Front Cover

Module Name:
Student ID: G87263
Date of Submission: 13th March, 2024
Word Count: 2,400
Prevalence and determinants of Hypertension Control Among Adults in the UK
Introduction
Hypertension management is a critical public health issue globally, impacting cardiovascular
health and mortality rates. In the United Kingdom, understanding the prevalence and
determinants of hypertension control among treated adults is essential for improving
healthcare outcomes. Through a comprehensive study encompassing nearly 100,000
treated adults, researchers aim to identify factors influencing effective hypertension control.
This research sheds light on healthcare practices, patient demographics, and treatment
modalities that contribute to successful hypertension management (Tapela N, et al. 2021).
The weight of hypertension is substantial. Its prevalence and the health repercussions of
poorly managed hypertension render it one of the most lethal diseases globally.
This annotated bibliography serves as a valuable tool for crafting and executing
hypertension programs, aiding in the development and modification of treatment protocols.
Its objective is to furnish a succinct delineation of the scientific underpinnings crucial for
addressing pivotal facets of hypertension control, thereby fostering a holistic approach to
managing hypertension. It's important to note that this compilation does not encompass all
facets of hypertension management and predominantly derives from English-language
scientific literature. The bibliography is structured as follows: initially, references for the
selected studies are provided. Next, the focus shifts to describing the study types and the
methodology employed in the search process. Following this, attention is directed towards
the study titles and an exploration of the inferred subject matter. Subsequently, the
abstracts are analyzed to ascertain the authors' perspectives and glean insights from the
research. This involves identifying two specific points of interest. Finally, the bibliography
concludes with a comprehensive summary of the literature pertaining to the prevalence of
hypertension control among adults in the UK.
Bibliography Annotations

References for the studies Describe the type of What is the title of the study? Does the abstract give a point U
chosen: study and how you What does this indicate to of view of the authors? What te
searched for this. you that the study will be is this? What else does it tell Ex
about? you? fr

1 The type of study is a The title is "Prevalence and The abstract provides the
Tapela N, et al. "Prevalence and cross-sectional determinants of hypertension authors' perspective on the
determinants of hypertension population-based study control among almost study. The authors present
control among almost 100,000 which is a type of 100,000 treated adults in the findings that suggest high
treated adults in the UK." Open observational study UK." This title indicates that levels of uncontrolled
Heart, 2021;8:e001461. DOI: design. the study aims to investigate hypertension among treated
10.1136/openhrt-2020-001461. the extent to which individuals. Risk factors
I searched for this journal hypertension is controlled in negatively associated with the
on Google scholar, a a large population of treated control of hypertension
prominent database for adults in the UK and the include aged, the use
accessing scholarly factors influencing this excessive use of alcohol, black
literature because it control. ethnicity, and obesity. Having
covers a wide range of comorbidities, especially
disciplines beyond cardiovascular diseases, is
biomedical and life positively associated with
sciences. Keywords and hypertension control.
phrases such as
"hypertension control,"
"elderly population," and
related terms were
employed to retrieve
relevant journal articles.

Finally, I used Boolean

operators, such as "AND"
and "OR," during the
search to refine and
target articles specifically
addressing hypertension
control in the elderly.
Filters, including
publication date and
study type, may have
been applied to narrow
down the results.
Muntner, Paul, et al. "Trends in The present investigation The title of the study is The abstract primarily Th
Blood Pressure Control Among adopts an observational "Trends in Blood Pressure articulates the authors' ar
US Adults With Hypertension, approach. In the quest Control Among US Adults viewpoint regarding the
1999-2000 to 2017-2018." JAMA, for relevant literature, With Hypertension, 1999- significance of managing Sh
vol. 324, no. 12, 2020, pp. 1190- PubMed, renowned for 2000 to 2017-2018." This title blood pressure to mitigate M
1200. DOI: its extensive biomedical suggests that the study the risk of cardiovascular fin
10.1001/jama.2020.14545. resources, served as the focuses on examining diseases. It delineates the flu
primary database. My changes in blood pressure study's aim, methodology, re
exploration strategy control among hypertensive and principal discoveries. It th
revolved around adults in the United States offers an unbiased summary, da
strategically chosen over nearly two decades. encapsulating the observed pr
keywords and phrases trends in blood pressure ac
such as "management of regulation among pr
Literature review summary

Introduction:
Hypertension, a widespread and persistent health issue worldwide, plays a substantial role
in the prevalence of cardiovascular ailments. Within the United Kingdom, a notable portion
of the adult population undergoes treatment for hypertension. Despite the array of
interventions at hand, attaining ideal control poses a formidable obstacle. The objective of
this review is to delve into the prevalence and key determining factors that are impacting
hypertension management among adults in the UK. Grasping the intricacies of these
influencing factors is paramount for enhancing public health outcomes and guiding precise
interventions.

