| Summary: | 碩士 === 臺北醫學大學 === 護理學研究所 === 97 === Title of Thesis: The Relationship Among Ambulatory Blood Pressure, Aortic Stiffness, and Autonomic Nervous System Function in Patients With Components of the Metabolic Syndrome
Institution: Graduate Institute of Nursing, Taipei Medical University
Author: Pei-Chuan Chiang
Thesis directed by: Pei-Shan Tsai, Ph. D., Professor
Aim: This study examined the relationship among ambulatory blood pressure, aortic stiffness, and autonomic nervous system (ANS) function in individuals with components of the metabolic syndrome (MS).
Method: This study used a cross-sectional and correlational design. MS was defined according to the criteria of the National Cholesterol Education Program’s Adult Treatment Panel III. The MS score was also calculated. The SpaceLabs ambulatory blood pressure (ABP) monitor, SphygmoCor pulse wave analysis system, and power spectral analysis were used to measure 48-hour ABP, aortic pulse wave velocity (PWV) and augmentation index (AI), and heart rate variability (HRV), respectively in ninety-eight participants with components of the MS.
Results: The major findings of this study were as followed: 1) The MS score and PWV were significantly and positively correlated (r= .225, p= .048), 2) The average MS Score were not significantly different among nondippers, dippers, and extreme dippers (F=1.430, p= .249), 3) Neither PWV nor AI was significantly different among nondippers, dippers, and extreme dippers (F=1.469, p= .238; F=0.461, p= .633). However, the AASI was significantly higher in nondippers than in dippers and extreme dippers (p= .018; p< .001); AASI was significantly higher in dippers than in extreme dippers (p= . 011), 4) The high-frequency HRV in normalized units (n.u.) did not play a role in moderating the relationship between the MS Score and nocturnal blood pressure dipping, and 5) AI did not influence the relationship between nocturnal blood pressure dipping and low-frequency HRV.
Conclusion: Caculating the MS Score may be more useful than determining the numbers of the MS components judging from their impact on aortic stiffness. The more the components of the MS one has, not only the less active the parasympathetic nervous system is, but also the more unbalanced between the sympathetic and parasympathetic nervous system are. This study did not support the notion that the ANS affects the relationship between MS and nocturnal blood pressure dipping. The study showed that AASI increased with the decrease in the nocturnal blood pressure dipping, suggestively that nocturnal blood pressure dipping was related to the degree of aortic stiffness. It also supported the notion that blunted nocturnal blood pressure dipping is not a benign phenomenon.
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