Effects of Application of Elastic
Compression Stockings on Blood
Pressure, Pulse Rate, and Hypotensive
Symptoms in Patients with Intradialytic
Hypotension
Hyun-Jung Kim
Hee-Jung Kim
emodialysis complications in-
H
clude hypotension, muscle
spasms, nausea, vomiting,
headache, chest pain, itching,
and fever. Among the complications
of hemodialysis, hypotension is the
most common complication, occur-
ring in 25% to 50% of all hemodialy-
sis treatments (Flythe, Xue, Lynch,
Curthan, & Brunelli, 2014). This is
caused by various factors, such as sud-
den hypovolemia due to hyperfiltra-
tion during hemodialysis, insufficient
compensatory mechanisms, such as
left ventricular dysfunction, disorder
of plasma recharge, regulation of
sympathetic nervous system, and
arterial vascular stiffness (Yamamoto
et al., 2012).
Intradialytic hypotension is a sig-
nificant and independent risk factor
that decreases the efficiency of
hemodialysis treatment and is associat-
ed with poor survival outcomes for
patients on hemodialysis (McIntyre &
Goldsmith, 2015). In addition, intradi-
alytic hypotension may contribute sig-
nificantly to morbidity in patients on
hemodialysis through subtle effects of
organ damage due to localized hypop-
Hyun-Jung Kim, RN, is an Assistant Professor,
Gumi University, Department of Nursing,
Gyungbuk, South Korea.
Hee-Jung Kim, PhD, RN, is an Associate
Professor, The Catholic University of Daegu,
College of Nursing, Daegu, South Korea.
Statement of Disclosure: The authors reported
no actual or potential conflict of interest in rela-
tion to this continuing nursing education activity.
Note: The Learning Outcome, additional state-
ments of disclosure, and instructions for CNE
evaluation can be found on page 462.
Nephrology Nursing Journal September-October 2018
Continuing Nursing
Education
Copyright 2018 American Nephrology Nurses Association.
Kim, H.J., & Kim, H.J. (2018). Effects of application of elastic compression stockings on
blood pressure, pulse rate, and hypotensive symptoms in patients with intradialytic
hypotension. Nephrology Nursing Journal, 45(5), 455-461.
This study was conducted to identify the effect of elastic compression stockings on
hypotension in patients with intradialytic hypotension. Subjects of this study were 59
patients (29 in the experimental group, 30 in the control group). Elastic compression
stockings were applied to patients in the experimental group during hemodialysis. To
evaluate effects of treatment, systolic blood pressure, diastolic blood pressure, pulse rate,
and hypotension symptom scores were measured. Results indicated the decrease in sys-
tolic blood pressure in the experimental group was less than that in the control group.
Hypotension symptom scores were significantly decreased in the experimental group.
Considering these results, the application of elastic compression stockings can be regard-
ed as an effective nursing intervention to help prevent intradialytic hypotension in
patients undergoing hemodialysis.
Key Words: Compression stocking, hemodialysis, hypotension, blood pressure.
erfusion acting to reduce blood flow Several methods have been studied
rate and potentially lowering patient to control intradialytic hypotension,
compliance, leading to early termina- such as sodium concentrations control
tion of hemodialysis (Bradshaw, (National Kidney Foundation [NKF],
Bennett, Hutchinson, Ockerby, & Kerr, 2015), low-temperature dialysis, pre-
2017). Therefore, intradialytic hypoten- treatment with antihypertensive med-
sion should be prevented to perform ication, and control of ultrafiltration
and maintain proper hemodialysis rate over time (Palmer & Henrich,
treatment. In addition, even without 2008). However, despite these inter-
symptoms, sudden changes in blood ventions, intradialytic hypotension is
pressure due to hypotension may cause the most frequent complication (Flythe
a decrease in health outcomes and et al., 2014).