Theoretical Review:
Various theoretical frameworks underlie the examination and comprehension of
hypertension regulation, with this investigation specifically examining the Health Belief
Model (HBM) and the Social Cognitive Theory. The Health Belief Model (HBM) acts as a
foundational structure, suggesting that individuals are more likely to embrace health-
promoting behaviors when they perceive themselves as vulnerable to a health issue, grasp
its severity, and recognize the advantages of preventative measures (Rosenstock, 1974).
This model emphasizes the significance of individuals' beliefs and perceptions in shaping
their decisions and actions regarding health.
Furthermore, Social Cognitive Theory, introduced by Bandura (1986), highlights the
importance of observational learning, self-efficacy, and social support in molding health
behaviors. According to this theory, individuals learn by observing the behaviors of others,
develop confidence in their ability to perform similar actions (self-efficacy), and are
influenced by the support and encouragement they receive from their social surroundings.
Social Cognitive Theory elucidates the intricate interplay between personal factors,
environmental influences, and behavioral outcomes, providing insights into the multifaceted
nature of health behavior alteration.
By merging the Social Cognitive Theory and Health Belief Model a comprehensive basis for
understanding the complexities of hypertension management emerges. This integrative
approach recognizes the interconnection of cognitive elements, social dynamics, and
environmental influences in shaping individuals' attitudes, beliefs, and behaviors pertaining
to hypertension control. It underscores the necessity for tailored interventions addressing
not only individuals' perceptions and motivations but also the surrounding ecological and
communal circumstances within which health behaviors manifest. Through this integrated
framework, healthcare practitioners can devise more efficient strategies for promoting
hypertension regulation and enhancing overall health outcomes.
Conceptual Review:
Conceptually, hypertension control involves multifaceted components, including medication
adherence, lifestyle modifications, and regular monitoring. Patient factors such as health
literacy, socioeconomic status, and cultural beliefs play a pivotal role (Maimaris et al., 2016).
Additionally, healthcare system factors, healthcare provider-patient communication, and
access to healthcare services contribute to the overall conceptualization of hypertension
control. This review aims to synthesize existing knowledge on these conceptual elements to
unravel the intricacies of hypertension management among the treated population in the
UK.

Empirical Review:
Several empirical studies have investigated hypertension control among adults in the UK.
This literature review synthesizes key findings from several studies, including Tapela et al.
(2021), Muntner et al. (2020), and Irazola et al. (2016), To thoroughly investigate the
frequency and factors influencing the management of high blood pressure in the adult
population.
Tapela et al. (2021) conducted a population-wide cross-sectional investigation in the UK,
investigating the prevalence and determinants of hypertension control among nearly
100,000 treated adults. Their findings revealed a significant prevalence of uncontrolled
hypertension among treated individuals, indicating potential gaps in management despite
available low-cost treatments. Notably, the study highlighted that comorbidities, especially
cardiovascular diseases, were positively associated with hypertension control.
Muntner et al. (2020) conducted a population-wide cross-sectional investigation in the
United States, examining trends in blood pressure control from 1999-2000 to 2017-2018.
The study observed fluctuations in blood pressure control rates over time, raising questions
about contributing factors such as changes in healthcare practices, access to medications,
lifestyle, and demographics. The study also emphasized variations in the management of
blood pressure across different demographic groups, underscoring the importance of
addressing health inequities.
Irazola et al. (2016) utilized a cross-sectional examination utilizing initial data from seven
surveys conducted within socioeconomically diverse communities across various income
levels. Their study, part of the “NHLBI/UHG Network of Centers of Excellence for Chronic
Diseases”, focused on hypertension prevalence, awareness, treatment, and control.
Noteworthy findings included wide variations in hypertension rates among different
communities and disparities in awareness, treatment, and control across diverse settings,
emphasizing the need for targeted interventions in low- and middle-income countries.
Cumulatively, existing literature indicates that the management of hypertension poses a
multifaceted challenge, shaped by an array of influencing elements, including comorbidities,
demographic characteristics, and temporal trends. Disparities in awareness, treatment, and
control exist across diverse populations, underscoring the importance of tailored
interventions to address specific contextual challenges.
Finally, the literature review establishes strong connections to previous research, such as
Tapela et al.'s emphasis on the prevalence of uncontrolled hypertension and the positive
association between comorbidities and control. Muntner et al.'s exploration of trends in
blood pressure control and disparities aligns with the broader understanding of
hypertension management. Irazola et al.'s study in low- and middle-income communities
complements the global perspective, highlighting the need for context-specific
interventions.

Limitations in Literature:
Despite the valuable insights provided by these studies, certain limitations exist.
Methodological constraints, potential biases, and the cross-sectional nature of some studies
may limit the generalizability of findings. Additionally, variations in healthcare systems and
practices between countries and over time may impact the comparability of results.

Conclusion and Identification of Research Gaps:

There is a need for further research to explore the nuanced interactions between
comorbidities and hypertension control, considering the potential role of healthcare system
interactions. Understanding the underlying factors contributing to fluctuations in blood
pressure control rates over time, as highlighted by Muntner et al., (2020) could guide
targeted interventions. Future studies should also focus on developing context-specific
strategies to improve hypertension management in diverse populations, especially in low-
and middle-income countries.
Ultimately, this synthesis of literature offers an extensive examination of the existing
understanding regarding the frequency and factors influencing the management of
hypertension among adults, drawing insights from key studies. The synthesized information
contributes to a better understanding of the complexities surrounding hypertension
management and serves as a foundation for future research and interventions in this critical
public health domain.
References
Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory.
Prentice-Hall, Inc.
Irazola, Vilma E et al. “Hypertension Prevalence, Awareness, Treatment, and Control in
Selected LMIC Communities: Results From the NHLBI/UHG Network of Centers of Excellence
for Chronic Diseases.” Global heart vol. 11,1 (2016): 47-59.
doi:10.1016/j.gheart.2015.12.008
Maimaris, W., Paty, J., Perel, P., Legido-Quigley, H., Balabanova, D., Nieuwlaat, R., & McKee,
M. (2016). The influence of health systems on hypertension awareness, treatment, and
control: a systematic literature review. PLoS Medicine, 13(11), e1002159.
Muntner, Paul, et al. "Trends in Blood Pressure Control Among US Adults With
Hypertension, 1999-2000 to 2017-2018." JAMA, vol. 324, no. 12, 2020, pp. 1190-1200. DOI:
10.1001/jama.2020.14545.
Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education
Monographs, 2(4), 328-335.
Tapela N, et al. (2021). Prevalence and determinants of hypertension control among almost
100,000 treated adults in the UK. Open Heart, 8, e001461. DOI: 10.1136/openhrt-2020-
001461.