Methodology

Picot: P: In adult patients with hypertension, I: how does exercise with medications. C: compared to medications alone. O: affect blood pressure readings T: within a year time frame?

Sampling

• How will the sample be selected?

Adults of the ages 35-65 with a diagnosis of hypertension will be selected from  primary care facilities to participate in the study.

• What type of sampling method is used? Is it appropriate to the design?

randomized controlled trials are used involving anti hypertensive medications, and exercise regimens. The authors of this study adopted a two- tiered data extraction strategy. The data found was then divided into categories. Exercise was divided into 1) Endurance, 2) Dynamic Resistance, 3) Isometric Resistance, and 4) Combination (Naci et al., 2018). Medications were categorized back on their class. The researchers then developed a flow diagram of the study identification, and selection.  

• Does the sample reflect the population as identified in the problem or purpose statement? yes

• Is the sample size appropriate? Why or why not?

  391 random controlled trials- 197 (10,461 participants) were evaluated on their exercise regimens, and 194 (29,281 participants) were evaluated on their anti hypertensive medications (Naci et al., 2018). 

  The participants range from between the ages of 35-65.

• To what population may the findings be generalized? What are the limitations in generalizability? Surveillance definition of hypertension prevalence: Individuals aged 18 years and older who are not pregnant and satisfy any of the following: Systolic blood pressure 140 mmHg or greater, Diastolic blood pressure 90 mmHg or greater, Current use of antihypertensive medication.

Research design

• What type of design will be used?

To realize the objectives of the study, it will be paramount to use random assignment for determining who will be in the control or treatment group. For the proposed investigation, the research design will be a casual research design. According to Flannelly & Jankowsk (2014), this design measures the impacts that specific changes have on existing assumptions and norms. Causal effect occurs when a variation in the independent variable results in a variation in the dependent variable. Because the design emphasizes on systemic selection of subjects and equity of comparison groups, it tends to have high internal validity (Flannelly & Jankowsk, 2014). Hence, it will be the most appropriate design for the study.

• Does the design seem to flow from the proposed research problem, theoretical framework, literature review, and hypothesis?

This randomized controlled trail was done to compare exercise regimens, and blood pressure medications, and to evaluate their effects on systolic blood pressure.  The medications included were ACEI, ARBs, CCB, and diuretics (Naci et al., 2018). The type of exercise included was endurance, dynamic resistance, isometric resistance, and combined. It is known that exercise and medications, both, are effective in lowering blood pressure

Reference:

Flannelly , K., & Jankowsk, K. (2014). Research designs and making causal inferences from health care studies. Journal of Health Care Chaplaincy, 20(1), 25-38.

Naci, H., Salcher- Konrad, M., Dias, S., Blum, M. R., Sahoo, S. A., Nunan, D., & Loannidis, J. P. (2018). How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomized controlled trials assessing exercise and medication effects on systolic blood pressure. British Journal of Sports Medicine, 16(3), 1-12.