Theory-based self-management to improve blood pressure control in stroke survivors: a systematic review and...

Blood pressure (BP) control is essential in post-stroke management; however, comprehensive evidence on the benefits of self-management interventions in this population remains limited.

To determine the effectiveness of self-management interventions on BP control in stroke survivors using a meta-analysis approach.

We searched PubMed, EMBASE, CINAHL, CENTRAL, and ProQuest Dissertation & Theses Global from their inception to January 2025. Randomized controlled trials investigating the effects of self-management on BP in post-stroke patients were included. We used the Cochrane Risk of Bias version 2 (RoB 2) to evaluate the quality of RCTs. The effect estimates for systolic BP (SBP) and diastolic BP (DBP) were calculated using mean differences (MDs) with their 95 % confidence interval (95 %CI) under a random-effects model.

Out of 2,708 records identified, 18 trials (5,435 participants) were included. All studies showed some concerns about the risk of bias. A greater reduction in both SBP and DBP was observed in the self-management group compared to control groups (MD -4.87; 95 %CI:6.82 to -2.92; I²=81 % and MD -1.34; 95 %CI:2.56 to -0.13; I²=65 %, respectively). The reduction in SBP appeared greater in trials lasting ≤ 6 months (MD -7.99; 95 %CI:12.41 to -3.58; I²= 64 %) compared with those over 6 months (MD -3.93; 95 %CI:6.99 to -0.87; I²=87 %).

Self-management interventions were effective in BP control for stroke survivors. However, the effectiveness of the intervention faded over time. Future investigations are crucial to solidify the role of self-management in secondary stroke prevention.