Developing a PICOT Question

Using exercise therapy to reduce blood pressure in adults with hypertension
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Using exercise therapy to reduce blood pressure in adults with hypertension
PART 1: Developing a PICOT question
A PICOT question essentially consists of 5 parts that identify the patient/problem (P); the proposed intervention (I); a comparison (C); outcomes (O); and timeline (T). For this project, the PICOT question is as follows:
In adults (P) suffering from high blood pressure, is engaging in exercises and physical activities (I) compared to taking hypertension drugs (C) more effective in reducing hypertension (O) in the initial 3 months following diagnosis? (T)
PART 2: Identifying a Problem
The identified problem is high blood pressure (HBP) in grownups. Grownups are defined as persons who are aged 18 years and above. High Blood Pressure is understood as a serious condition which can bring about kidney failure, stroke, heart failure, coronary heart disease, in addition to other health complications (Jorge & Paula, 2012). Blood pressure in essence, refers to the force of blood which thrusts against the walls of the arteries as the heart is pumping blood. If this particular pressure stays high over a period of time or increases, it can actually result in damaging of the body in several ways. Roughly 67 million persons – one in three adults – in America has HBP and only approximately 47 percent of these persons have their HBP condition under control (O’Connell, 2014). Since this disease usually has no any warning symptoms or signs, it is sometimes referred to as the silent killer and a lot of people in fact are not aware that they have it.
The settings where high blood pressure can be observed is the primary care settings that focus on caring for adults with this condition. In essence, high blood pressure has been proven as having a substantial impact on the work environment, the quality of care that health professional provide, as well as patient outcomes. According to Jorge and Paula (2012) persons with high blood pressure need long-term care and have to be closely watched in order to identify if they are receiving the right health care and attain their expected health outcomes. High-quality care entails regular screening for blood pressure and awareness of preventive care for hypertension. It also includes active self-management by the individual himself or herself, involvement of other clinical specialties, and proper communication between patients and their health care providers (Cornelissen & Smart, 2013).
Hypertension medicines such as beta-blockers, Angiotensin Converting Enzyme Inhibitors (ACE), and diuretics have quite a lot of side effects that make patients with high blood pressure uncomfortable when using them. Dimeo (2012) stated that ACE Inhibitors are known to cause persistent dry cough, loss of taste, and skin rash. These drugs essentially block the formation of the hormone which makes the blood vessels to become narrow. The side effects that patients with hypertension experience when using beta-blockers include depression, insomnia, erection problems, asthma symptoms, as well as cold hands and feet. These hypertension medications are known to make the heart of the patient to beat more slowly and less forcefully (Fagard & Cornelissen, 2007). The other popular medicines for hypertension are diuretics. Studies have demonstrated that diuretics bring about extra urination, erection problems, abrupt and severe foot pain, in addition to leg cramps or weakness and fatigue (Jackson, Herber-Gast & Brown, 2014). The medical condition of High Blood Pressure is significant to nursing since nursing staffs are expected to deliver nursing services that will bring about optimal outcomes for people who have hypertension. Since the majority of medications available today that are used in managing this medical condition have some side effects, nursing staffs should advise patients with high blood pressure to engage more in physical activities to control and better manage this condition.
To address the problem, the proposed solution is for people to be engaged more in physical activities and doing exercises such as swimming, biking, running, jogging, aerobic exercises, and brisk walking in order to reduce their blood pressure. Padilla, Wallace and Park (2005) pointed out that there is a connection between physical inactivity and developing high blood pressure. For those with hypertension, doing regular exercises could actually help in controlling this ailment. Regular exercises such as jogging and biking walking have been proven to lower a person’s high blood pressure.
The Center for Advancement of Health (2007) noted that engaging regularly in exercises and physical activities makes one’s heart to be stronger. This is important considering that a heart that is stronger is able to pump more blood with use of less amount of effort. If the heart could work less in pumping blood, then the force on the arteries will reduce, and this way the blood pressure of that person reduces (Guimaraes et al., 2014). It is of note that by engaging in regular exercises and physical activities, a person’s systolic blood pressure can be decreased by an average of 4 mm Hg to 9 mm Hg, which is actually as good as some drugs used for high blood pressure. Kokkinos et al. (2008) noted that for some people, exercises is adequate to reduce the need for blood pressure medicines. In addition, regular exercises and physical activity helps a person to maintain a healthy weight, something that is also of great importance in controlling and managing blood pressure.
PART 3: Selecting sources
American Heart Association. (2013). Leisure-time Exercise Could Lower Your Risk of High Blood Pressure. American Heart Association.
In this article, the American Heart Association (2013) stated that more than 77 million adults in the United States have high blood pressure. Doing physical activities during spare time helps in maintaining blood pressure at a level and this is actually healthy. This source points out that high blood pressure is a major contributing factor for cardiovascular and kidney diseases.
Center for the Advancement of Health. (2007). Physical Activity Reduces Hypertension Risk in Young Adults. ScienceDaily.
According to this article, young adults – people aged 18 to 30 years – who spend more time engaging in physical exercises have a decreased likelihood of developing high blood pressure within the next 15 years – the author makes reference to a recent research study. In comparison to the study participants who were less active, young adults who participated in physical activities for an average of five times each week and used up 300 calories for each exercise session had a 17 percent reduction in the chances of developing high blood pressure.
Cornelissen, V. A., & Smart, N. A. (2013). Exercise Training for Blood Pressure: A Systematic Review and Meta-analysis. Journal of American Heart Association.
This is a research-based article. After conducting their research study, the authors of this article learned that isometric, dynamic resistance, and endurance training lower systolic blood pressure (SBP) and diastolic blood pressure (DBP). They also found that combined training reduces only diastolic blood pressure. This article therefore supports my proposed solution which entails engaging in exercise and physical activity in order to reduce high blood pressure instead of using hypertension drugs. Cornelissen and Smart (2013) point out that the occurrence of high blood pressure actually varies with gender and ethnicity, adding that in the United States population, the prevalence rate is between 25 and 43 percent.
Dimeo, F., Pagonas, N., Seibert, F., Arndt, R., Zidek, W., & Westhoff, T. H. (2012). Aerobic Exercise Reduces Blood Pressure in Resistant Hypertension. Hypertension; 60(3):653
In their research study, Dimeo et al. (2012) found that doing exercises significantly reduced diastolic and systolic daytime ambulatory blood pressure. Doing physical activities on a regular basis actually reduced blood pressure on exertion. The authors stated that doing physical exercises could reduce blood pressure even in those with low responsiveness to hypertension drugs. Therefore, they conclude that therapeutic approach to resistant high blood pressure should include exercises (Dimeo et al., 2012).
Fagard, R. H., & Cornelissen, V. A. (2007). Effect of Exercise on Blood Pressure Control in Hypertensive Patients. European Journal of Preventive Cardiology; 14(1):12-17.
This is a research-based article and the results suggested that endurance training actually reduces blood pressure by reducing systemic vascular resistance where the rennin-angiotensin system and sympathetic nervous system seem to be involved (Fagard & Cornelissen, 2007). Exercise is an essential remedy in the prevention, treatment, as well as controlling of high blood pressure....