Lifestyle approaches to hypertension for prevention of stroke and vascular cognitive impairment: a realist review protocol.

Autor:	Ibrahim S; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.; Program for Health System and Technology Evaluation, Toronto General Research Institute, Toronto, Ontario, Canada.; Jay and Sari Sonshine Centre for Stroke Prevention & Cerebrovascular Brain Health, University Health Network, Toronto, Ontario, Canada.; Centre for Advancing Collaborative Healthcare & Education (CACHE), University of Toronto, Toronto, Ontario, Canada., Bielecki J; Toronto Health Economics and Health Technology Assessment (THETA) Collaborative, University of Toronto, Toronto, Ontario, Canada., Kocabas E; Jay and Sari Sonshine Centre for Stroke Prevention & Cerebrovascular Brain Health, University Health Network, Toronto, Ontario, Canada., Singh S; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, Massachusetts, USA.; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.; Broad Institute of MIT and Harvard, Cambridge, MA, Massachusetts, USA.; Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Senff JR; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, Massachusetts, USA.; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.; Broad Institute of MIT and Harvard, Cambridge, MA, Massachusetts, USA.; Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Casaubon LK; Department of Neurology, Toronto Western Hospital, Toronto, Ontario, Canada.; Department of Medicine, Division of Neurology, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada., Rosand J; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, Massachusetts, USA.; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.; Broad Institute of MIT and Harvard, Cambridge, MA, Massachusetts, USA.; Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Rac VE; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.; Program for Health System and Technology Evaluation, Toronto General Research Institute, Toronto, Ontario, Canada., Pikula A; Jay and Sari Sonshine Centre for Stroke Prevention & Cerebrovascular Brain Health, University Health Network, Toronto, Ontario, Canada aleksandra.pikula@uhn.ca.; Department of Neurology, Toronto Western Hospital, Toronto, Ontario, Canada.; Department of Medicine, Division of Neurology, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.; Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Sep 30; Vol. 14 (9), pp. e088631. Date of Electronic Publication: 2024 Sep 30.
DOI:	10.1136/bmjopen-2024-088631
Abstrakt:	Introduction: Stroke and vascular cognitive impairment (VCI) are major global public health pandemics. The increased incidence of stroke and VCI is in part due to modifiable risk factors (MRFs), with hypertension (HTN) being the strongest single MRF. Even though the underlying causes of HTN are multifactorial, lifestyle choices (eg, poor diet, physical inactivity, alcohol consumption) are chief contributors. Lifestyle medicine (LSM) is a medical and evidence-based discipline that is a promising approach for preventing stroke and cognitive impairment, including VCI. The empirical evidence from systematic reviews, meta-analyses and large population-based studies has reported on the effectiveness of LSM interventions. However, the evaluation of such complex, social and behavioural interventions warrants more information to allow its successful implementation into innovative clinical care models. More importantly, we need to understand how such interventions work, who it works for and under what circumstances to successfully manage HTN and other MRFs (eg, hyperlipidaemia, smoking, alcohol use and diet). Methods and Analysis: This realist review will follow the Realist and Meta-narrative Evidence Synthesis: Evolving Standards. The review will comprise four stages: (1) clarify the scope, (2) search for the evidence, (3) critically appraise primary studies and extract data focusing on the context, mechanism and outcome configuration and (4) synthesise evidence and draw conclusions. Ethics and Dissemination: Research ethics board approval is not required for this review. The primary output of this review will be an evidence-based programme theory for LSM interventions for the management of HTN and other MRFs to reduce the risk of stroke and VCI. Findings from this review will be disseminated at three levels: micro (eg, patients, caregivers, clinicians, non-research partners), meso (eg, public, national not-for-profit organisations, professional associations and centres) and macro (eg, policymakers and government partners). Prospero Registration Number: CRD42024511566. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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