Hypertension PICOT Statement Essay

Posted: November 11th, 2022

Hypertension PICOT Statement Essay

Conduct a literature search to locate research articles focused on your selected practice problem of interest. This literature search should include both quantitative and qualitative peer-reviewed research articles to support your practice problem. Select six peer-reviewed research articles which will be utilized through the next 5 weeks as reference sources. Be sure that some of the articles use qualitative research and that some use quantitative research. Create a reference list in which the six articles are listed. Beneath each reference include the article’s abstract. The completed assignment should have a title page and a reference list with abstracts. PICOT statement must include something as the nurse I can do for the patient. Hypertension PICOT Statement Essay

Problem Statement

Cardiovascular risk among adults patients aged 40-60 years diagnosed with hypertension is gradually increasing. The conventional use of hypertensive medications alone has not proven to be effective in reducing this risk, increasing the need to research for more practical approaches.

PICOT Statement

Among male and female adults aged 40-60 years with hypertension, how does lifestyle modification compared to the use of hypertensive medications reduce cardiovascular risk within ten years?

Literature Review

“Yang, M. H., Kang, S. Y., Lee, J. A., Kim, Y. S., Sung, E. J., Lee, K. Y., Kim, J. S., Oh, H. J., Kang, H. C., Lee, S. Y. (2017)”Hypertension PICOT Statement Essay

Background: The cardiovascular risk among patients diagnosed with hypertension visiting primary care providers is high. Objective: we sought to establish the lifestyle behaviors associated with effective control of blood pressure and their ability to reduce cardiovascular risk. Method: In a quantitative research design, the researchers conducted a survey in 15 hospitals from 2008-2010 where1453 patients who were prescribed candesartan took part. Initially, an evaluation of the participants’ lifestyle modification was done using questionnaires and a follow-up was done at 4, 8 and 12 weeks. Data analysis: Multivariate analyses on alcohol consumption, smoking, salt intake, and comorbidities were done for 1139 patients whose results were available. Results: It was concluded that reducing salt intake had no impact on the levels of catecholamine’s, renal function and blood lipids. Conclusion: lifestyle modification was associated with a lower risk of fatal coronary artery disease and stroke in adults. Among children, reducing sodium intake reduces blood pressure.

“Connell, P., McKevitt, C., & Wolfe, C. (2015)”

Background: There level of detection of hypertension among populations in the black Caribbean is good although the control is not sufficient. Objective:  to determine how black Caribbean patients understand hypertension and the approaches used in management. Study Design: Qualitative design by the use of interviews. Method:  An online search was done to identify black Caribbean’s who were well known with hypertension. Patients identified underwent in-depth-interviews. Results: 19 of patients interviewed understood their condition well and used prescribed anti-hypertensive medications. Some stopped taking medications due to unwanted effects and others when they felt better. Conclusion: Patients make reasoned decisions on the management of hypertension basing on socio-cultural practice and notions. This may result in divergence from the recommended purpose. Hypertension PICOT Statement Essay

“Thinyane, K. H., Mothebe, T., Sooro, M., Namole, L. D., & Cooper, V. (2015)”

Background: reducing cardiovascular risk and morbidity related to hypertension is key to the management of high blood pressure. Objective: to establish the management and control of hypertension in primary care settings in Lesotho. Methods: Cross-sectional study design among patients with hypertension attending Domiciliary Health Clinic in Maseru between April and May 2013. Medical records were reviewed and evaluated to establish how blood pressure was being managed in the last 12 months. Interviews were also conducted to assess medication adherence of patients. Factors associated with increased cardiovascular risk and poor blood pressure controls were analyzed using a logistic regression.

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             Results: Majority of patients had poorly controlled hypertension that was strongly associated with age (above 65 years). Most of the patients with an increased cardiovascular risk had not done a lifestyle modification. Conclusion: there is an increased need for combined pharmacological and non-pharmacological interventions to improve the care of hypertensive patients in primary care settings to reduce cardiovascular risk. These efforts should aim at improving how hypertensive patients are assessed, optimize antihypertensive medications and promote adherence to lifestyle modification. Hypertension PICOT Statement Essay

“Hasandokht, T., Farajzadegan, Z., Siadat, Z. D., Paknahad, Z., & Rajati, F. (2015)”

