Non-Pharmacological Interventions for Hypertension Management: A Systematic Review

Objective: To systematically review the current global evidence on the efficacy, safety, and implementation of non-pharmacological interventions (NPIs) for managing hypertension, including lifestyle modifications, dietary changes, physical activity, stress reduction, and behavioral therapies. Methods: A comprehensive search was conducted across prospective clinical trials, observational studies, and meta-analyses published up to 2025. Studies evaluating NPIs in adults with hypertension or prehypertension were included. Data on blood pressure reduction, cardiovascular risk, quality of life, feasibility, and cultural adaptability were extracted and analyzed. Results: NPIs such as dietary interventions (including the DASH diet), increased physical activity, weight management, stress reduction techniques, and behavioral therapies demonstrate significant efficacy in lowering blood pressure and reducing cardiovascular risk. These interventions also improve patient adherence and quality of life, with fewer side effects compared to pharmacological treatments. The feasibility and sustainability of NPIs vary based on cultural context and resource availability. Integration of digital health tools enhances NPI delivery and patient engagement. Conclusion: Non-pharmacological interventions are essential complementary or alternative strategies for hypertension management worldwide. Tailoring these interventions to individual and cultural needs, supported by emerging technologies, can optimize blood pressure control and reduce cardiovascular morbidity. Further research is needed to enhance long-term adherence, evaluate combined interventions, and integrate NPIs into routine clinical practice.