Primary Hypertension. Applied Physiology, Nutrition, And Metabolism, 39(7), 856 Article Review Sample

Identification of Best Evidence-based Intervention

Identification of Best Evidence-based Intervention

Introduction

Primary hypertension, also known as essential hypertension, is a type of high blood pressure condition which develops gradually mostly in people of 18 years and above, but it has no identifiable cause (Calhoun, et. al, 2011). High blood pressure may indicate an underlying medical problem. However, primary hypertension has no definitive cause. Millar & Goodman (2014) estimates the prevalence of primary hypertension to be at about 95% of all cases of hypertension, with the rest being cases of secondary hypertension. Although there are no definitive causes of primary hypertension, genetics, stress, diet, and obesity and overweight are some of the contributing factors to the condition. Evidence-based interventions refer to treatments that have been proven to be effective in the management of diseases after an outcome evaluation. The interventions for primary hypertension mostly focuses on behavioral and lifestyle changes in the patients. This paper will explore evidence-based intervention for primary hypertension.
Cormick, G., Ciapponi, A., Mazzoni, A., Belizán, J. M., & Cafferata, M. L. (2012). Calcium
Supplementation for Prevention of Primary Hypertension. The Cochrane Library.
This article explores the use of calcium as a preventive intervention to primary hypertension. Calcium has been proven through studies to have an inverse relationship with primary hypertension. However, the mechanisms through which calcium works in preventing primary hypertension is not well understood, and it calls for more research to establish its viability and importance.
Garjón, J., Azparren, A., Elizondo, J. J., Gaminde, I., Ariz, M., Erviti, J., & Saiz, L. C.
(2013). Monotherapy versus Combination Therapy used as First‐line Therapy for
Primary Hypertension. The Cochrane Library.
This article sought to establish the efficacy of monotherapy as compared to combination therapy as a first line intervention for primary care. Monotherapy involves the use of drugs for a certain period, until the normal blood pressure is reached. Combination therapy involves use of two drugs at a low dosage to manage the condition. The article concludes that combination therapy is more effective than monotherapy, although the use of a combination of drugs hasn’t been widely accepted because of the associated adverse effects.
Millar, P. J., & Goodman, J. M. (2014). Exercise as Medicine: Role in the Management of

858.
Primary hypertension has no underlying cause, and its management is dependent on improving the lifestyle and behaviors of the patients. This article recommends lifestyle modification as a frontline prevention measure which involves dietary changes, physical exercises, reduction in smoking, and alcohol intake. This article emphasizes on the importance of physical activities, as they have been proven to be safe in reducing primary high blood pressure.
Crabtree, M. M., Stuart-Shor, E. & McAllister, M. (2013). Home Blood Pressure Monitoring:

An Integrated Review of Literature. The Journal for Nurse Practitioners, 9(6), 356

363
According to this article, home based monitoring for blood pressure is a process through which patients partner with their care providers for self-care management. Evidence shows that home-based monitoring is more effective than office-based monitoring. It not only contributes to low costs of treatment, but has also been seen to improve outcomes for people with primary hypertension. Home based care involves team-based care, self management education n the necessary skills, as well as evidence-based skills for the patient, hence the improved health outcomes.
MacManus, R. J., et. al. (2010). Tele-monitoring and Self Management in the Control of Hypertension (TASMINH2): A Randomized Control Trial. The Lancet, 376: 163-172
This study sought to establish the effectiveness of self-management skills when incorporated with tele-monitoring compared to the usual care in patients with hypertension. At the end of the study, patients who integrated self-management skills in managing hypertension were reported to have a lower systolic and diastolic pressure. The article concluded that a combination of self management skills with tele-monitoring presents a new and effective way of managing hypertension.
Calhoun, D. A., et. al. (2011). Effects of a Novel Aldosterone Synthase Inhibitor for

Treatment of Primary Hypertension Results of a Randomized, Double-Blind, Placebo

and Active-Controlled Phase 2 trial. Circulation, 124(18), 1945-1955.
This study sought to establish the efficacy of Aldosterone synthase inhibition in the treatment and management of clinical and ambulatory primary care hypertension. Aldosterone synthase inhibition was found to have a positive effect in reducing blood pressure with the least side effects. Only a few participants experienced the release of Cortisol due to the stimulation by the drugs. Therefore, Aldosterone synthase inhibition can be used as an effective and evidence-based treatment for primary hypertension.
Rabia, H. & Gozum, S. (2011). The effect of Patient Education and Home Monitoring on

