Nurse-led interventions for hypertension management in Sub-Saharan Africa: A scoping review

Sub-Saharan Africa exhibits the lowest global rates of hypertension detection, treatment, and control. Task shifting from traditionally physician-led care to other healthcare team members, mainly nurses, has been considered a viable solution to address the hypertension burden in this region.

This study aimed to map the available evidence on nurse-led hypertension management in Sub-Saharan Africa.

We followed the JBI guidelines for evidence synthesis in scoping reviews. A systematic database search was conducted across PubMed, Embase, Scopus, CINAHL Complete, Web of Science, Cochrane Library, ProQuest, African Journals Online, and Google Scholar from November 2, 2025 to December 1, 2025. Three reviewers independently conducted data screening, extraction, and charting. A narrative description of the findings is presented, while thematic analysis was used to synthesize and integrate the data.

We included a total of 26 articles, comprising 14 interventional, five observational, four qualitative, two mixed-methods studies, and one participatory group concept mapping. Intervention durations in interventional studies ranged from 2 weeks to 14 months. The key nursing care models in the region can be thematically grouped into expanded task-shifting with pharmacologic management, self-management-centered behavioral modification, and bundled multicomponent interventions. Researchers conducting the interventional studies reported significant within-group reductions in systolic and diastolic blood pressure of -8.3 to -22.0 mmHg and -4.7 to -12.4 mmHg, respectively. In two studies that combined mobile health modalities with clinical management of hypertension, researchers reported the largest mean differences in systolic blood pressure change, favoring the intervention groups. Additionally, positive intervention effects were observed in blood glucose levels, medication adherence, self-efficacy, and stress management in some studies. Facilitators identified for successful nurse-led interventions included support from patients, nurses, and other stakeholders. Conversely, challenges, such as nursing staff shortages, inadequate training, and resource limitations, were reported as barriers.

Nurse-led interventions in Sub-Saharan Africa demonstrated substantial improvements in blood pressure outcomes and showed promising effects on other physiological, behavioral, and patient-reported outcomes. Successful scale-up may possibly be accomplished by integrating mobile health technologies and overcoming systemic constraints through collaborative planning, investing in nurse training, human resources, equipment, and infrastructure.

The protocol was registered on Open Science Framework (DOI: 10.17605/OSF.IO/3JRV4) on October 30, 2025.