Key result
Cultural beliefs and dietary traditions strongly shape hypertension self-care behaviors in Southeast Asia.
Why the study?
Cultural factors influence hypertension perception and management in Southeast Asia, but regional synthesis of evidence is limited, hindering culturally appropriate interventions.
Systematic Review (n=2,252)
Cultural beliefs and communal traditions heavily influence hypertension self-care in Southeast Asia, underscoring the need for culturally responsive communication and family engagement to support adherence.
May inform culturally adapted hypertension counseling in Southeast Asia; leaves open efficacy of tailored interventions in trials.
Hypertension is a significant public health burden, and cultural factors influence the perception and management of hypertension in Southeast Asia. However, regional synthesis of evidence remains limited, hindering the development of culturally appropriate and scalable interventions. This study examined how cultural beliefs and practices influence hypertension self-care behaviors among adults with hypertension in selected Southeast Asia countries. Five electronic databases (PubMed, Scopus, Web of Science, ProQuest, and SAGE Journals) were searched in 2025 for studies published from 1 January 2015 to 31 March 2025. Eligible studies included adults (≥18 years) with hypertension in Southeast Asia settings and reported cultural influences on self-care. Two reviewers conducted a narrative synthesis with thematic coding (third-party adjudication for disagreements), and methodological quality was assessed using the critical evaluation tools from the Joanna Briggs Institute. Twelve studies involving 2,252 participants were included, and the protocol was registered in PROSPERO (CRD420250656487). Five themes emerged: illness perceptions, traditional and spiritual self-care practices, dietary traditions, sociocultural barriers to engagement with biomedical care, and community-based approaches. Examples included preferences for natural or spiritual practices in Malaysia, herbal and spiritual rituals that delay biomedical engagement in Indonesia, and the illness metaphor malapot na dugo (“thick blood”) that shapes treatment decisions in the Philippines. Communal dietary practices and collective decision-making also influenced the negotiation of self-care within families and communities. Hypertension self-care in Southeast Asia is embedded in collectivist and culturally specific contexts. For community nursing practice, culturally responsive assessment, communication, and family–community engagement are essential to support adherence and integrate cultural practices with evidence-based care. Policy should support culturally safe care; further research in underrepresented settings is needed.
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Dewi et al. (2026) conducted a systematic review in Hypertension (n=2,252). Cultural beliefs, values, and practices was evaluated on Cultural influences on hypertension self-care behaviors (themes including illness perceptions, traditional practices, and dietary traditions). Cultural influences, including non-chronic illness perceptions, reliance on traditional practices, and communal dietary traditions, profoundly shape hypertension self-care behaviors in Southeast Asia.
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