Background: lifestyle aspects such as high sodium intake, obesity, and physical exercise have proven to be effective in the management of hypertension and reducing cardiovascular risk in patients. Objective: to determine the effectiveness on multifactorial lifestyle interventions on hypertension of Iranian women. Methods; Randomized Clinical Trial that was done in four health centers through the recruitment of 161 women aged 35-65 years with high blood pressures. They were randomized to a 4-week modification of lifestyle.  Results:  There was a significant difference in blood pressure readings after the 4 week period. A correlation was also noted between blood pressure, BMI, salt intake, and levels of physical exercise. A regression analyses revealed that salt intake, physical exercise, weight, and dietary intake were major predictors of cardiovascular risk and blood pressure. Conclusion: The results evidently suggest that lifestyle modification is linked to a high improvement in the levels of blood pressure and reduced cardiovascular risk in Iranian women. Hypertension PICOT Statement Essay

“Hardy, S. T., Loehr, L. R., Butler, K. R., Chakladar, S., Chang, P. P., Folsom, A. R., Heiss, G., MacLehose, R. F., Matsushita, K., Avery, C. L. (2015)”

Background: the reduction policies of blood pressure in the US are limited to people with hypertension and the accompanying benefits are often approximated based on interventions that are not realistic. Method: A multivariate linear regression was used to estimate the differences in the incidence rate that contrast the impact of two hypothetical interventions used to influence a reduction in stroke, heart failure, and heart disease. 1) A population-wide intervention which influenced a reduction in the systolic blood pressure by 1mmHg. 2) Target-interventions that directly reduced the prevalence of untreated, uncontrolled or unaware hypertension above the goals. Results: population-wide and target interventions were associated with reduced risks of heart failure, coronary artery disease, and stroke. Conclusion: Population-wide interventions have a huge impact on reducing the incidence of cardiovascular disease and should be implemented parole with interventions that specifically target individuals with hypertension above goal.Hypertension PICOT Statement Essay

“Golshahi, J., Ahmadzadeh, H., Sadeghi, M., Mohammadifard, N., & Pourmoghaddas, A. (2015)”

Background: self-care approach to the management of hypertension has recently proven to be highly effective in the secondary prevention of cardiovascular risk in hypertensive patients. Objective: to determine whether self-care behaviors were effective in modulating the levels of blood pressure, to compare the different methods of training on self-care on the adherence of patients in controlling hypertension and reduction of cardiovascular risk. Methods: prospective randomized control clinical trial that was done on 180 patients suffering from hypertension between July and December 2013.  Participants were divided into 4 groups. Group A: patient and family were educated by a cardiology resident on self-care behaviors in 8 sessions. Group B and C got self-care education through 8 brief message services and four pamphlets, Group D got the usual hypertension care without information on self-care management. Results: subjected who regularly took their anti-hypertensive medications, increased vegetable intake and reduced salt intake were in group A as compared to other groups (P = 0.001, P < 0.001 and P < 0.001, respectively).  Group A participants also had a significant reduction of blood pressure and reports of cardiovascular events than others groups (−8.18 ± 18.3 and − 3.89 ± 4.1; P < 0.001, respectively).Conclusion:  the integration of self-care management in the usual hypertension care besides using SMS and other informational materials helps to improve the effectiveness and efficiency of adherence to strategies to achieve a good blood pressure control and reduce cardiovascular risk. Hypertension PICOT Statement Essay

References

Connell, P., McKevitt, C., & Wolfe, C. (2005). Strategies to manage hypertension: a qualitative study with black Caribbean patients. The British journal of general practice : the journal of the Royal College of General Practitioners, 55(514), 357-61.

Golshahi, J., Ahmadzadeh, H., Sadeghi, M., Mohammadifard, N., & Pourmoghaddas, A. (2015). Effect of self-care education on lifestyle modification, medication adherence and blood pressure in hypertensive adults: Randomized controlled clinical trial. Advanced biomedical research, 4, 204. doi:10.4103/2277-9175.166140

Hasandokht, T., Farajzadegan, Z., Siadat, Z. D., Paknahad, Z., & Rajati, F. (2015). Lifestyle interventions for hypertension treatment among Iranian women in primary health-care settings: Results of a randomized controlled trial. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 20(1), 54-61.

Hardy, S. T., Loehr, L. R., Butler, K. R., Chakladar, S., Chang, P. P., Folsom, A. R., Heiss, G., MacLehose, R. F., Matsushita, K., Avery, C. L. (2015). Hypertension PICOT Statement Essay

Thinyane, K. H., Mothebe, T., Sooro, M., Namole, L. D., & Cooper, V. (2015). An observational study of hypertension treatment and patient outcomes in a primary care setting. The Pan African medical journal, 20, 424. doi:10.11604/pamj.2015.20.424.5040

Yang, M. H., Kang, S. Y., Lee, J. A., Kim, Y. S., Sung, E. J., Lee, K. Y., Kim, J. S., Oh, H. J., Kang, H. C., Lee, S. Y. (2017). The effect of lifestyle changes on blood pressure control among hypertensive patients. Hypertension PICOT Statement Essay