health-related quality of life, such as Active interventions by nephrology
increased cardiovascular complications nurses are essential to prevent intradi-
and mortality in patients on hemodial- alytic hypotension. However intradia-
ysis (Sasaki et al., 2005). Thus, it is nec- lytic hypotension often occurs sudden-
essary to identify the timing of intradi- ly, and some of these interventions
alytic hypotension and to develop a may require a physician’s order, which
strategic intervention plan for safe may require time to acquire. Mills,
hemodialysis (Kim, Choi, Won, & Kim, Fung, Travlos, and Krassioukov (2015)
2015). found that physical counter maneu-
Vol. 45, No. 5 455
Effects of Application of Elastic Compression Stockings on Blood Pressure, Pulse Rate, and
Hypotensive Symptoms in Patients with Intradialytic Hypotension
vers, such as pressing the abdomen or
lower extremities using an abdominal
band or elastic stockings, or crossing
the legs, were effective in reducing
hypotension after hemodialysis. How-
ever, the abdominal band has some
disadvantages, such as the need for
equipment and the need to measure
and maintain constant abdomen pres-
sure (Yamamoto et al., 2006). The leg-
crossing method was significantly
effective in maintaining blood pres-
sure but did not relieve other symp-
toms (Kim et al., 2015).
Some studies have been done to
prevent hypotension by applying elas-
tic compression stockings. In a study
of pregnant women who underwent
Cesarean section under spinal anes-
thesia, wearing elastic compression
stockings helped prevent hypotension
(Sutherland, Wee, Weston-Smith,
Skinner, & Tomas, 2004). Moreover,
in a study in which hemodynamic
changes were observed by applying
anti-embolization stockings during
hemodialysis, leg compression helped
reduce intradialytic hypotension in
patients (Kim, Lee, Kwon, Song, &
Kim, 2010). This is thought to be
caused by the elastic compression
stockings reducing the storage of
blood in the lower legs by applying
constant pressure to the lower limbs,
leading to increased central blood
flow (Sun et al., 2004). This approach
is non-invasive, has few side effects,
does not require additional equip-
ment, is easy to apply, and has eco-
nomic advantages. Consequently, the
application of elastic compression
stockings would be expected to
reduce the discomfort caused by
hypotension relatively easily and to be
an appropriate intervention method if
symptoms are not severe.
Our study was conducted to
develop a nursing intervention that
could prevent intradialytic hypoten-
sion by examining the effectiveness of
elastic compression stockings on
reducing intradialytic hypotension
patients. Specific objectives were to
determine the effectiveness of the
elastic compression stockings on the:
• Systolic blood pressure of patients
with intradialytic hypotension.
456
• Diastolic blood pressure of patients
with intradialytic hypotension.
• Pulse of patients with intradialytic
hypotension.
• Hypotension symptoms of patients
with intradialytic hypotension.
Methods
Design
This study was a quasi-experimen-
tal study by using a randomized con-
trolled trial with a non-equivalent
control group pretest-posttest design.
Ethical Considerations
This study was reviewed and
approved by the university hospital’s
Institutional Review Board. Before
the study, the researcher explained to
participants the purpose and method
of the study, measurements to be
taken, how to complete the question-
naire, participant confidentiality safe-
guards, and possible benefits and dis-
advantages of participating in the
study. Participants were assured their
refusal to participate in or withdrawal
from the study would not affect the
quality of care they would receive.
Written consent was obtained from all
participants. All participants received
their elastic compression stockings
and hand cream as a reward for par-
ticipating in the study.
Participants
Participants in this study were out-
patient patients on hemodialysis in
the hemodialysis unit of a university
hospital in South Korea. Inclusion cri-
teria were:
• Patients receiving hemodialysis
three times a week for four hours
on an outpatient basis.
• Patients aged 20 (the legal age of
majority in South Korea) to 80
years.
• Patients who have had at least two
hypotensive episodes with a sys-
tolic blood pressure lower than 20
mmHg during the last three
hemodialysis sessions.
