Managing high blood pressure: Can nurse-led care help?

The Bottom Line

  • Hypertension, also known as high blood pressure, is common and needs to be properly treated to avoid serious health risks.
  • Nurse-led care models, where your care is coordinated mostly by a nurse or nursing team, may be an effective care choice to help you reduce your blood pressure in the short-term.
  • Your local health authority and family doctor’s office can help you learn more about nurse-led care and where to access it. 

Hypertension, also known as high blood pressure, impacts nearly one in four Canadians (1). High blood pressure happens when your blood vessels have too much pressure (140/90 mmHg or more) (2-4). You may not feel any symptoms if you have high blood pressure, and the only way to know if you have it is to get your blood pressure checked by a health professional (4;5).

If left untreated, high blood pressure can lead to serious health issues such as heart attack, stroke, heart failure, irregular heartbeat, and more (4; 6-7). Luckily, making lifestyle changes can reduce blood pressure and the risks that it can bring. Lifestyle changes include eating healthy, being physically active, maintaining a healthy weight, taking medications as prescribed, and visiting your healthcare professional as needed (2;4).

Knowing what lifestyle changes to make and how to make them is important. Often, this requires working with healthcare professionals to come up with a plan. Nurse-led care is an option for this. Nurse-led care models typically involve your care being coordinated mostly by a nurse or nursing team—including nurse practitioners, registered nurses, and advanced practice nurses. Nurses will work together with you, your caregivers, and other healthcare professionals to develop a care plan. This type of care often goes beyond just medical management to include health counselling and education for patients (2;8-11).

You may be wondering how nurse-led care compares to usual hypertension care, such as clinic-based care management, home blood pressure monitoring, or doctor-led care, which focuses on medical treatments. A recent systematic review addresses this by comparing the two for hypertension management in people with high blood pressure. Other areas of interest include changes to lifestyle behaviours and patient knowledge (3).

So, how does nurse-led care compare?

What the research tells us

Among studies within the review, most of the nurse-led care was delivered face-to-face and included education and counselling about high blood pressure.

The review found some positive effects. For example, nurse-led care may be more effective than usual care at reducing both diastolic and systolic blood pressure for up to six months. These effects, however, are not maintained at 12 months. The findings are based on low to moderate certainty evidence, meaning they may change as more evidence emerges.

When it comes to lifestyle behaviour modification and knowledge, there is some limited evidence that nurse-led care may improve certain aspects of diet, as well as physical activity, while it is unclear what impact it has on smoking, alcohol intake, and knowledge of the disease or risk factors (2).

While more high-quality research would be helpful, these results show that accessing nurse-led care may benefit you if you have high blood pressure. If you are interested, you can check with your local health authority to learn more about nurse-led care and how to access it in your community. Your family doctor’s office may also have nurse practitioners or other types of nurses on staff that you can access.

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  1. Heart & Stroke. Health professionals concerned about blood pressure in Canada. [Internet] 2022. [cited July 2023]. Available from
  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. Williams B, Mancia G, Spiering W, et al. ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39:3021-3104.
  4. World Health Organization. Hypertension. [Internet] 2023. [cited July 2023]. Available from
  5. Fleming S, Atherton H, McCartney D, et al. Self-screening and non-physician screening for hypertension in communities: A systematic review. Am J Hypertens. 2015; 28:1316-1324. doi: 10.1093/ajh/hpv029.
  6. Musini VM, Tejani AM, Bassett K, et al. Pharmacotherapy for hypertension in adults 60 years or older. Cochrane Database Syst Rev. 2019; 6:CD000028. doi: 10.1002/14651858.CD000028.pub3.
  7. Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics—2011 update: A report from the American Heart Association. Circulation. 2011; 123:e18-e209. doi: 10.1161/CIR.0b013e3182009701.
  8. Alzhanova A, Schultz T, Hendriks J, et al. Effectiveness of nurse-led clinics for patients with coronary heart disease. PROSPERO.
  9. 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.
  10. Karatas̀§ 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.
  11. 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.

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