PICOT and Literature Evaluation Table

PICOT and Literature Evaluation Table

GCU Literature Evaluation Table

Student Name:

Summary of Clinical Issue (200-250 words):

PICOT Question: In middle aged hypertensive and overweight adults, does lifestyle modification in the form exercise and diet changes result in weight loss and reduced blood pressure within 12 months.


Criteria Article 1 Article 2 Article 3
APA-Formatted Article Citation with Permalink Herrod, P., Doleman, B., Blackwell, J., O’Boyle, F., Williams, J. P., Lund, J. N., & Phillips, B. E. (2018). Exercise and other non-pharmacological strategies to reduce blood pressure in older adults: a systematic review and meta-analysis. Journal of the American Society of Hypertension: JASH, 12 (4), 248–267. https://doi.org/10.1016/j.jash.2018.01.008 Alsinani, T. S., Abdullah, A. A., Alghamdi, T. A., Alsaigh, S. A. S., Alanazi, M. D., Alkahtani, M. A., Alzahrani, T. A., & Alabdrabalrasol, E. A. (2018). Lifestyle modifications for hypertension management. The Egyptian journal of hospital medicine, 70(12), 2152-2156. doi: 10.12816/0045044 retrieved from https://scholar.googleusercontent.com/scholar?q=cache:dAVaJnOL-XEJ:scholar.google.com/&hl=en&as_sdt=0,5&as_ylo=2017&scioq=how+diet+and+exercise+affect+hypertension Lee, C. J., Kim, J. Y., Shim, E., Hong, S. H., Lee, M., Jeon, J. Y., & Park, S. (2018). The effects of diet alone or in combination with exercise in patients with prehypertension and hypertension: a randomized controlled trial. Korean circulation journal, 48(7), 637-651. https://doi.org/10.4070/kcj.2017.0349 retrieved from https://synapse.koreamed.org/articles/1108775
How Does the Article Relate to the PICOT Question? This study looks at the strategies that reduce blood pressure such as exercise This study looked into the many lifestyle changes that a patient can do to maintain and control blood pressure and improve their quality of life. This article was to assess the efficacy of a home-based lifestyle change intervention on blood pressure control.
Quantitative, Qualitative (How do you know?) qualitative study

Publication views are analyzed.

Qualitative study

It displays views of other different studies

Quantitative since blood pressure measurements are analyzed.
Purpose Statement To display non-pharmacologic strategies that reduce blood pressure To ascertain that lifestyle modifications are effective in management of hypertension Assess the effectiveness of the combination of diet and exercise interventions in lowering blood pressure
Research Question How do non-pharmacological strategies lead to blood pressure reduction? Are lifestyles modifications effective at controlling blood pressure? Is the combination of exercise and diet effective in lowering blood pressure?
Outcome In elderly people, an exercise-based lifestyle intervention may result in a 5/3 mm Hg drop in blood pressure. Isometric exercise has the potential to be more beneficial. with modification of lifestyles, hypertension is effectively managed Diet and exercise-focused lifestyle changes were helpful in decreasing blood pressure and should be preferred over diet-only changes.

(Where did the study take place?)

Community setting Community setting The study is home based
Sample 5139 participants with a mean age of 69 articles published from 1976 through February 2017 85 patients aged over 20 years with prehypertension and mild hypertension
Method Systematic review of randomized controlled trials Randomized controlled trials Randomized controlled trial
Key Findings of the Study Non-pharmacological interventions lead to a better control of blood pressure application of most lifestyle modifications leads to a greater control of blood pressure For effective blood pressure lowering, both active dietary and activity interventions are required.
Recommendations of the Researcher Hypertensive patients should be encouraged to practice these non-pharmacological interventions for better control of blood pressure Health professionals should educate and encourage patients to undertake the modifications because of the benefits. A combination of diet and exercise should be implemented instead of a single modification


Criteria Article 4 Article 5 Article 6

APA-Formatted Article Citation with Permalink. PICOT and Literature Evaluation Table 