• Patients who understand the pur-
pose of this study and sign the writ-
ten informed consent voluntarily.
Nephrology Nursing Journal
Exclusion criteria were as follows:
• Patients with cuts, redness, or skin
diseases in the lower legs.
• Patients whose blood pressure-relat-
ed medication was changed within
the prior month or were planning a
therapeutic change that may affect
hypotension during the study peri-
od.
• Patients with heart failure.
• Patients who were pregnant.
Sample Size
The sample size was calculated
using power analysis for the repeated
measures ANOVA with an effect size
of 0.25, a type error of 0.05, and
power of 95% using the G*Power
3.1.3 program. The number of sub-
jects required in this study was 52,
with 26 assigned to each group. A
total of 60 patients were included in
this study in consideration of the
potential dropout rate. During the
study, one participant in the control
group failed to receive all planned
hemodialysis treatments due to
hypotension. Therefore, there were
ultimately 30 patients in the experi-
mental group and 29 patients in the
control group.
Measurements
Blood pressure and pulse. To
measure changes in blood pressure
and pulse, systolic blood pressure,
diastolic blood pressure, and pulse
were measured before the beginning
of hemodialysis; then at 1, 2, and 3
hours after hemodialysis was begun;
and again at the end of hemodialysis.
Blood pressure and pulse rate were
measured using an automatic blood
pressure monitor mounted on a
hemodialyzer (Pheonix, GAMBRO,
Sweden).
Hypotensive symptoms. Hypo-
tensive symptoms were measured
with a questionnaire developed for
this study to determine a hypotensive
symptom score. The questionnaire
consisted of six items: abdominal dis-
comfort, yawning, nausea, muscle
spasms, sweating, and dizziness.
Items were based on a literature
review of intradialytic hypotensive
symptoms (K/DOQI Workgroup of
September-October 2018 Vol. 45, No. 5
the NKF, 2005). The content validity
was supported in preliminary work:
the questionnaire was reviewed by
one nephrologist and two nurses
experienced in hemodialysis, each
with more than 10 years of experi-
ence, and had an item level content
validity index (CVI) of 0.95.
Questionnaire items were rated on a
scale of 1 to 5, with a higher rating
indicating increased severity. The
scores on the questionnaire could
range from 6 to 30 points.
Preliminary Study
To assess the discomfort of partici-
pants during the study and to investi-
gate the feasibility of the study, five
eligible participants were selected for
the preliminary study. After explain-
ing the purpose of the study and
obtaining written informed consent,
preliminary surveys were conducted.
Results showed that there was no
inconvenience to patients, and no
problems were found during the
experiment.
Intervention
The elastic compression stockings
(Rxtar Compression Stocking, Elastic
Therapy, Inc., USA) were approved by
the U.S. Food and Drug Administration
(FDA) and were certified by ISO 9001.
The stockings were a thigh type with a
pressure of 20 to 30 mmHg as
employed in a previous study (Kim et
al., 2010), in the appropriate size for
each participant. After the researcher
checked the fit of the stockings on each
participant, hemodialysis was started.
Data Collection
The researcher visited the nursing
department and the hemodialysis
unit, and the treating nephrologist
explained the methods and purpose of
the research and was allowed to begin
data collection. Patients meeting eligi-
bility criteria were selected. After the
researcher’s brief explanation of the
study and obtaining written informed
consent from participants, they were
randomly assigned to the experimen-
tal group and the control group by
coin toss. Data collection was con-
ducted from September 1, 2013, to
Nephrology Nursing Journal September-October 2018
March 31, 2014, in the hemodialysis
unit.
The experimental group members
were asked to complete a question-
naire about general characteristics
when they arrived for hemodialysis,
and then were asked to wear elastic
compression stockings on the bed. All
participants were dialyzed in beds,
which is the usual practice in this unit.
