Integrative, multimodal nursing intervention for uncontrolled hypertension: randomized controlled trial effects on...

Uncontrolled hypertension is a major modifiable risk factor for cardiovascular diseases. This study evaluated the effectiveness of the Uncontrolled Hypertension Treatment Intervention in Nursing Model (UHTINuM), a nurse-led, integrative, multimodal intervention combining yoga, adherence education, and home blood pressure (BP) monitoring.

In this single-blind, randomized controlled trial, 48 adults aged 50-65 years with uncontrolled hypertension were randomized 1:1 to receive either the 12-week UHTINuM program or usual care. The intervention included structured group yoga sessions, individualized adherence education, and home BP self-monitoring with telefeedback. Primary outcomes were systolic and diastolic BP, perceived stress, and medication adherence. Secondary outcomes were body mass index (BMI) and physical activity level. Analyses were conducted using the intention-to-treat principle.

Compared with controls, the intervention group achieved significantly greater reductions in systolic BP (mean difference = -21.8 mmHg; 95% confidence interval [CI], -25.9 to -17.6) and diastolic BP (-11.4 mmHg; 95% CI, -14.9 to -7.9). Perceived stress decreased by -4.2 points (95% CI, -6.3 to -2.1), and adherence improved by -3.1 points (95% CI, -4.8 to -1.3). Secondary outcomes also favored the intervention group, with a modest reduction in BMI (-0.7 kg/m²; 95% CI, -1.1 to -0.3) and a shift from inactive to minimally active physical activity levels in 58% of participants.

The multimodal, nurse-led UHTINuM intervention integrating yoga, education and self-monitoring significantly improved BP control, reduced stress and enhanced medication adherence in middle-aged adults with uncontrolled hypertension. Implementing similar integrative strategies could bolster community hypertension management.

ClinicalTrials.gov Identifier: NCT04809519.