 Mahmood, S., Shah, K. U., Khan, T. M., Nawaz, S., Rashid, H., Baqar, S., & Kamran, S. (2019). Non-pharmacological management of hypertension: in the light of current research. Irish journal of medical science, 188(2), 437–452. https://doi.org/10.1007/s11845-018-1889-8 Aronow, W. S. (2017). Lifestyle measures for treating hypertension. Archives of medical science: AMS, 13(5), 1241.doi: 10.5114/aoms.2017.68650 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5575221/ Yang, M. H., Kang, S. Y., Lee, J. A., Kim, Y. S., Sung, E. J., Lee, K. Y., Kim, J. S., Oh, H. J., Kang, H. C., & Lee, S. Y. (2017). The effect of lifestyle changes on blood pressure control among hypertensive patients. Korean journal of family medicine, 38(4), 173. https://dx.doi.org/10.4082%2Fkjfm.2017.38.4.173
How Does the Article Relate to the PICOT Question? The study looked at the importance of non-pharmacological management of blood pressure The study focused on the Lifestyle measures that can be used to control blood pressure The article assessed how lifestyle changes affect control of blood pressure among the hypertensive patients.
Quantitative, Qualitative (How do you know?) quantitative

Pretest and posttest blood pressure values are obtained


Results are in numerical form

Purpose Statement Emphasizing the effectiveness of lifestyle modifications strategies in blood pressure control To identify the effectiveness of the lifestyle modification strategies in treating blood pressure Suggest factors and lifestyle changes linked to blood pressure control in patients on antihypertensive medications.
Research Question How effective are the non-pharmacological interventions in control of blood pressure? How do different lifestyle modifications contribute in treating blood pressure? Which lifestyle factors contribute to increased blood pressure and how can they be modified to control blood pressure?
Outcome Assuming multiple non-pharmacological interventions lead to effective control of blood pressure Lifestyle measures like reduced salt intake and exercise lead to blood pressure control sex (OR, 3.55; 95% CI, 2.02 to 6.26; P<0.001), salt intake (OR, 0.64; 95% CI 0.43 to 0.97; P=0.034), and comorbidity (OR, 1.82; 95% CI, 1.23 to 2.69; P=0.003) were associated with successful blood pressure control

(Where did the study take place?)

Community setting Community setting and clinical centers hospital setting
Sample 6779 hypertensive patients A total of 206316 participants 1453 hypertensive patients on candesartan with 64 years as the average age
Method randomized control trials Randomized controlled trials

Observational study

Survey using questionnaires
Key Findings of the Study combination of multiple non pharmacological interventions lead to significant control of blood pressure Lifestyle modifications contribute a greater percentage in the treatment of hypertension Lifestyle factors that lead to hypertension can be modified to control blood pressure
Recommendations of the Researcher several non-pharmacological interventions should be combined for effective management of blood pressure Lifestyle changes should be used to prevent prehypertension and also in treating mild hypertension Doctors should advise patients on lifestyle modifications in inclusion of the antihypertensive.



Summary of the Problem

Hypertension can be defined as a situation where the blood exerts too much pressure against the arterial walls. It is described as having a blood pressure of more than 140/90, and severe if the pressure is higher than 180/120 (Yang et al., 2017). Overweight is a weight that is higher than what is deemed acceptable, as indicated by the body mass index (BMI). Lifestyle modification is changing long-term behaviors, such as eating or exercising, and sticking to the new routine. Obesity and hypertension are some of the diseases that can be managed effectively through lifestyle changes. According to Alsinasi et al. (2018), factors that increase and complicate hypertension are mostly linked to poor lifestyle behaviors such as sedentary lifestyle and unhealthy eating habits. For example, a sedentary lifestyle where the food consumed has a lot of fat and lack of exercise predisposes one to hypertension. Simple modification of these factors can potentially alleviate suffering in hypertensive patients. Interventions such as engaging in aerobic exercises lead to weight loss as the exercise helps burn excess fat deposited in blood vessel lumens. This increases the lumen size, thus reducing blood pressure. Diet changes also lead to blood pressure control. Reduced salt and fat intake play a significant role in controlling blood pressure (Mahmood et al., 2019). Other modifiable risk factors include the limitation of alcohol intake and stress management. These interventions are vital in controlling blood pressure in addition to taking antihypertensive.