Integrative, multimodal nursing intervention for uncontrolled hypertension: randomized controlled trial effects on blood pressure, perceived stress, and medication adherence

İngilizce (OpenAlex)

Background: 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.Methods: 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.Results: Compared with controls, the intervention group achieved significantly greater reductions in systolic BP (mean difference = -21.8mmHg; 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/m 2 ; 95% CI, -1.1 to -0.3) and a shift from inactive to minimally active physical activity levels in 58% of participants.Conclusions: 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.