An evidence-based guideline : using progressive muscle relaxation exercise in maintaining optimal blood pressure for adult patients with hypertension

Abstract

Hypertension is one of the most common chronic medical problems around the world and it is an important public health challenge. Hypertension can lead to cerebrovascular disease, ischemic heart disease, renal failure, myocardial infraction or stroke. According to the statistics from the Census and Statistics Department, it revealed that the ratio of people with known hypertension was about 11.0% in 2011/12. Exposure to stress has been evidenced by different studies as a risk factor for hypertension. Stress included occupational stress, stressful events from the social environment, and low socioeconomic status. Progressive muscle relaxation therapy plays an important role in controlling hypertension apart from the traditional management such as the use of medication or diet control. Objective The objectives of the translational nursing research are to develop an evidence- based guidelines for hypertension patients to maintain an optimal blood pressure level. Methods 5 electronic databases including Medline (Ovid SP) (1950–Aug week 4 2012), Pubmed, ISI web of knowledge (1956- Aug 2012) , The PsycINFO database (1980- Aug 2012) and Cochrane Library (1950- Aug 2012) are used for systematic search of literature. Five suitable are identified while three studies are randomized controlled trials and two are quasi-experimental design. The 5 studies were summarized and a table of evidence is formed. The Scottish Intercollegiate Guidelines Network (SIGN) checklist was used for critical appraisal. The findings indicate that progressive muscle relaxation exercise has significant effects in maintaining optimal blood pressure for hypertension patients. In order to implement the evidence- based protocol, an implementation plan is developed. A pilot test is implemented before the full- scale implementation of innovation. An evaluation plan is developed in order to assess the effectiveness of the program. Conclusion There are all together 8 recommendations are made in this protocol which based on the 5 chosen studies. According to SIGN’s “Grades of Recommendation”, all 8 recommendations in the protocol are graded as “A”. The innovation is proposed to implemented at an outpatient clinic for the hypertension patients. The progressive muscle relaxation exercise would be last for 6 weeks, which is effective in maintaining optimal blood pressure in hypertension patients. In the views of the transferability of the evidences, the feasibility and the cost-effectiveness of the program, the proposed program is considered as rewarding to carry out at the outpatient clinic in Hong Kong.