3 strategies to gear up to get blood pressure down

The Bottom Line

  • Significantly decreasing the prevalence of high blood pressure by 2030 is a collective goal for the global community.
  • Nurse-led clinics, forest therapy, and lower blood pressure targets may help people living with or at risk of high blood pressure enhance their blood pressure and other aspects of their health.
  • Consult your healthcare team about safe and accessible strategies for your tailored prevention or treatment plan. 

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). Click on the links below to learn more.


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. 


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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. 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.
  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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