Coronary Artery Bypass Grafting Surgery: Hypertension Management

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Ahmed, Z., Kumar, V., Kamal, Achakzai, A., Khatri, A., & Khushk, S. (2021). Frequency of hypertension and diabetes mellitus in patients undergoing coronary artery bypasses grafting surgery. Annals of the Romanian Society for Cell Biology, 25(6), 914–924.

The article suggests that individuals with hypertension are at a higher risk of developing short-term and long-term complications following a coronary artery bypass grafting surgery. For the purposes of this quantitative study, 196 participants aged 18 to 65 with no previous history of cardiac surgery were recruited. The participants with a history of hypertension and diabetes underwent elective coronary artery bypass, with their condition being monitored after the procedure. During the study, the demographic data of the participants and their medical histories were collected and analyzed using SPSS version-21 statistics software. The authors conclude that hypertension is the primary risk factor for developing cardiovascular disease and is positively correlated with long-term and short-term postoperative complications. In particular, it was noted that male patients are more likely to be hypertensive and, therefore, are at higher risk of complications. The article on the prevalence of hypertension in patients undergoing coronary artery bypass grafting surgery can provide needed background information on the risks of surgery and the need for postoperative hypertension management.

Dymek, J., Gołda, A., Polak, W., Lisowski, B., & Skowron, A. (2019). Effect of education for hypertensive patients with correctly performed self-blood pressure monitoring (SBPM).Pharmacy, 7(3), 1–12. Web.

The study under consideration aims to examine the effect of patient education on hypertension management. Specifically, the impact of pharmacist-led education on the patients’ knowledge and ability to maintain blood pressure within normal parameters was evaluated. The participants were required to measure their blood pressure for 20 consecutive workdays, followed by an individualized training session with a pharmacist, who further educated patients on self-blood pressure monitoring. In addition, the knowledge of participants on hypertension and blood pressure measuring was assessed through three tests. The first test was offered to the participants before observed blood pressure measurements, the second took place after the 20 successive days of self-blood pressure monitoring, and the third occurred six months after the personal education sessions. The authors conclude that educating patients with hypertension on independent blood pressure monitoring is highly effective and beneficial as it translates into a decreased frequency of measurement errors. The study can meaningfully contribute to the proposed research as it demonstrates the advantages of education on maintaining blood pressure within the normal range post coronary artery bypass surgery.

Kim, J., Park, J., Lee, J., Min, J. J., Lee, S., Lee, Y., Kim, W. S., Song, S., Yeo, J. H., & Cho, H. (2020). Comparative efficacy of angiotensin converting enzyme inhibitors and angiotensin receptor blockers after coronary artery bypass grafting.Scientific Reports, 10, 1–7. Web.

This quantitative research study emphasizes the importance of secondary interventions following coronary artery bypass grafting surgery. In particular, the study compares the effect of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme (ACE) inhibitors in reducing blood pressure in patients during the postoperative period. The overall sample included 5456 participants who underwent bypass surgery, with 1198 patients prescribed antihypertensive medication. The data on antihypertensive medication prescribed to patients and their clinical outcomes was collected using Clinical Data Warehouse Darwin-C. The authors evaluated whether the patients experienced any major adverse cardiovascular and cerebrovascular events following the surgery and analyzed the differences between patients prescribed ARBs and ACE inhibitors. It was concluded that patients given ARBs for management of hypertension following coronary artery bypass grafting surgery experienced better protective effects than persons prescribed ACE inhibitors. The study contributes to the proposed research as it examines the impact of antihypertensive drugs on patients who underwent coronary bypass surgery and can inform the study on postoperative blood pressure management.

Maslakpak, M. H., Rezaei, B., & Parizad, N. (2018). Does family involvement in patient education improve hypertension management? A single-blind randomized, parallel group, controlled trial.Cogent Medicine, 5(1), 1–13. Web.

The research study discusses the effect of family involvement on patient education concerning hypertension management. The authors carried out a single-blind randomized, parallel-group, controlled trial in order to estimate the impact of family participation in hypertension education sessions offered by healthcare facilities. One hundred participants were divided into the control group, patient-oriented, family-oriented, and mixed groups receiving education on blood pressure management and monitoring. The researchers measured the patients’ adherence to medication, low sodium diet, and medical appointments before and following the education intervention. The study shows that family involvement in patient education is positively correlated with better antihypertensive drug and physician appointments adherence as well as observance of a healthy diet. The authors note that separate patient education and family members training on hypertension management are effective. Nevertheless, education sessions carried out in the presence of both patients with hypertension and their family members were found to be more effective. The study can inform the proposed research as it illuminates the effectiveness of client education on hypertension management and can be invaluable for patients following coronary artery bypass surgery.

Song, T., Liu, F., Deng, N., Qian, S., Cui, T., Guan, Y., Arnolda, L., Zhang, Z., & Yu, P. (2020). A comprehensive 6A framework for improving patient self-management of hypertension using mHealth services: Qualitative thematic analysis.Journal of Medical Internet Research, 23(6), 1-15. Web.

The qualitative study assesses patient experiences with the 6A framework for improving hypertension management. The 6A framework (access, assessment, assistance, awareness, ability, and activation) defines the mechanisms offered to patients utilizing mHealth services for monitoring and maintaining blood pressure within the normal parameters. These services provide patients with educational information on hypertension and blood pressure measuring as well as reminders on when to measure blood pressure and automatic feedback on results. Overall, the researchers conducted in-depth, semi-structured interviews with 22 patients with hypertension using mHealth services. The interviews show that most patients are content with mHealth service for hypertension management. In particular, the assistance function that gives patients access to educational materials and self-management reminders was highly praised. The authors conclude that the employment of mHealth services for hypertension management improves patients’ self-management ability and leads to better health outcomes. This study contributes to a better understanding of patient behaviors and adherence to blood pressure monitoring and medication outside the hospital. Therefore, it can inform the proposed research study on how to educate patients and support them in antihypertensive drugs adherence after coronary artery bypass surgery.

Research Synthesis

Overall, based on these quantitative and qualitative studies, it can be argued that education on hypertension management is critical for patients undergoing coronary artery bypass grafting surgery. The studies indicate that the majority of persons that need the surgery have issues with high blood pressure and require additional medication such as ARBs and ACE inhibitors to manage hypertension during the postoperative period. It can also be concluded that education on the management of hypertension results in better adherence to medication and timely blood pressure monitoring. In addition, research articles indicate that patients have a positive experience with educational materials pertinent to their condition and mHealth services. The literature gathered for the review can grant a better understanding of patient experience with education on hypertension management following bypass surgery. Moreover, the selected literature helps comprehend the efficiency of different antihypertensive drugs such as ARBs and ACE inhibitors on patients following surgery. Nevertheless, seeking additional information on what prevents patients from adhering to the prescribed blood pressure medication after an operation would be helpful.

References

Song, T., Liu, F., Deng, N., Qian, S., Cui, T., Guan, Y., Arnolda, L., Zhang, Z., & Yu, P. (2020). A comprehensive 6a framework for improving patient self-management of hypertension using mHealth services: Qualitative thematic analysis.Journal of Medical Internet Research, 23(6), 1-15.

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Coronary Artery Bypass Grafting Surgery: Hypertension Management

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