Wahidin | Comparative Analysis Of The Effectiveness Of Relaxation Techniques And Physical Exercise On Controlled Blood Pressure: A Meta-Analysis.
Journal of Educational Nursing (JEN) Vol.
9 No.
1 January Ae June .
page 124-138 p-ISSN: 2655-2418.
e-ISSN: 2655-7630 journal homepage: https://ejournal.
DOI: https://doi.
org/10.
37430/jen.
Article history:
Received: January 13th 2026 Revised: January 19th 2026 Accepted: January 20th 2026 Comparative Analysis Of The Effectiveness Of Relaxation Techniques And Physical Exercise On Controlled Blood Pressure: A Meta-Analysis Wahidin1.
Dina Raidanti2.
Christin Jayanti3.
Didin Syaefudin4.
Rina Wijayanti5 Fikes Muhammadiyah University of Tangerang1.
STIKES RSPAD Gatot Soebroto Jakarta2345 E-mail: didinwahidin1977@students.
Abstract Background: Hypertension is a major global public health problem, with prevalence increasing particularly among adults and older adults.
Non-pharmacological interventions such as relaxation techniques .
, breathing exercises, massage-based relaxation, progressive muscle relaxation, mindfulness, and guided imager.
and physical exercise .
, aerobic exercise, isometric handgrip exercise, yoga, tai chi, and multicomponent trainin.
are widely recommended for blood pressure However, comparative evidence regarding their relative effectiveness remains limited.
Objective: This study aimed to compare the efficacy of relaxation techniques and physical exercise in reducing blood pressure using a meta-analytic approach.
Methods: This meta-analysis was conducted in accordance with PRISMA 2020 guidelines.
Randomized controlled trials and quasiexperimental studies evaluating relaxation techniques or physical exercise interventions on blood pressure outcomes were included.
Statistical analyses were performed using a random-effects model with standardized mean differences (SMD.
as effect sizes.
Subgroup analyses by age group and intervention type were conducted, and heterogeneity was assessed using the IA statistic.
Results: A total of 33 studies were included.
Overall, non-pharmacological interventions significantly reduced blood pressure (SMD = Oe0.
p < 0.
Subgroup analysis showed that relaxation techniques produced a greater reduction in blood pressure (SMD = Oe0.
than physical exercise (SMD = Oe0.
The most significant effect was observed among older adults (SMD = Oe1.
Substantial heterogeneity was identified across studies (IA = 74.
1%), likely reflecting variations in intervention type, intensity, duration, and population characteristics.
Conclusion: Both relaxation techniques and physical exercise are effective non-pharmacological interventions for reducing blood pressure.
Relaxation techniques demonstrate greater and more consistent effects, particularly among older adults, supporting their prioritization in age-appropriate hypertension management strategies.
Keywords: Hypertension.
Older adults.
Relaxation techniques.
Physical exercise.
Meta-analysis INTRODUCTION Hypertension is one of the most prevalent non-communicable diseases worldwide and a leading risk factor for cardiovascular disease, stroke, and renal failure .
Ae.
The World Health Organization estimates that more than one billion people globally live with hypertension, and prevalence increases markedly with age .
In both developing and developed countries, hypertension among older adults poses a significant challenge because of its association with functional decline, multimorbidity, and increased healthcare costs .
Hypertension management has comprehensive approaches that combine pharmacologic and nonpharmacologic Nonpharmacologic interventions are strongly recommended Journal Educational of Nursing (JEN) Vol.
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Wahidin | Comparative Analysis Of The Effectiveness Of Relaxation Techniques And Physical Exercise On Controlled Blood Pressure: A Meta-Analysis.
as first-line or complementary therapy because they are generally safe, costeffective, and sustainable .
Among techniquesAisuch as slow-stroke back massage, deep breathing, progressive muscle relaxation, mindfulness, and guided imageryAiand physical exerciseAi including aerobic exercise, isometric handgrip exercise, yoga, tai chi, and multicomponent trainingAihave been widely studied and implemented .
Ae.
From a physiological perspective, relaxation techniques primarily influence blood pressure regulation by modulating the autonomic nervous system, reducing sympathetic activity, and enhancing parasympathetic dominance .
Physical exercise, by contrast, lowers blood pressure through structural and functional cardiovascular adaptations, including improved endothelial function, reduced peripheral resistance, and enhanced arterial compliance .
, .
Despite strong theoretical support, empirical heterogeneous .
Despite strong theoretical and empirical support for both relaxation techniques and physical exercise as nonRESEARCH METHODOLOGY Literature Search Strategy This study used a meta-analytic Design, following the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) 2020 guidelines .
, .
A comprehensive literature search was conducted to identify relevant studies published up to December 2025.
Electronic databases, including PubMed.
Scopus.
Web of Science.
CINAHL, and Google Scholar, were systematically searched to ensure broad coverage of both international and regional publications.
