Hypertension in Older Adults

Hypertension in Older Adults
Hypertension is a major health concern among the aged. Anker et al. (2018) define hypertension as a condition of extreme elevation of pressure against the arteries. Long-term exposure to hypertension has adverse consequences for the patients causing risk factors such as dementia, arterial disease, heart failure, and stroke, leading to premature death. Hypertension may be primary or secondary, depending on the intensity. Secondary hypertension amounts to 6-10% of the cases caused by endocrine disorders and kidney diseases (Anker et al., 2018). The remaining percentage is caused by primary factors such as genetic factors and poor lifestyle. Hypertension is also classified based on blood pressure, which can be diastolic or systolic. However, adults' normal blood pressure range is between 140/90 and 130/80mmHg (Oliveros et al., 2020). Medications, stress, and lifestyle changes lead to changes in the normal blood pressure causing hypertension. However, lifestyle adjustments such as reducing salt intake, physical activeness, and weight loss are classified may be primary solutions to hypertension. High blood pressure is accompanied by specific signs and symptoms, including nose bleeds and shortness of breath. The symptoms are not specific and vary from one person to another. The paper addresses hypertension in older adults and evidence-based clinical solutions.
Background
Hypertension among older adults is majorly linked to stress. According to Oliveros et al. (2020), stress is a primary cause of hypertension, leading to depression among older adults. Resistance to normal blood flow is a major issue in most adults due to late-life actions and inconveniences. Stress is common among older adults and leads to vasoconstriction, causing hypertension (Oliveros et al., 2020). Besides, it may be accounted for by diastolic dysfunction, cardiac preload, and venous return. Older adults also experience pulse pressure leading to isolated systolic hypertension. The older people have increased arterial stiffness caused by aging and are highly impacted by high blood pressure. Due to increased stressful experiences and situations, the body is forced to produce surge hormones; the hormones make the heart beat faster and narrows the blood vessels, which leads to increased pressure. However, older adults experience chronic stress, which is long-term, exposing them to hypertension and adverse effects such as stroke. Different interventions have been researched to address common hypertension among older adults. However, most interventions are not mutually exclusive and may cause other challenges such as vascular issues. Therefore, the project highlights the most effective, feasible, and cost-effective intervention in addressing hypertension among older adults.
Clinical Problem Statement
Hypertension is a critical issue accompanied by different clinical problems. Heart attack and stroke are the main issues accompanying hypertension in older adults. The two problems are caused by the hardening and thickening of the arteries, which is common among older adults. The weak body system of older adults affects critical organs such as the heart, exposing them to extreme danger. Besides, according to World Health Organization (2022), 7.6 million people perish annually due to hypertension. Besides, 13.5% of global deaths are caused by hypertension. Therefore, hypertension is a critical problem that needs to be effectively addressed to restore patients' health, especially older adults.
Purpose of the Change Proposal
The purpose of the change proposal is to establish a reliable and effective intervention plan which can be used to reduce stress among older adults. It is noticeable that older adults are the major population that experiences the adverse effects of hypertension. Establishing an evidence-based solution would reduce the cases and restore the health of older adults. Besides, the change proposal prevents increased hypertension cases instead of treatment options. Past research shows adverse effects of medications among the hypertensive, such as cardiac issues (Anker et al., 2018). Therefore, the proposal focuses on a friendly and cost-effective intervention that would safeguard the health of older adults.
PICOT Question
Among the older adults (Population), how effective is managing stress (Intervention) compared to monitoring blood pressure (Comparison) in reducing hypertension (Outcome) within six months (T)?
Literature Search Strategies
The search strategy was a systematic review. A systematic review is evidence-based research used to identify, define, and assess the secondary resources by adhering to the provided topic (Tawfik et al., 2018). The method is vital since it is used in extracting and interpreting the already published data, thus increasing the eligibility. The researcher considered the method since it is based on evidence-based practices and minimizes bias. A systematic review is also valid since it provides real-time and quality evidence for answering the PICOT question. The researcher used valid secondary sources to establish a reliable intervention to increase hypertension among older adults. Therefore, the method was viable and feasible with the PICOT question.
