3 strategies to gear up to get blood pressure down

Over the past 15 years, the global community has been working towards
the collective goal of decreasing the prevalence of high blood pressure
by 33%. With the 2030 deadline for achieving this target fast
approaching, let’s discuss a few potentially helpful strategies for
people living with or at high risk of high blood pressure (1).

1. Nurse-led clinics

Lifestyle
changes are an important tool in the fight against high blood
pressure, but they should be made with help and guidance from a
healthcare professional. While we often hear about doctor-led care,
researchers have also shown interest in nurse-led care for people living
with high blood pressure. This type of comprehensive care involves
management, counselling, and education, and is generally coordinated by one or more nurses (2-6). Research shows that compared to usual
care, nurse-led care may decrease high blood pressure for up to six
months and potentially enhance some aspects of diet and exercise. More
high-quality research is needed to further support these
results and shed light on long term impacts (2).

2. Forest therapy

Some
evidence links city living with an increased risk of developing high
blood pressure, as well as negative mental health impacts (7-11).
Seeking solace in natural environments like forests within urban
settings is not uncommon. Forest therapy, which involves immersing
yourself and your senses in nature by walking or sitting in a forest, is
one way of doing this (7;12-14). Research shows that forest therapy may
reduce blood pressure for people living in urban areas, especially for those with already elevated blood pressure. Additionally, limited
evidence demonstrates a potential positive effect on stress. More
high-quality research is needed to solidify these findings and help us
better understand what optimal forest therapy programs look like (7).

3. Lower blood pressure targets

Medication
is often used to reach a specific blood pressure target.
Recommendations on the best target vary. Some are more relaxed, meaning
they aim for higher blood pressure targets (e.g., systolic
blood pressure less than 150 to 160 mmHg), while others are more
aggressive and aim for lower blood pressure targets (e.g., systolic
blood pressure less than 140 mmHg). Research shows that lower targets
are more beneficial than their higher counterparts at reducing the risk
of stroke in older adults with high blood pressure. More research is
needed on the risk of minor and serious side effects from medications
used to reach blood pressure goals (15).

Goal, set, match?
As we work towards lowering high blood pressure in the hopes of meeting
our own health goals alongside those of the global community, we can tap
into a variety of strategies that support us along the way. Reaching
out to a healthcare provider to discuss safe and accessible options for
your treatment plan is always a good first step.

References

1. World Health Organization. Hypertension. [Internet] 2023. [cited April 2025]. Available from https://www.who.int/news-room/fact-sheets/detail/hypertension.
2. Bulto LN, Roseleur J, Noonan S, et al. Effectiveness of nurse-led interventions versus usual care to manage hypertension and lifestyle behaviour: A systematic review and meta-analysis. Eur J Cardiovasc Nurs. 2023; 0:zvad040. doi: 10.1093/eurjcn/zvad040.
3. Alzhanova A, Schultz T, Hendriks J, et al. Effectiveness of nurse-led clinics for patients with coronary heart disease. PROSPERO.
4. Carrington MJ, Zimmet P. Nurse health and lifestyle modification versus standard care in 40 to 70 year old regional adults: study protocol of the management to optimise diabetes and metabolic syndrome risk reduction via nurse-led intervention (modern) randomized controlled trial. BMC Health Serv Res. 2017; 17:813.
5. Karataş T, Polat Ü. Effect of nurse-led program on the exercise behavior of coronary artery patients: Pender’s health promotion model. Patient Educ Couns. 2021; 104:1183-1192.
6. Aronow WS, Ahmed MI, Ekundayo OJ, et al. A propensity-matched study of the association of peripheral arterial disease with cardiovascular outcomes in community-dwelling older adults. Am J Cardiol. 2009; 103:130-135. doi: 10.1016/j.amjcard.2008.08.037.
7. Qiu Q, Yang L, He M, et al. The effects of forest therapy on the blood pressure and salivary cortisol levels of urban residents: A meta-analysis. Int J Environ Res Public Health. 2022; 20(1):458. doi: 10.3390/ijerph20010458.
8. Steyn K, Bradshaw D, Norman R, et al. Determinants and treatment of hypertension in South Africans: The first demographic and health survey. South Afr Med J. 2008; 98:376-380.
9. Sobngwi E. Exposure over the life course to an urban environment and its relation with obesity, diabetes, and hypertension in rural and urban Cameroon. Int J Epidemiol. 2004; 33: 769-776.
10. Huang B, Xiao T, Grekousis G, et al. Greenness-air pollution-physical activity-hypertension association among middle-aged and older adults: Evidence from urban and rural China. Environ Res. 2021; 195:110836.
11. Singh R, Suh I, Singh V, et al. Hypertension and stroke in Asia: Prevalence, control and strategies in developing countries for prevention. J Hum Hypertens. 2000; 14:749-763.
12. Shosha M. Forest bathing therapy: The healing power of nature. Int J Psychiatry Res. 2021; 4: 1-2.
13. Li Q, Morimoto K, Nakadai A, et al. Forest bathing enhances human natural killer activity and expression of anti-cancer proteins. Int J Immunopathol Pharmacol. 2007; 20:3-8.
14. Antonelli M, Donelli D, Carlone L, et al. Effects of Forest bathing (Shinrin-yoku) on individual well-being: An umbrella review. Int J Environ Health Res. 2021; 32:1842-1867.
15. Falk JM, Froentjes L, Kirkwood JEM, et al. Higher blood pressure targets for hypertension in older adults. Cochrane Database Syst Rev. 2024; 12: CD011575. doi: 10.1002/14651858.CD011575.pub3.

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