Blood pressure and pulse rate were
measured before the start of hemodial-
ysis, on the hour for the next three
hours, and again at the end of
hemodialysis. After hemodialysis, par-
ticipants were asked to complete a
questionnaire on hypotensive symp-
toms. The control group was meas-
ured with the same procedure as the
experimental group.
The hemodialysis process was per-
formed as usual in both experimental
and control groups. The dialysis tem-
perature was set at 35.4° C, the blood
flow rate was set at 200 to 250
mL/minute according to the patient’s
blood vessel condition, and the
hemodialysis dialyzer membrane was
1.4 to 1.7 m². The perfusion rate was
500 mL/minute, and the composition
of the dialysate was not changed dur-
ing the study. In addition, both groups
underwent general intervention in the
event of intradialytic hypotension.
Data Analysis
Statistical analysis was conducted
using IBM SPSS for Windows (Ver.
19.0; Chicago, IL). Baseline data were
analyzed using descriptive statistics.
The homogeneity test for general and
clinical characteristics of the experi-
mental group, and the control group
was performed using a Chi-square test
and an independent t test. The homo-
geneity of the dependent variables in
both groups was tested using an inde-
pendent t test. Differences between
groups in blood pressure and pulse rate
over time were analyzed using the
repeated measures ANOVA, and post-
hoc analysis was performed by the
Bonferroni test. The difference between
groups for each hypotensive symptom
was analyzed using the Mann-Whitney
U test, and the total score of the
hypotensive symptom was analyzed
Vol. 45, No. 5
using an independent t test. All tests
conducted were two-tailed, and a p
value less than 0.05 was considered sta-
tistically significant.
Results
Demographic and Clinical
Characteristics of Participants
Demographic and clinical charac-
teristics of participants were similar
between groups. In addition, the
homogeneity of the dependent vari-
ables before experiment was con-
firmed (see Table 1).
Effects of Elastic Compression
Stockings on the Systolic
Blood Pressure
The interaction between group*
time was significant; the systolic blood
pressure of the experimental group sig-
nificantly decreased over time com-
pared to the control group (F=3.33,
p=0.025). There was a significant differ-
ence according to the time of measure-
ment (F=99.35, p=<0.001) (see Table
2). In a repeated measures ANOVA
analysis, the significant interaction in
group*time indicates the significant dif-
ference between the two groups over
time.
Effects of Elastic Compression
Stockings on the Diastolic
Blood Pressure
The interaction between group*time
was not significant regarding the effects
of compression stocking on the diastolic
blood pressure. There was no significant
difference in the diastolic blood pressure
between two groups over time (F=2.06,
p=0.102), and there was no significant
difference in the diastolic blood pressure
between groups (F = 0.00, p=0.997).
There was a significant difference
according to the time of measurement
(F=17.65, p=<0.001) (see Table 3).
Effects of Elastic Compression
Stockings on the Pulse Rate
The interaction between group*time
was not significant, pulse rate in two
groups had no significant difference
over time (F=0.38, p=0.723). There was
no significant difference in pulse change
457