During the literature search, the researcher used specific inclusion and exclusion criteria. The researcher used a step-by-step approach to conduct the literature research. The first step was framing the PICOT question: Among older adults, how effective is managing stress compared to monitoring blood pressure in reducing hypertension within six months? The second step was identifying relevant work, as summarized in appendix 1. The relevant work is considered a well-established structured and unambiguous framework. At the same time, the quality of resources was a priority to prevent ethical problems. The researcher finally summarized the data and interpreted the findings.
The inclusion criteria were based on the (1) date, (2) study design, and (3) PICOT approach. Only sources five years and below relating to hypertension among older adults were considered to ensure eligibility and reliability. Besides, the researcher focused on qualitative and quantitative studies for reliable data and interpretations. Only sources related to the PICOT question were considered. The literature search also considered specific exclusion criteria, including (1) outdated sources, (2) sources that have not been peer-reviewed, (3) duplicated sources, and (4) abstract-only papers. The exclusion was considered to avoid bias and make the information valid. The researcher considered systematic reviews due to their advantages in medical-related research. The key advantage is its applicability in strengthening and clarifying conclusions and its high statistical analysis power (Munn et al., 2018). Besides, it allows the researcher to compare different research questions and ethically interpret data without bias. Therefore, the literature research was effective and valid.
Evaluation of Literature
The literature evaluation was based on eight valid and quality resources. The first research was conducted by Morrissey, among others, in 2018. Morrissey et al. (2018) found that digital technologies in educating older adults are critical in addressing hypertension among older adults. The findings also agreed with the study of Bradbury et al. (2018), which claimed digital education on stress management is cost-effective and efficient. Bradbury et al. (2018) and Morrissey et al. (2018) focused on optimizing digital education using 4110 patients and 36 patients in their samples. The major limitations experienced by the authors were reduced openness and limited data. However, from the findings, the researchers concluded that digital intervention is the key solution to addressing increased hypertension among older adults. Therefore, the author's findings align with the PICOT question, which considers psychoeducation to be more effective in stress management and prevention of hypertension.
According to Wright et al. (2018), combining medications and psychoeducation is the best solution to hypertension among adults. For instance, Wright et al. (2018) used 24 trials and found that patients who used thiazides and went through regular psychoeducation resolved the problem of hypertension. Agarwal et al. (2018) also agreed with the study after sampling 85 older adults and assessing psychoeducation and medications in addressing hypertension. Regardless of using different sample sizes, such as 58,040 patients and 85 patients, the authors considered 55 years old and above as the inclusion criteria, thus making the research relevant and effective. The researchers relied on the primary data to answer their respective research questions. However, different limitations, such as inadequate information, were noted by Agarwal et al. (2018) and Wright et al. (2018). The researchers concluded that psychoeducation was an effective solution to hypertension.
According to Conroy et al. (2018), older adults heavily experience hypertension due to a lack of adequate knowledge on stress management. Conroy et al. (2018) used 65years old patients and a sample size of 18 to study the reasons for increased hypertension in the population. The outstanding reason was the weak body system and stress impacts. Ashoorkhani et al. (2018) also agreed with Conroy et al. (2018) that diversifying the educational techniques would reduce hypertension cases. Non-adherence approach allowed Ashoorkhani et al. (2018) to conclude that the age range defines hypertension. The major limitations of their research were limited data and bias. Therefore, the researchers justified that addressing stressors among the old would reduce hypertension.
Lastly, Akinlua et al. (2018) agreed with Rahmawati et al. (2018) that the increased mortality rate among older adults is preventable using stress management techniques. Using 30 participants, Rahmawati et al. (2018) noted that psychoeducation should be combined with anti-hypertensive medications to restore the health of older adults. Rahmawati et al. (2018) collected the views of the patients. However, Akinlua et al. (2018) used the same technique...