ESSENTIALS OF EVIDENCE BASED PRACTICE

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Clinical Issue Identified: Causes of Heart Disease among the Elderly Population

Adebusola Balogun

Walden University

Essentials of Evidence-Based Practice

NURS 6052

March 19th, 2023.

Clinical Issue Identified: Causes of Heart Disease among the Elderly Population

Relevant Peer Reviewed Articles from Walden Library

Fuchs, F. D., & Whelton, P. K. (2020). High blood pressure and cardiovascular disease.

Hypertension, 75(2), 285-292.

https://doi.org/10.1161/HYPERTENSIONAHA.119.14240

Groenewegen, A., Rutten, F. H., Mosterd, A., & Hoes, A. W. (2020). Epidemiology of heart

failure. European journal of heart failure, 22(8), 1342-1356.

https://doi.org/10.1002/ejhf.1858

Hayes, R. B., Lim, C., Zhang, Y., Cromar, K., Shao, Y., Reynolds, H. R. ... & Thurston, G. D.

(2020). PM2. 5 air pollution and cause-specific cardiovascular disease mortality.

International journal of epidemiology, 49(1), 25-35. https://doi.org/10.1093/ije/dyz114

Jankowski, J., Floege, J., Fliser, D., Böhm, M., & Marx, N. (2021). Cardiovascular disease in

chronic kidney disease: pathophysiological insights and therapeutic options. Circulation,

143(11), 1157-1172. https://doi.org/10.1161/CIRCULATIONAHA.120.050686

Each Study Results from Review

The first study in the list masks the overall cardiovascular disease picture. The results in

this article indicated that the right-sided population shift in blood pressure distribution causes

cardiovascular disease. The study demonstrated less rise in blood pressure with aging, more so

among the Indian communities in Brazil who had minimal salt. The findings indicated that BP

would reduce vascular effects associated with aging (Fuchs & Whelton, 2020). Cohort studies in

this study showed that high blood pressure is a vital risk factor for dementia, heart failure, aortic

syndromes, atrial fibrillation, heart valve disease, and chronic kidney disease.

The second research article's findings indicate a slow decline in heart failure and that the

mortality rate associated with heart failure is rising among individuals living in low-income

countries because of the western lifestyle and the communicable diseases' double burden

(Groenewegen et al., 2020). The results show that although the number of mixed heart failure

incidences has reduced among the young, there are still opposite trends thought to be caused by

obesity.

The third study results show that increased particulate matter by 10 milligrams per square

meter with completely adjusted models increased ischemic heart disease mortality by 16% and

stroke-related mortality by 14%. The results indicated little difference in the exposure found in

factors such as marital status, tobacco or alcohol use, sex, body mass index, and education,

unlike in the racial factor, where the non-Hispanic blacks showed the highest exposure.

The fourth article summarizes the cardiovascular disease clinical consequences in chronic

kidney disease (CKD). Results showed that nearly all the patients with stage 4 and 5 CKD

exhibit cardiovascular heart disease, and between 40% to 50% of the cardiovascular heart

disease-associated deaths have CKD. As indicated in the results, the CKD effect on

cardiovascular heart disease was not neutralized by the more than 70 studies' non-dialyzed

individuals.

Reflection on the Unfiltered Database Use to Search for the Articles

It took much work to search the articles from the unfiltered databases compared to

searching for peer-reviewed articles from databases whose filters are complete and the option to

put the query in the manner I wish to. This gave me an open eye on the literature search and

enabled me to critically and keenly find relevant articles depending on the clinical issue selected.

The search activity was fun, even though it was time-consuming.

Research Methodologies' Reflection for Each Article

The first study utilized cohort studies' randomized controlled trials and meta-analysis as

the research design. The second research study used echocardiographic screening meta-analysis

studies. The methodology employed in the third study is descriptive statistics with a Cox

regression base model. The fourth study utilized a meta-analysis methodology.

Analysis of Methodologies Used in the Peer-Reviewed Articles

I chose this article because it focuses on identifying the causes of heart disease, including

high blood pressure that it identifies. The national institute also approves general medical

services. This study aimed to determine how blood pressure shift affects cardiovascular disease.

The research methodology utilized was a meta-analysis which is a mixed-method approach. The

strength of the research article involved the pooling of data from many cohort studies, and that

means that the accuracy of the results obtained is high. This makes the method utilized in this

reliable.

The second article utilized meta-analysis with cohort studies applied to a population,

including the Chicago heart cohort and cardiovascular heart study. This study aimed at ambulant

patients' characteristics with heart failure with reduced registry studies based on the geographical

region. It focused on identifying the causes based on the region and income level. The

methodology is reliable because it uses study samples from different continents, and the results

can be generalized. The strength of this study is that it was well-funded by the Dutch heart

foundation.

The descriptive statistics methodology was used in the third article. It included using a

baseline questionnaire for medical history, diet, and physical activity. The mailing of the

questionnaire to 3.5 million and getting answers from 566398 makes these results generalizable

and, in turn, reliable because the sample is representative (Hayes et al., 2020). The strength of

this study is that it obtained data from a large sample and used a single point, the email, to collect

data from the participants using the questionnaire. This study aims to find out the risk of ambient

air pollution to cardiovascular disease at exposure to particulate matter at low levels in the

United States of America and other places.

The fourth article utilised the meta-analysis methodology to demonstrate the exponential

death risk increase with decreased functioning of the kidney in determining the relationship

between risk for all causes of cardiovascular mortality and non-dialyzed-dependent chronic

kidney disease. The results from this study and the method used are reliable because they

involved more than 1.4 million participants (Jankowski et al., 2021). The large sample size of

1,371,990 patients remains the strength of this article because the results obtained can be

generalized. Further, the greater the sample, the higher the accuracy of the findings. This study

aimed at finding out whether the risk of developing the cardiovascular disease for patients with

chronic kidney disease is higher than that of reaching end-stage kidney disease.

References