Eur J Cardiovasc Nurs. 2023 May 3:zvad040. doi: 10.1093/eurjcn/zvad040. Online ahead of print.
ABSTRACT
AIM: This review aimed to investigate the effectiveness of nurse-led interventions versus usual care on hypertension management, lifestyle behaviour, and patients’ knowledge of hypertension and associated risk factors.
METHODS: A systematic review with meta-analysis was conducted following Joanna Briggs Institute (JBI) guidelines. MEDLINE (Ovid), Emcare (Ovid), CINAHL (EBSCO), Cochrane library and ProQuest (Ovid) were searched from inception to 15th of February 2022. Randomised controlled trials (RCTs) examining the effect of nurse-led interventions on hypertension management were identified. Title and abstract, and full text screening, assessment of methodological quality, and data extraction were conducted by two independent reviewers using JBI tools. A statistical meta-analysis was conducted using STATA version 17.0.
RESULTS: A total of 37 RCTs and 9,731 participants were included. The overall pooled data demonstrated that nurse-led interventions may reduce systolic blood pressure (Mean difference -4.66; 95% CI -6.69, -2.64; I2= 83.32; 31 RCTs; low certainty evidence) and diastolic blood pressure (Mean difference -1.91; 95% CI -3.06, -0.76; I2 = 79.35; 29 RCTs; low certainty evidence) compared to usual care. The duration of interventions contributed to the magnitude of blood pressure reduction. Nurse-led interventions had a positive impact on lifestyle behaviour and effectively modified diet and physical activity, but the effect on smoking and alcohol consumption was inconsistent.
CONCLUSION: This review revealed beneficial effects of nurse-led interventions in hypertension management compared to usual care. Integration of nurse-led interventions in routine hypertension treatment and prevention services could play an important role in alleviating the rising global burden of hypertension.
DATA REGISTRATION: CRD42021274900.
PMID:37130339 | DOI:10.1093/eurjcn/zvad040
