JMIR Publications

ABSTRACT

Background:

Hypertension remains a major contributor to cardiovascular morbidity and mortality worldwide, and long-term blood pressure control depends greatly on patients’ ability to engage in daily self-management. Interventions such as mobile health, web-based education, SMS reminders, telemonitoring, nurse-led support, and structured patient education are increasingly used to improve hypertension self-management. However, the evidence is diverse in terms of intervention type, setting, delivery mode, and outcomes measured.

Objective:

This scoping review aimed to map the range of interventions used to improve self-management among adults with hypertension and summarize the outcomes targeted by these interventions.

Methods:

A scoping review was conducted using evidence identified from PubMed, CINAHL, Cochrane Library, and Web of Science. Eligible studies included adults with hypertension and evaluated interventions designed to improve self-management or related outcomes, including medication adherence, blood pressure monitoring, lifestyle modification, self-efficacy, health literacy, quality of life, and blood pressure control. Data were charted according to author, year, country, study design, population, intervention, outcomes, and key findings. A descriptive numerical summary and thematic synthesis were used to map the evidence.

Results:

A total of 76 studies were included. Most studies were published between 2022 and 2025, indicating growing interest in hypertension self-management interventions. Randomized trials accounted for the largest proportion of included studies. Mobile app and SMS-based interventions were the most common intervention category, followed by education or self-management training, family/community support, digital monitoring or telehealth, web-based programs, and nurse- or clinician-led support. Blood pressure control was the most frequently assessed outcome, followed by self-management behaviors, medication adherence, self-efficacy, health literacy, knowledge, and quality of life. Many interventions improved systolic blood pressure, medication adherence, self-monitoring, and self-management behaviors, although some studies reported stronger behavioral than clinical effects. Thematic analysis showed that effective interventions commonly combined structured education, digital delivery, self-monitoring, feedback, reminders, and human support.

Conclusions:

The evidence shows that hypertension self-management interventions are expanding rapidly, particularly through digital and mobile health approaches. Interventions appear most promising when they combine education, monitoring, feedback, reminders, and professional or family support rather than relying on technology alone. More context-sensitive research is needed in low-resource settings, especially in Africa, to determine which intervention components are most feasible, scalable, and effective for improving blood pressure control and long-term self-management.