Effects of an Integrated Knowledge, Exercise, and Blood Pressure Self-Monitoring Program on Older Adults With Hypertension: A Quasi-Experimental Study

Vollständiger Abstract

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Background: Hypertension management among older adults requires not only pharmacological treatment but also adequate knowledge, regular physical activity, and blood-pressure self-monitoring. However, the short-term effectiveness of integrated self-management interventions on knowledge and blood-pressure outcomes remains uncertain. Objective: This study aimed to evaluate the effects of an integrated hypertension education, structured exercise, and blood-pressure self-monitoring program on hypertension knowledge and blood pressure among older adults. Methods: A quasi-experimental pretest–posttest control-group study was conducted among 90 older adults with hypertension, comprising 45 participants in the intervention group and 45 in the control group. The intervention group received an integrated hypertension self-management program, whereas the control group received usual care. Outcomes included systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension knowledge. Change scores were compared using independent-samples t-tests, and post-test outcomes were analyzed using analysis of covariance after adjustment for baseline values. Effect sizes were reported as Cohen’s d and partial eta squared. Results: The change in SBP did not differ significantly between the intervention and control groups (−2.31 ± 2.95 vs. −2.76 ± 2.75 mmHg; p = 0.461; Cohen’s d = 0.156). DBP change differed significantly between groups (−1.31 ± 2.24 vs. −3.24 ± 2.98 mmHg; p < 0.001; Cohen’s d = 0.733), although the greater reduction occurred in the control group. Knowledge improvement was substantially greater in the intervention group than in the control group (38.22 ± 9.72 vs. 1.73 ± 3.77; p < 0.001; Cohen’s d = 4.949). After baseline adjustment, no significant group effect was found for post-test SBP (F[1,87] = 0.377; p = 0.541; partial η² = 0.004). Significant group effects were observed for DBP (F[1,87] = 9.422; p= 0.003; partial η² = 0.098) and knowledge (F[1,87] = 703.356; p < 0.001; partial η² = 0.890). Conclusion: The integrated intervention produced a substantial improvement in hypertension knowledge but did not improve systolic blood pressure compared with usual care. The significant DBP difference favored the control group. Longer and more intensive interventions may be required to translate improved knowledge into sustained blood-pressure control.