Medication Compliance, Hypertension Management, Healthy Lifestyle Behaviors and

BMI in a Primary Healthcare Setting. Journal of Clinical Nursing, 20(5), 692
705
Hypertension patients can also benefit from patient-centered education and home-based monitoring in managing primary hypertension. The education focuses on pharmacological and non-pharmacological interventions, and how patients can adhere to them. The article results showed a positive correlation between combination of education with medication and lifestyle change therapies. Patients who received education together with medications were observed to be more adherent to therapies than patients who didn’t receive any education.
Ogedegbe, G., et. al. (2009). Counseling African Americans to Control Hypertension
(CAATCH) Trial: A Multilevel Intervention to Improve Blood Pressure Control in

Hypertensive Blacks. Circulation: Cardiovascular Quality and Outcomes, 2,

249-256
This guideline provides evidence on the diagnosis of primary hypertension. Primary hypertension can be challenging to diagnose because normal blood pressure varies throughout the day. Moreover, primary hypertension has no contributory causes, which makes it challenging to diagnose. Consequently, treatment of the same becomes a challenge as well. This article highlights the NICE guidelines that are vital in diagnosing and treating primary hypertension, with lifestyle changes like dietary modifications, stress reduction, and engaging in physical exercises being identified as a frontline for management of the condition.
Munro, A. J. & Niblock, P. G. (2010). Telemonitoring- or Better Follow Up? The Lancet,

376, 1737

Tele-monitoring is the process via which primary care physicians trace the impact of their interventions on patients. This article compares the effectiveness of tele-monitoring when compared to the traditional follow ups. According to the study carried out, tele-monitoring doesn’t have significant impacts on the management of hypertension. Moreover, it is an expensive strategy and its use is not justifiable. Unlike tele-monitoring, follow-ups assess other things like adherence to medication and physical exercises, rather than merely the progress of the hypertension.
Masi, C., et. al. (2011). Using an Established Tele-health Model to Train Urban Primary Care

Providers on Hypertension Management. Journal of the American Society of

Hypertension, 14(1), 45-52
Most interventions for the management of hypertension are usually targeted towards the patients and their contribution towards the management of the condition. However, this study explored a different route of managing hypertension, by assessing the impact of videoconference-based tele-health network on increasing hypertension management knowledge and self-assessed competency among primary care providers, PCPs. Those who received the intervention were observed to have increased knowledge on management of hypertension compared to the control group. Therefore, interventions for hypertension should also focus on empowering care providers with relevant information.

References

Calhoun, D. A., et. al. (2011). Effects of a Novel Aldosterone Synthase Inhibitor for
Treatment of Primary Hypertension Results of a Randomized, Double-Blind, Placebo
and Active-Controlled Phase 2 trial. Circulation, 124(18), 1945-1955.
Cormick, G., Ciapponi, A., Mazzoni, A., Belizán, J. M., & Cafferata, M. L. (2012). Calcium
Supplementation for Prevention of Primary Hypertension. The Cochrane Library.
Crabtree, M. M., Stuart-Shor, E. & McAllister, M. (2013). Home Blood Pressure Monitoring:
An Integrated Review of Literature. The Journal for Nurse Practitioners, 9(6), 356
363
Garjón, J., Azparren, A., Elizondo, J. J., Gaminde, I., Ariz, M., Erviti, J., & Saiz, L. C.
(2013). Monotherapy versus Combination Therapy used as First‐line Therapy for
Primary Hypertension. The Cochrane Library.
Masi, C., et. al. (2011). Using an Established Tele-health Model to Train Urban Primary Care
Providers on Hypertension Management. Journal of the American Society of
Hypertension, 14(1), 45-52
Millar, P. J., & Goodman, J. M. (2014). Exercise as Medicine: Role in the Management of
Primary Hypertension. Applied Physiology, Nutrition, and Metabolism, 39(7), 856
858.
Munro, A. J. & Niblock, P. G. (2010). Telemonitoring- or Better Follow Up? The Lancet,
376, 1737
Ogedegbe, G., et. al. (2009). Counseling African Americans to Control Hypertension
(CAATCH) Trial: A Multilevel Intervention to Improve Blood Pressure Control in
Hypertensive Blacks. Circulation: Cardiovascular Quality and Outcomes, 2,
249-256
Rabia, H. & Gozum, S. (2011). The effect of Patient Education and Home Monitoring on
Medication Compliance, Hypertension Management, Healthy Lifestyle Behaviors and
BMI in a Primary Healthcare Setting. Journal of Clinical Nursing, 20(5), 692
705