Effects of Application of Elastic Compression Stockings on Blood Pressure, Pulse Rate, and
Hypotensive Symptoms in Patients with Intradialytic Hypotension

Table 1
Demographic and Clinical Characteristics of Participants
Exp. (n=30) Cont. (n=29)
(N=59)
Characteristics Categories n (%)/Mean(SD) n (%)/Mean(SD) c²/t p
Sex Male 17 (56.7) 17 (58.6) 0.02 0.544
Female 13 (43.3) 12 (41.4)
Age (years) ≤40 3 (10.0) 3 (10.3) 7.10 0.130
41-50 9 (30.0) 4 (13.8)
51-60 8 (26.7) 3 (10.3)
61-70 6 (20.0) 10 (34.5)
≥71 4 (13.3) 9 (31.0)
Level of education ≤ Elementary 11 (36.7) 6 (20.7) 4.79 0.188
Middle school 7 (23.3) 5 (17.2)
High school 9 (30.0) 9 (31.0)
≥ College 3 (10.0) 9 (31.0)
Duration of ≤12 5 (16.7) 4 (13.8) 7.22 0.204
hemodialysis (months)
13 to 24 10 (33.3) 3 (10.3)
25 to 36 1 (3.3) 5 (17.2)
37 to 48 5 (16.7) 5 (17.2)
49 to 60 4 (13.3) 4 (13.8)
≥61 5 (16.7) 8 (27.6)
Vascular access route AVF 25 (83.3) 27 (93.1) 4.40 0.111
AVG 4 (13.3) 0 (0.0)
Quinton catheter 1 (3.3) 2 (6.9)
Dry weight (Kg) 60.32 (11.98) 60.92 (9.23) 0.21* 0.831
Ultrafiltration volume (L) 2.70 (0.70) 2.55 (0.61) 0.92* 0.360
SBP (mmHg) 155.03 (17.45) 157.28 (17.50) 0.49 0.624
DBP (mmHg) 80.60 (13.01) 82.55 (10.43) 0.64 0.528
Pulse rate (/min) 73.53 (11.14) 76.83 (13.99) 1.00 0.320
Notes: Exp. = experimental group, Cont. = control group, AVF = arteriovenous fistula, AVG = arteriovenous graft, SBP = systolic
blood pressure, DBP = diastolic pressure.
*t test

Table 2
Effects of Elastic Compression Stockings on the Systolic Blood Pressure
Exp. (n=30) Cont. (n=29)
F (N=59)
Time Mean (SD) Mean (SD) p
At start 155.03 (17.45) 157.28 (17.50)
1 hour after starting hemodialysis 144.50 (17.13) 138.97 (15.16) G 0.21 0.650
2 hour after starting hemodialysis 135.33 (20.47) 136.31 (14.73) T 99.35 <0.001
3 hour after starting hemodialysis 132.87 (17.55) 132.55 (14.64) G*T 3.33 0.025
At finish 131.87 (19.79) 125.45 (13.35)

Notes: Exp. = experimental group, Cont.= control group, G = group, T = time.

458 Nephrology Nursing Journal September-October 2018 Vol. 45, No. 5

 Table 3
Effects of Elastic Compression Stockings on the Diastolic Blood Pressure
Exp. (n=30) Cont. (n=29)
(N=59)
Time Mean (SD) Mean (SD) F p
At start 80.60 (13.01) 82.55 (10.43)
1 hour after starting hemodialysis 78.53 (11.69) 77.83 (8.76) G 0.00 0.997
2 hours after starting hemodialysis 74.77 (14.13) 75.21 (9.88) T 17.65 <0.001
3 hours after starting hemodialysis 72.80 (12.26) 74.72 (8.18) G*T 2.06 0.102
At finish 75.77 (13.31) 72.21 (7.93)

Notes: Exp. = experimental group, Cont.= control group, G = group, T = time.

Table 4
Effects of Elastic Compression Stockings on the Pulse Rate
Exp. (n=30) Cont. (n=29)
(N=59)
Time Mean (SD) Mean (SD) F p
At start 75.53 (11.14) 76.83 (13.99)
1 hour after starting hemodialysis 72.17 (11.34) 76.48 (14.15) G 1.49 0.227
2 hours after starting hemodialysis 71.20 (11.78) 75.66 (13.92) T 4.27 0.011
3 hours after starting hemodialysis 72.93 (12.22) 75.83 (14.14) G*T 0.38 0.723
At finish 74.53 (12.88) 79.14 (14.20)

Notes: Exp. = experimental group, Cont.= control group, G = group, T = time.

between groups (F=1.49, p=0.227);
however, there was a significant differ-
ence according to the time of measure-
ment (F=4.27, p=0.011) (see Table 4).
Effects of Elastic Compression
Stockings on the Hypotensive
Symptom Scores
The total score of hypotensive
symptoms was 13.40 ± 2.04 in the
experimental group and 15.03 ± 2.32
in the control group (t=2.87, p=0.006).
