007 June;49(6):1298-306.
(53) Liu L, Zhang Y, Liu G, Li W, Zhang X, Zanchetti A. The Felodipine Event Reduction (FEVER) Study: a randomized long-term placebo-controlled trial in Chinese hypertensive patients. J Hypertens 2005 December;23(12):2157-72.
(54) Whelton PK, He J, Appel LJ, Cutler JA, Havas S, Kotchen TA, Roccella EJ, Stout R, Vallbona C, Winston MC, Karimbakas J, National High Blood Pressure Education Program Coordinating Committee. Primary prevention of hypertension: clinical and public health advisory from The National High Blood Pressure Education Program.[see comment]. JAMA 2002 October 16;288(15):1882-8.
(55) Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM. Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension 2003 November;42(5):878-84.
(56) FAGARD RH. Exercise characteristics and the blood pressure response to dynamic physical training. [Article]. Medicine & Science in Sports & Exercise 2001 June;33(6):S484-S492.
(57) Meredith IT, Jennings GL, Esler MD, Dewar EM, Bruce AM, Fazio VA, Korner PI. Time-course of the antihypertensive and autonomic effects of regular endurance exercise in human subjects. [Article]. Journal of Hypertension 1990 September;8(9):859-66.
(58) Appel LJ, Champagne CM, Harsha DW, Cooper LS, Obarzanek E, Elmer PJ, Stevens VJ, Vollmer WM, Lin PH, Svetkey LP, Stedman SW, Young DR. Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA 2003 April 23;289(16):2083-93.
(59) Bernardi L, Porta C, Gabutti A, Spicuzza L, Sleight P. Modulatory effects of respiration. Auton Neurosci 2001 July 20;90(1-2):47-56.
(60) Piepoli M, Sleight P, Leuzzi S, Valle F, Spadacini G, Passino C, Johnston J, Bernardi L. Origin of respiratory sinus arrhythmia in conscious humans. An important role for arterial carotid baroreceptors. Circulation 1997 April 1;95(7):1813-21.
(61) Elliott WJ, Izzo JL, Jr., White WB, Rosing DR, Snyder CS, Alter A, Gavish B, Black HR. Graded blood pressure reduction in hypertensive outpatients associated with use of a device to assist with slow breathing. Journal of Clinical Hypertension 6(10):553-9; quiz 560-1, 2004 October.
(62) Bernardi L, Passino C, Porta C, Anesi E, Palladini G, Merlini G. Widespread cardiovascular autonomic dysfunction in primary amyloidosis: does spontaneous hyperventilation have a compensatory role against postural hypotension? Heart 2002 December;88(6):615-21.
(63) Lehrer P, Sasaki Y, Saito Y. Zazen and cardiac variability. Psychosom Med 1999 November;61(6):812-21.
(64) Bernardi L, Spadacini G, Bellwon J, Hajric R, Roskamm H, Frey AW. Effect of breathing rate on oxygen saturation and exercise performance in chronic heart failure. Lancet 1998 May 2;351(9112):1308-11.
(65) Reay C, Menes J, Bousfield D, Colechin E, Sims A. Buyer's guide, Hospical grade non-invasive blood pressure monitors. 2008. Centre for Evidence-based Purchasing.
Ref Type: Pamphlet
(66) Alpert BS. Validation of the Welch Allyn Spot Vital Signs blood pressure device according to the ANSI/AAMI SP10: 2002. Accuracy and cost-efficiency successfully combined. Blood Press Monit 2007 October;12(5):345-7.
(67) Vollmer WM, Sacks FM, Ard J, Appel LJ, Bray GA, Simons-Morton DG, Conlin PR, Svetkey LP, Erlinger TP, Moore TJ, Karanja N. Effects of diet and sodium intake on blood pressure: subgroup analysis of the DASH-sodium trial. Ann Intern Med 2001 December 18;135(12):1019-28.
(68) Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation 1998 May 12;97(18):1837-47.
(69) Sallis JF, Haskell WL, Wood PD, Fortmann SP, Rogers T, Blair SN, Paffenbarger RS, Jr. Physical activity assessment methodology in the Five-City Project. Am J Epidemiol 1985 January;121(1):91-106.
