Journal List > J Korean Acad Nurs > v.48(1) > 1003292

J Korean Acad Nurs. 2018 Feb;48(1):1-11. Korean.
Published online February 28, 2018.
© 2018 Korean Society of Nursing Science
Effects of Aromatherapy on Stress Responses, Autonomic Nervous System Activity and Blood Pressure in the Patients Undergoing Coronary Angiography: A Non-Randomized Controlled Trial
Eun Jeong Song,1 and Mi Young Lee2
1Department of Nursing, Eulji University Hospital, Daejeon, Korea.
2College of Nursing, Eulji University, Daejeon, Korea.

Address reprint requests to: Lee, Mi Young. College of Nursing, Eulji University, 77 Gyeryong-ro, 771beon-gil, Jung-gu, Daejeon 34824, Korea. Tel: +82-42-259-1718, Fax: +82-42-259-1709, Email:
Received June 14, 2017; Revised December 18, 2017; Accepted December 23, 2017.

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. ( If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.



The purpose of this study was to examine the effects of aromatherapy on stress responses, autonomic nervous system (ANS) activity, and blood pressure in patients hospitalized to receive coronary angiography (CAG).


A non-equivalent control group with a pretest-posttest design was used. The subjects were patients admitted to the day angiography room to receive CAG at E University Hospital (34 in the experimental group and 30 in the control group). The experimental group treatment was inhalation of the aroma oil blended with lavender, ylang-ylang, and neroli at a ratio of 4:2:1 twice before and after CAG. The measurements of stress index, ANS activity, and blood pressure were performed 5 times as follows: at admission, at pre-CAG after treatment I, at post-CAG, 2 hours after treatment II, and 4 hours after treatment II. The data were analyzed using the Mann-Whitney U Test and repeated-measures analysis of variance.


Significant interactions in the high frequency of ANS (F=5.58, p=.005) were observed between group and time. Stress index (z=2.14, p=.016), systolic blood pressure (z=4.14, p<.005), and diastolic blood pressure (z=3.28, p=.001) were significantly different between the experimental and control groups after 4 hours of treatment II.


The findings showed that aromatherapy was not effective before CAG, but was effective after CAG. Therefore, aromatherapy can be used as a nursing intervention for patients receiving CAG.

Keywords: Aromatherapy; Blood pressure; Coronary angiography; Autonomic nervous system



Table 1
Homogeneity of General Characteristics and Dependent Variables between Groups (N=64)
Click for larger imageClick for full tableDownload as Excel file

Table 2
Comparison of Stress, Nerve Activity, and Blood Pressure between Groups (N=64)
Click for larger imageClick for full tableDownload as Excel file


CONFLICTS OF INTEREST:The authors declared no conflict of interest.

This manuscript is based on a part of the author's master's thesis from Eulji University.

