PICOT Question


This research review is centered on literature relevant to uncontrolled hypertension of adults ages 18-45 with hypertension. The age group of 18-45 year olds forms the majority of the population all across the world. The assumption would be that this is a healthy group of people without risk of major chronic illnesses. However, this is not the case in the modern world. This group of people is at a higher risk of uncontrolled hypertension due to the changing lifestyles, majority of the people are too busy with family and career life and thus they hardly have time to exercise. In addition, eating habits have changed with minimal attention to the foods that strengthen the heart. The purpose of this paper is to find current research attempting to answer the PICOT, that is, does yoga, meditation and relaxation effectively reduce high blood pressure? These three methods have a number of benefits that lead to a reduction in the blood pressure of individuals suffering from hypertension. These methods aim at reducing and managing stress, which is one of the major causes of high blood pressure.

Making use of yoga has many benefits to the patient, not just in management of hypertension, but for the general health. One of the benefits is stress reduction with several studies showing that yoga can help to reduce anxiety and stress, and also works wonders in reducing blood pressure (Gupta, 2006). This also helps to improve one’s mood and the overall sense of well being. Yoga is also helpful in improving fitness, which means improving one’s balance, flexibility, strength and range of motions. This translates into less chances of injuring oneself in other physical activities. Yoga is also useful in managing chronic illnesses such as high blood pressure and heart diseases.

Meditation refers to a state of concentrated attention on some thought, object or awareness with the main aim being directing attention to the mind itself. During meditation, the mind dissolves and frees itself of all thoughts. Relaxation and medication also have the same health benefits as yoga and a few minutes of medication can help a person to restore calmness and internal peace. Meditation also helps in improving the emotional well being of a person. Through the meditation, one is able to clear away the entire work and information overload that leads to building up of stress. This, therefore, helps in managing illnesses that are stress related like heart disease, hypertension, sleep problems and depression.

Recent research reveals that daily relaxation through meditation of at least two sessions lasting 15minutes each will result in a considerable reduction in the blood pressure. This method is very safe and requires no or little physician attention. Using meditation to lower the blood pressure levels works by creating the most peaceful and silent levels of consciousness allowing someone to get in touch with the innermost self. This is especially more effective with the Transcendental Meditation Technique. During meditation, the body requires a less amount of oxygen, mostly up to 20% less depending on the type of meditation and the experience of the person meditating. The fact that this method does not need a physician makes it very cheap and cost effective.

As stated earlier, the research made use of the following databases in an attempt to answer the research question: Pubmed/ Medline, Cumulating Index of Nursing and Allied health Literature (CINAHL), Academic Search Premier, Google Scholar, and Cochrane.  For easier results, the keywords chosen included Hypertension, uncontrolled, adult, yoga, meditation and relation programs, though they were modified with each database for the best results. These will be the main words to be used interchangeably in the search for articles.

The first database review was on pubmed review and the searches with the key words were yoga and meditation to reduce hypertension in adults between the ages of 18-45 years.  This search resulted in four databases, but one of them proved to be most relevant in answering the question. This was titled Effect of yoga based lifestyle intervention on state and trait anxiety. This article addressed how yoga deals with all anxiety disorders, which leads people into living unhealthy lifestyles and consequently contracting hypertension (Gupta, 2006). It also revealed that the anxiety is one of the major causes of high boold pressure and dealing with anxiety was as good as dealing with high blood pressure. The article identifies Yoga as one of the successful way of dealing with anxiety and thus hypertension. Though the article was done in 2006, it is very effective in this study.

The second database search used CINAHL with hypertension and relaxation as the key words, which produced 46results but one article on relaxation proved more relevant than all the other articles. The article discussed the effectiveness of relaxation exercises and walking in reducing hypertension (Coler, 2010).

The third database was the Academic Search Premier which comprises of one of the largest databases in the  world. Under this database, the search started with meditation and hypertension as the key words and it yielded 15 articles worth reviewing. However, one of the articles by Chung et-al, published in 2012 was the most relevant. It analysed the use of yoga and meditation in reducing blood pressure as an alternative treatment method. It also discussed the need to raise awareness on these natural practices of lowering blood pressure, rather than depending on the medical treatments to deal with high blood pressure (Chung et-al, 2012).

The fourth database used was the Google scholar, which gave a result of nine articles. The keys words were yoga and meditation in reducing high blood pressure. Three of the articles were written in the 70s though they were still relevant to the research study. Five were not relevant to the research question while one article proved very helpful in this research. This was a publication titled Yoga in cardiac health (Satyajit, 2004)).

The fifth database was the Cochrane library, and using the key words yoga and meditation in reducing uncontrolled hypertension gave zero results. In light of this, The key words for the search were modified to controlling hypertension in adults through yoga, which revealed six articles, which were not relevant to the research question.


The process of searching for articles from various databases needs a deep understanding of the process involved. The search for databases with the keys words  Hypertension, uncontrolled, adult, yoga, meditation and relation programs did reveal many articles, but others we too general t be used in answering the research question. This search gave rise to eighty sources, but four of them were most relevant and useful in answering the research question.

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