(70) Dishman RK, Steinhardt M. Reliability and concurrent validity for a 7-d re-call of physical activity in college students. Med Sci Sports Exerc 1988 February;20(1):14-25.
(71) Chien M, Wu Y, Kwan W, Chien C. Reliability of the Chinese version of the 7-day recall physical activity questionnaire and its correlation with impairments of disease and function. FJPT 2003;28(1):1-8.
(72) Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983 December;24(4):385-96.
(73) 初麗娟, 高. 壓力知覺對負面心理健康影響:靜坐經驗、情緒智能調節效果之探討. 中華心理學刊 2005;47(2):157-79.
(74) 林一真. 中國人A型量表編製初步報告. 中國測驗學會測驗年刊 1989;36:13-24.
(75) 林一真. 中國A型量表之建構效度研究. 中國測驗學會測驗年刊 1990;37:73-96.
(76) Simon A, Levenson J. Early detection of subclinical atherosclerosis in asymptomatic subjects at high risk for cardiovascular disease. Hypertension 1993;15(6):1069-76.
(77) Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K, Koji Y, Hori S, Yamamoto Y. Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 2002 May;25(3):359-64.
(78) Yamashina A, Tomiyama H, Arai T, Hirose K, Koji Y, Hirayama Y, Yamamoto Y, Hori S. Brachial-ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk. Hypertens Res 2003 August;26(8):615-22.
(79) Kubozono T, Miyata M, Ueyama K, Nagaki A, Otsuji Y, Kusano K, Kubozono O, Tei C. Clinical significance and reproducibility of new arterial distensibility index. Circ J 2007 January;71(1):89-94.
(80) McDermott MM, Liu K, Criqui MH, Ruth K, Goff D, Saad MF, Wu C, Homma S, Sharrett AR. Ankle-brachial index and subclinical cardiac and carotid disease: the multi-ethnic study of atherosclerosis. Am J Epidemiol 2005 July 1;162(1):33-41.
(81) Sadowsky HS. Pulmonary Diagnostic Tests and Procedures. In: Ellen A.Hillegass, editor. Essentials of Cardiopulmonary Physical Therapy. Second ed. Saunders; 2001. p. 434-6.
(82) Imholz BP, Wieling W, van Montfrans GA, Wesseling KH. Fifteen years experience with finger arterial pressure monitoring: assessment of the technology. Cardiovasc Res 1998 June;38(3):605-16.
(83) Kuo TB, Chan SH. Continuous, on-line, real-time spectral analysis of systemic arterial pressure signals. Am J Physiol 1993 June;264(6 Pt 2):H2208-H2213.
(84) La Rovere MT. Baroreflex sensitivity as a new marker for risk stratification. Z Kardiol 2000;89 Suppl 3:44-50.
(85) La Rovere MT, Pinna GD, Raczak G. Baroreflex sensitivity: measurement and clinical implications. Ann Noninvasive Electrocardiol 2008 April;13(2):191-207.
(86) Kuo TB, Lin T, Yang CC, Li CL, Chen CF, Chou P. Effect of aging on gender differences in neural control of heart rate. Am J Physiol 1999 December;277(6 Pt 2):H2233-H2239.
(87) Novak V, Saul JP, Eckberg DL. Task Force report on heart rate variability. Circulation 1997 August 5;96(3):1056-7.
(88) Grossman E, Grossman A, Schein MH, Zimlichman R, Gavish B. Breathing-control lowers blood pressure. J Hum Hypertens 2001 April;15(4):263-9.
(89) Viskoper R, Shapira I, Priluck R, Mindlin R, Chornia L, Laszt A, Dicker D, Gavish B, Alter A. Nonpharmacologic treatment of resistant hypertensives by device-guided slow breathing exercises. Am J Hypertens 2003 June;16(6):484-7.
(90) Hesse C, Charkoudian N, Liu Z, Joyner MJ, Eisenach JH. Baroreflex sensitivity inversely correlates with ambulatory blood pressure in healthy normotensive humans. Hypertension 2007 July;50(1):41-6.
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