In the experimental group, the most
severe symptoms were muscle spasm,
dizziness, and nausea. In the control
group, muscle spasms and vertigo
were severe. The differences between
the two groups were significant in
three items: abdominal discomfort
was 1.40 ± 0.56 in the experimental
group and 1.97 ± 0.78 in the control
group (z=2.98, p=0.003), yawning was
1.67 ± 0.66 in the experimental group
and 2.17 ± 0.71 in the control group
(z=2.68, p=0.007), and dizziness was
2.77 ± 0.90 in the experimental group
and 3.21 ± 0.90 in the control group
(z=2.05, p=0.041) (see Table 5).
Discussion
This study was conducted to eval-
uate the effects of the use of elastic
compression stockings on blood pres-
sure, pulse, and hypotensive symp-
toms in patients on hemodialysis with
intradialytic hypotension.
In this study, wearing elastic com-
pression stockings had a significant
effect on the systolic blood pressure of
patients with intradialytic hypoten-
sion. In repeated measures ANOVA
analysis, the significant interaction in
group*time indicates the significant
difference between the two groups
over time. Although studies on
patients on hemodialysis were not
previously conducted, a study of com-
pression stocking use in patients who
underwent Cesarean section (under
spinal anesthesia) showed results con-
sistent with this study. It is thought
that storage of blood in the lower
limbs is reduced while blood flow to
the heart is increased, thereby pre-
venting hypotension (Sun et al., 2004;
Sutherland et al., 2001). Results of this
study are very likely due to the same
mechanisms.
Because a reduction of diastolic
blood pressure during hemodialysis
leads to myocardial ischemia by
decreasing myocardial perfusion pres-
sure (Selby & McIntyre, 2007), control
of diastolic blood pressure is also
important for patients on hemodialy-
sis. Although not statistically signifi-
cant in this study, changes in diastolic
blood pressures after hemodialysis in
the experimental group were lower
than those in the control group.
Considering that diastolic blood pres-
sure is affected when the amount of
blood ejected at the systolic phase is
small, or when the resistance of the

Nephrology Nursing Journal September-October 2018 Vol. 45, No. 5 459

Effects of Application of Elastic Compression Stockings on Blood Pressure, Pulse Rate, and
Hypotensive Symptoms in Patients with Intradialytic Hypotension
Effects of Elastic Compression Stockings on the Hypotension Symptom Scores
Classification
Abdominal discomfort
Yawn
Nausea
Muscle cramp
Dizziness
Cold sweating
Total
* t test.
Notes: Exp. = experimental group, Cont.= control group, G = group, T = time.
peripheral blood vessel is decreased
(Kim et al., 2010), the pressure of the
stockings applied in this study may
have been insufficient to affect the
diastolic blood pressure. Therefore, it
would be informative to repeat the
study by applying stockings with high-
er than the 20 to 30 mmHg pressure
utilized here. It may also be an effec-
tive and simple intervention in clinical
practice if it is used with other inter-
ventions that have been effective in
maintaining diastolic blood pressure.
In this study, the elastic compres-
sion stockings were effective for ame-
liorating symptoms of hypotension. In
the experimental group, most symp-
toms (abdominal discomfort, yawning,
muscle spasm, dizziness, and sweating)
showed lower scores relative to the
control group. Abdominal discomfort,
yawning, and dizziness were scored
significantly lower in the experimental
group than in the control group. In
several studies evaluating intradialytic
hypotension, 64% to 80% of subjects
had one or more symptoms, such as
dizziness, fatigue, and headache (Kim
et al., 2015; Yamamoto et al., 2012).
However, in these studies, the differ-
ence in the degree of the subject’s
symptoms was not compared because
it was only measured by the number of
occurrences (Lee et al., 2007;
Yamamoto et al., 2006).