1. Statistics Korea. 2015 cause of death in Korea [Internet]. Daejeon: Statistics Korea; c2016 [cited 2016 Sep 27].
2. Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL. In: Harrison's principles of internal medicine. 16th ed. New York: McGraw-Hill; 2005. pp. 1277-1278.pp. 1410-1413.
3. Park AR, Choi JY. Factors predicting patient discomfort after coronary angiography. J Korean Acad Nurs 2009;39(6):860–867. [doi: 10.4040/jkan.2009.39.6.860]
4. Ann SR, Suzanne MT, Paulena N. In: Family life management. 6th ed. New York: Macmillan; 1986. pp. 269-307.
5. Lee HS, Hwang HS, Kim YA. Effects of hand massage with aroma oil on stress responses and serum immunity of registered nurse during the night duty. J Korean Acad Soc Nurs Educ 2007;13(2):169–176.
6. Jamshidi N, Abbaszadeh A, Kalyani MN, Sharif F. Effectiveness of video information on coronary angiography patients' outcomes. Collegian 2013;20(3):153–159. [doi: 10.1016/j.colegn.2012.06.001]
7. Kang MS, Park KM, Park CJ. Deducing coronary artery disease anxiety through musical therapy and providing information. J Korean Acad Nurs 2000;30(2):380–390. [doi: 10.4040/jkan.2000.30.2.380]
8. Lee HY, Kim SY. The trends of nursing research on aromatherapy in Korea. J East West Nurs Res 2010;16(2):85–95.
9. Homeyra T, Ghahraman M, Vahid M, Soghra H, Homeyra A, Niloofar R. The impact of aromatherapy on the anxiety of patients experiencing coronary angiography. Zahedan J Res Med Sci 2012;14(3):51–55.
10. Tahmasebi H, Abbasi E, Zafari M, Darvishi H. The impact of aromatherapy on hemodynamic condition of patients experiencing coronary angiography. Med Surg Nurs J 2013;2(1-2):26–32.
11. Karadag E, Samancioglu S, Ozden D, Bakir E. Effects of aromatherapy on sleep quality and anxiety of patients. Nurs Crit Care 2017;22(2):105–112. [doi: 10.1111/nicc.12198]
12. Shiina Y, Funabashi N, Lee KH, Toyoda T, Sekine T, Honjo S, et al. Relaxation effects of lavender aromatherapy improve coronary flow velocity in healthy men evaluated by transthoracic Doppler echocardiography. Int J Cardiol 2008;129(2):193–197. [doi: 10.1016/j.ijcard.2007.06.064]
13. Nomura S, Maeyama K, Ito K. Enhancement of autonomic stress response and reduction of subjective stress by lavender inhalation during a short-term calculation task. Adv Biomed Eng 2016;5:7–12. [doi: 10.14326/abe.5.7]
14. Salvatore B. In: The complete guide to aromatherapy. 2nd ed. Brisbane: International Centre of Holistic Aromatherapy; 2003. pp. 236-279.pp. 409
15. Mahmood RN, Javad B, Mahdi BM, Hossein A. Effect of aromatherapy on anxiety in patients with acute coronary syndrome hospitalized in cardiac care unit. Bali Med J 2017;6(2):331–336. [doi: 10.15562/bmj.v6i2.385]
16. Choi JY, Oh HK, Chun KK, Lee JS, Park DK, Choi SD, et al. A study for antistress effects of two aromatic synergic blending oils. Ann Clin Neurophysiol 2000;2(2):70–80.
17. Cho MY, Min ES, Hur MH, Lee MS. Effects of aromatherapy on the anxiety, vital signs, and sleep quality of percutaneous coronary intervention patients in intensive care units. Evid Based Complement Alternat Med 2013;2013:381381. [doi: 10.1155/2013/381381]
18. Kim HY, Lee S. Effects of aromatherapy on anxiety and sleep of inpatients with coronary angiography. J People Plants Environ 2014;17(6):457–463.
19. Jennine S. In: The autonomic nervous system and aromatherapy: A therapist's guide to working with the two systems. New Westminster: International Essential Oil Corporation; 1998. pp. 2-10.
20. Bae JM, Park GH. In: An illustrated guide to medical statistics using SPSS. Seoul: Hannarae Publishing Co; 2012. pp. 1-367.
21. Lim SU, Park HJ. The effects of aroma inhalation therapy on stress, anxiety and depression in coronary care unit patients. J Korea Contents Assoc 2016;16(3):1–10. [doi: 10.5392/JKCA.2016.16.03.001]
22. Muzzarelli L, Force M, Sebold M. Aromatherapy and reducing preprocedural anxiety: A controlled prospective study. Gastroenterol Nurs 2006;29(6):466–471.
23. Peng SM, Koo M, Yu ZR. Effects of music and essential oil inhalation on cardiac autonomic balance in healthy individuals. J Altern Complement Med 2009;15(1):53–57. [doi: 10.1089/acm.2008.0243]
24. Bae IL, Hur MH. The effects of essential oil inhalation on the stress and sympathetic nerve activity. Korean J Stress Res 2016;24(2):75–83. [doi: 10.17547/kjsr.2016.24.2.75]
25. Shin YS, Cho YS, Jung YJ. The effects of aromatherapy on autonomic nerve system and physical resistance of a stress. J Korean Biol Nurs Sci 2004;6(2):5–17.
26. Kim IH, Kim C, Seong K, Hur MH, Lim HM, Lee MS. Essential oil inhalation on blood pressure and salivary cortisol levels in prehypertensive and hypertensive subjects. Evid Based Complement Alternat Med 2012;2012:984203. [doi: 10.1155/2012/984203]
27. Hwang JH. The effects of the inhalation method using essential oils on blood pressure and stress responses of clients with essential hypertension. J Korean Acad Nurs 2006;36(7):1123–1134. [doi: 10.4040/jkan.2006.36.7.1123]

Eun Jeong Song

Mi Young Lee

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