Hypertension is a global health problem, leading source of mortality and burden of disease. Its management remains suboptimal (Howes et al., 2013). Hypertension, in different circumstances called high blood pressure, is a condition whereby the blood vessels have consistent raised pressure. Having hypertension, the patient could be at risk of having heart, brain, kidney, and other diseases (WHO, 2021). Moreover, hypertension is also the main risk factor favorizing the development of cardiovascular disease which is the number one cause of death worldwide (Margerison et al., 2020). Nowadays, to improve hypertension, patients may focus on hypertension self-management behaviors such as BP (Blood Pressure) self-monitoring, lifestyle changes, improving adherence to medications, and shared medical decision-making. Effective lifestyle changes such as eating, exercise habits, and abstinence or moderation in alcohol consumption may impact of lowering Blood Pressure compared to a single antihypertensive medication (Carey et al., 2018). Therefore, identification and management of lifestyle risk factors should have beneficial effects on blood pressure and a clinical priority in all hypertensive patients (Howes et al., 2013).
My clinical question is “In hypertensive patients, do lifestyle changes compared to medication alone, reduce the risk of cardiovascular diseases?” I am searching for qualitative studies using the PICo format, where P: Hypertensive patients, I: lifestyle changes, Co: cardiovascular diseases. The search terms that I used: ((Hypertension or High blood pressure) AND (lifestyle changes or diet or exercises)) AND (cardiovascular diseases). The databases searched were PubMed and Medline with full text, date range 2012 to 2022, English language, peer reviewed and qualitative.
Choosing to do research on hypertension is beneficial to me as one of the hypertensive patients. Four years ago, I was sent to the hospital after visiting my family doctor at the clinic with headache, elevated blood pressure reading and chest pain. It was terrifying for my husband and three kids. I was scared and intimidated with questions about whether I was having a cardiac arrest from the symptoms I was having, and it is one of the risk factors of cardiovascular diseases. The development of these risk factors in patients may raise blood pressure, blood glucose, blood lipids, and overweight and obesity. Primary care facilities may measure and indicate an increased risk of heart attack, stroke, heart failure and other complications (WHO, 2021). However, after spending hours in the emergency and having a blood test and ECG test (Electrocardiogram), I was happy and relieved with the results stating that I did not have a cardiac arrest. It was recommended and advised to me to continue with my treatment and lifestyle modification to manage hypertension.
The first article was a qualitative interview focus group. The article focused on identifying barriers to lifestyle management in hypertensive patients in Australian general practice and GP registrars. The interview was focused on six focus groups of 4 to 6 participants each, and the purpose was to select a large group practice (n=30). All patients were audio recorded and transcribed. The research was conducted between June and July 2008 within general practices. In conclusion, General Practitioners (GPs) recognized the importance of lifestyle risk factor assessment and management for hypertension. Effective lifestyle modification can lower BP equivalent to a single antihypertensive drug. Also, some barriers to lifestyle counselling in general practice such as lack of time, training, knowledge, reimbursement, and patient interest. The evidence answered my research question in the case that lifestyle interventions have been highlighted and their influences in reducing the need for drug therapy and improving overall cardiovascular disease risk (Howes et al., 2013).
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