This study also reported the de-
gree of symptoms participants felt,
and results indicated elastic pressure
460
Table 5
Exp. (n=30) Cont. (n=29)
Mean (SD) Mean (SD)
1.40 (0.56) 1.97 (0.78)
1.67 (0.66) 2.17 (0.71)
2.57 (0.94) 2.21 (0.82)
2.97 (0.85) 3.21 (0.82)
2.77 (0.90) 3.21 (0.90)
2.03 (1.10) 2.21 (0.90)
13.40 (2.04) 15.03 (2.32)
stocking was effective for both objec-
tive and subjective indicators. In par-
ticular, considering negative effects of
hypotensive symptoms on the treat-
ment adherence of patient on
hemodialysis (K/DOQI Workgroup
of the NKF, 2005), the improvement
of subjective symptoms may have a
positive impact on the management
of intradialytic hypotension in
patients on hemodialysis. However,
some of these patients may not have
hypotension symptoms, so careful
attention should also be paid to the
degree, frequency, and duration of
hypotension (K/DOQI Workgroup
of the NKF, 2005). More effective
intervention is anticipated if hypoten-
sive symptoms are more frequently
measured during hemodialysis and if
the timing of hypotensive symptoms
is more predictable. However, most
studies using elastic compression
stockings have never been interrupt-
ed by reported side effects (Cho, Kim,
Seol, Shin, & Choi, 2005; Kim et al.,
2010; Yamamoto et al., 2006).
Consequently, this intervention of
using elastic compression stockings is
considered to have relatively low dis-
comfort and side effects compared
with other common interventions.
This study confirmed the use of
elastic compression stockings was effec-
tive in preventing the reduction of sys-
tolic blood pressure and hypotensive
symptoms in patients with intradialytic
hypotension. In repeated measures
Nephrology Nursing Journal
(N=59)
z/t p
2.98 0.003
2.68 0.007
1.53 0.127
1.71 0.087
2.05 0.041
0.88 0.382
2.87* 0.006
ANOVA analysis, the significant inter-
action in group*time indicates the sig-
nificant difference between the two
groups over time. Moreover, elastic
compression stockings are noninvasive
and have fewer side effects. This inter-
vention can be applied to patients with
potential hypotension, as well as
patients with intradialytic hypotension.
Based on these results, we suggest the
following for further research: First, we
suggest that a future study could meas-
ure the effect of using elastic compres-
sion stockings with higher pressures
than the 20 to 30 mmHg in this study.
This is because the pressure of the
stockings applied in this study may
have been insufficient to affect the dias-
tolic blood pressure to a statistically sig-
nificant degree. Second, to try to pre-
dict changes in blood pressure, pulse,
and hypotensive symptoms, we suggest
repeating the study by reducing the
measurement interval.
Conclusion
This study was conducted to
investigate the effect of wearing elas-
tic compression stockings on blood
pressure, pulse, and hypotensive
symptoms in patients with intradialyt-
ic hypotension. There were 30 partic-
ipants in the experimental group and
29 participants in the control group.
Results of this study showed that
changes in systolic blood pressure
within the experimental group were
September-October 2018 Vol. 45, No. 5
significantly less than those in the con-
trol group. In repeated measures
ANOVA analysis, the significant inter-
action in group*time indicates the sig-
nificant difference between the two
groups over time. Diastolic blood pres-
sure reduction in the experimental
group was less than that of the control
group, but it was not a statistically sig-
nificant difference. Notably, the
hypotensive symptom score was lower
in the experimental group. As a result,
it is suggested that the use of elastic
compression stockings is an effective
and safe intervention to decrease
changes in systolic blood pressure and
to reduce hypotensive symptoms in
patients with intradialytic hypotension.
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461
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After completing this learning activity, the learner will be able For more on management of hypertension, view the session entitled, “Landmark
to provide results of a pilot study exploring the impact of elas- SPRINT Trial on Hypertension Management: Where Do We Go from Here?” by
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