PICOT question is; In overweight, diabetic patients with hypertension, is the use of lisinopril as a treatment option compared to the use of diet and exercises more effective in managing blood pressure in the first six months of treatment?

PICOT Question-Overweight Diabetic Patients with Hypertension

My selected topic is hypertension, and the relevant PICOT question is; In overweight, diabetic patients with hypertension, is the use of lisinopril as a treatment option compared to the use of diet and exercises more effective in managing blood pressure in the first six months of treatment?

I chose this topic and developed the question due to the current prevalence of obesity and diabetes in the United States. I also reviewed the relationship between diabetes, obesity, and hypertension. The complications associated with comorbid hypertension in obese and diabetic patients were also considered. I reviewed the available evidence on hypertension management and treatment options, including medical options such as angiotensin-converting enzyme inhibitors (ACE inhibitors) and non-medical approaches such as dieting and physical exercise. I also considered how long I would like to achieve and review the outcomes of the interventions.

Diabetes and obesity elevate blood pressure or worsen the condition if it already exists. Hypertension risks complications such as stroke, coronary artery disease, vascular diseases, nephropathy, and retinopathy (Jia & Sowers, 2021). Evidence shows that the use of the renin-angiotensin-aldosterone system (RAAS) inhibiting medications such as ACE inhibitors efficiently manages hypertension and related complications (Ghatage et al., 2021). Additionally, ACE inhibitors, when used as antihypertensive therapeutic options, improve the management of diabetes-related complications (Chakraborty & Roy, 2021).

The PICOT question is important as it compares a medical and non-medical approach to compare the efficiency of medical management of hypertension in obese diabetic patients. It determines whether the use of lisinopril, an ACE inhibitor, can help improve blood pressure outcomes and other complications in obese diabetic patients in the shortest time possible as compared to non-medical alternatives, specifically diet and exercise. Prolonged hypertension due to lack of sufficient management in obese diabetic patients further worsens insulin resistance and diabetes and related complications (Jia & Sowers, 2021).

References

Chakraborty, R., & Roy, S. (2021). Angiotensin-converting enzyme inhibitors from plants: A review of their diversity, modes of action, prospects, and concerns in the management of diabetes-centric complications. Journal of Integrative Medicine, 19(6), 478–492. https://doi.org/10.1016/J.JOIM.2021.09.006