| Citation | Research Question | Study Design | Sample Size and Method | Independent Variables and Measures | Dependent Variables and Measures | Results | General Strengths | General Weaknesses | Overall Quality of Study | Summary Statements for Practice | Column12 | Column13 |
| Ozemek, C., Tiwari, S., Sabbahi, A., Carbone, S., & Lavie, C. J. (2020). Impact of therapeutic lifestyle changes in resistant hypertension. Progress in cardiovascular diseases, 63(1), 4-9. | What is the value of exercise and diet for lowering BP in patients with resistant hypertension? | Trial Overview | One hundred forty patients with resistant hypertension (mean age, 63 years). Random sampling | Exercise and diet | BP levels | Between-group comparisons revealed that the reduction in clinic systolic BP was greater in C-LIFE compared to compared with SEPA. 24-hour ambulatory systolic BP also was reduced in C-LIFE with no change in SEPA | Diet and exercise can lower BP in patients with resistant hypertension. | Hypertension is a condition that is different amongst different people | High | This topic is vital in the nursing course since it suggests ways of improving the care that the nursing seeks to provide. |
| Kimani S, Mirie W, Chege M, et al (2020) Association of lifestyle modification and pharmacological adherence on blood pressure control among patients with hypertension at Kenyatta National Hospital, Kenya: a cross-sectional study BMJ Open 2019;9:e023995. doi: 10.1136/bmjopen-2018-023995 | What is the association of lifestyle modification and pharmacological adherence among patients with hypertension attending a national referral hospital in Kenya? | Descriptive, cross-sectional. | 229 patients diagnosed with primary hypertension for at least 6 months. Random sampling | Lifestyle modification and pharmacological adherence | Hypertension | Respondents on antihypertensive medication, those engaged in healthy lifestyle and took their prescribed medications had lower mean BPs than those on medication only (138/85 vs 140/90) | Ageing was associated with elevated diastolic blood pressure (BP) (p<0.05), heart rate (HR) and cholesterol. | The study was limited by its cross-sectional design | Medium | Missed targets for BP control and hypertension-related risks are associated with ageing, female gender, fast food and animal fat intake. |
| Guptha, L. S. (2021). A Cross-Sectional Epidemiology Study of the Relationships between Body Mass Index and the Risk of Diabetes, and Diabetes and the QRISK2 10-Year Cardiovascular Risk Score Using India Heart Watch Data (Doctoral dissertation, Trident University International). | Examine the effect of National Institute of Health and Clinical Excellence and American Diabetes Association consensus adjusted BMI on the risk of T2DM in a representative sample of ~ 6,000 Asian Indians to narrow the knowledge gap and achieve population specificity | A quantitative, epidemiologic, cross-sectional design | 6000.Random sampling | Body mass | Diabetes | Increase dietary calcium and magnesium intake through natural sources | Both lifestyle changes and medical treatment are significant on hypetrension management | The debate continues as to whether the benefits of treating high BP are simply due to the quality of BP control or whether the choice of drug therapy adds to the benefit of BP lowering (beyond BP effect) | CCB, ACE inhibitors or ARB and not beta-blockers or diuretics should be the initial therapy in hypertension management. | Reducing systolic and diastolic BP can decrease cardiovascular risk and this can be achieved by non-pharmacological (lifestyle measures) as well as pharmacological means. |
| Fu, J., Liu, Y., Zhang, L., Zhou, L., Li, D., Quan, H., ... & Zhao, Y. (2020). Nonpharmacologic interventions for reducing blood pressure in adults with prehypertension to established hypertension. Journal of the American Heart Association, 9(19), e016804. | Nonpharmacologic interventions that modify lifestyle can lower blood pressure (BP) and have been assessed in numerous randomized controlled trials and pairwise meta‐analyses. It is still unclear which intervention would be most efficacious. | Meta‐analyses | Random sampling; 14 923 participants | Nonpharmacologic interventions that modify lifestyle | blood pressure | A total of 60 166 articles were identified in the initial systematic search, and 888 potentially eligible articles were retrieved as full text. Overall, 120 articles (corresponding to 126 RCTs) with 14 923 participants met the inclusion criteria and were included in the network meta‐analysis | The effects of interventions were estimated with direct evidence | The study reported only the effectiveness of nonpharmacologic interventions in lowering BP, lacking secondary end points such as rate of BP control, incidence of hypertension, and mortality due to complications of hypertension, | Nonpharmacologic interventions, including dietary approaches, are a cornerstone for the prevention and treatment of hypertension | DASH was the most effective intervention in lowering BP for adults with prehypertension to established hypertension. |
| Kario, K., Nomura, A., Harada, N., Okura, A., Nakagawa, K., Tanigawa, T., & Hida, E. (2021). Efficacy of a digital therapeutics system in the management of essential hypertension: the HERB-DH1 pivotal trial. European heart journal, 42(40), 4111-4122. | | randomized, open-label HERB-DH1 study | 390 patients (20–64 years); randomly sampled | Therapeutics | Essential hypertension | Between-group differences in 24-h ambulatory, home, and office SBPs at 12 weeks were −2.4 (95% confidence interval −4.5 to −0.3), −4.3 (−6.7 to −1.9), and −3.6 (−6.2 to −1.0) mmHg, respectively. No major programme-related safety events occurred up to 24 weeks. | The study made an evaluation of the ambulatory and home BP-lowering effects of digital therapeutics compared with standard lifestyle modifications in untreated patients with hypertension | The trial enrolled a selected group of patients with hypertension (i.e. those not currently receiving pharmacological therapy who agreed to non-drug management for at least 12 weeks, and without an indication for immediate drug treatment) | The HERB-DH1 pivotal study showed the superiority of digital therapeutics compared with standard lifestyle modification alone to reduce 24-h ambulatory, home, and office BPs in the absence of antihypertensive medications. | The results of this study highlight the potential effects of digital therapeutics for non-pharmacological lifestyle modification to reduce BP in untreated patients with essential hypertension. |
| Hyperlinks: |
| https://www.ahajournals.org/doi/full/10.1161/JAHA.120.016804 |
| https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055329 |
| https://bmjopen.bmj.com/content/9/1/e023995 |
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3028941/ |
| https://academic.oup.com/eurheartj/article/42/40/4111/6358480?login=true |
| PICOT: | In adults within the age frame of 40 and 70 with hypertension (P), how does the adjustment of lifestyle (I) (routine physical exercises and dietary adjustments) compared to pharmacological therapy (C) help to manage (O) the condition and reduce chances of prognosis (O) to complications within the recuperation period inside six months (T) |
| Databases: | Googlescholar.com |
| Key Words: | Blood Pressure, hypertension, dietary therapy, physical activity, pharmacotheraphy, Digital therapeutics, Lifestyle modification, Ambulatory blood pressure, Home blood pressure |
Damoche
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