The search strategy combined Medical Subject Headings (MeSH) and free-text terms related to hypertension and nonpharmacological interventions, including Auhypertension,Ay Aublood pressure,Ay pharmacological strategies for blood pressure control, the existing evidence remains inconsistent and fragmented.
Most previous studies and meta-analyses have evaluated these interventions separately, making it difficult to draw direct comparisons regarding their relative In addition, variations in intervention type, study design, population characteristics, and age group have contributed to heterogeneous findings across the literature.
Notably, comparative evidence evaluating relaxation techniques and physical exercise simultaneously within a single meta-analytic framework, particularly with attention to age-related differences, remains limited.
Therefore, the present study aimed to conduct a comparative meta-analysis to evaluate the effectiveness of relaxation techniques and physical exercise in controlling blood pressure.
This study also sought to examine whether the magnitude of intervention effects differs across age groups, thereby providing more targeted evidence to inform age-appropriate, nonpharmacological management strategies in nursing and community health practice.
Aurelaxation techniques,Ay Audeep breathing,Ay Aumassage,Ay Aumindfulness,Ay Auguided imagery,Ay Auphysical exercise,Ay Auaerobic exercise,Ay Auyoga,Ay Autai chi,Ay and Auisometric exercise.
Ay Boolean operators (AND/OR) were applied to refine the search.
Reference lists of included articles were also manually screened to identify additional eligible Study Selection and Data Extraction After removal of duplicates, titles and abstracts were independently screened by two reviewers to assess eligibility based on the predefined inclusion and exclusion Full-text Journal Educational of Nursing (JEN) Vol.
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Wahidin | Comparative Analysis Of The Effectiveness Of Relaxation Techniques And Physical Exercise On Controlled Blood Pressure: A Meta-Analysis.
subsequently reviewed to confirm Discrepancies discussion and consensus.
Data extracted included author, year of publication, country, study design, sample size, participant characteristics, intervention type, comparison group, outcome measures, and intervention duration.
Eligible randomized controlled trials (RCT.
and quasi-experimental studies that examined the effects of relaxation techniques or physical exercise on blood pressure The inclusion criteria were: .
participants with elevated blood pressure or diagnosed hypertension.
nonpharmacological interventions categorized as relaxation techniques or physical .
reported systolic and/or diastolic blood pressure outcomes.
sufficient quantitative data for effect size Studies exclusively on pharmacological therapy or lacked a control group were excluded.
Data extracted from each study included author, year, country, study Design, characteristics, intervention type, control group, and study weight.
A random-effects model was used to account for betweenstudy variability, and the analysis was conducted in Open MEE.
Effect sizes were differences (SMD.
with 95% confidence Heterogeneity was assessed using CochranAos Q test and the IA statistic.
Subgroup analyses were conducted by age group and intervention type.
Risk-of-Bias Assessment The methodological quality and risk of bias of the included studies were assessed independently by two reviewers.
Randomized controlled trials were evaluated using the Cochrane Risk of Bias tool, while quasi-experimental studies were assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist.
The domains assessed included selection bias, performance bias, detection bias, attrition bias, and reporting bias.
Studies were categorized as having low, moderate, or high risk of bias.
Any disagreements in assessment were resolved through consensus.
The overall risk-of-bias assessment was considered in the interpretation of the pooled results and subgroup analyses.
RESULTS AND DISCUSSION
RESULTS
1 Characteristics of the Analyzed Study A total of 33 studies were included in this meta-analysis.
The characteristics of the included studies are presented in Table 1A and Table 1 B.
Table 1A.
Characteristics of the Relaxation Method Study Author (Yea.
Tricahyo .
Wulan .
Gusti Ayu .
Octalina .
Hafid .
Hafid .
Intervention Slow Stroke
Back Massage Slow Stroke
Back Massage Slow Stroke
Back Massage Acupressure Murottal AlQurAoan Progressive Muscle Relaxation Guided Imagery Populasi
Country Control Type
Weight
(%)
Adult
Indonesia
3,692
Elderly Indonesia
Usual care
1,065
Adult
Indonesia
Usual care
3,204
Elderly Indonesia
Usual care
4,424
Elderly Indonesia
Placebo
2,536
Elderly Indonesia
Usual care
2,201
Journal Educational of Nursing (JEN) Vol.
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Wahidin | Comparative Analysis Of The Effectiveness Of Relaxation Techniques And Physical Exercise On Controlled Blood Pressure: A Meta-Analysis.
Zulkarnain .
Amaliah .
Eguchi .
Babak .
Yoon .
Ellya .
Slow Deep Breathing Natural Deep Breathing Structured Deep Breathing Aromatherapy Aroma Foot Massage MindfulnessBased Stress Reduction Mindfulness & Qigong Music Therapy Iko .
Guided Imagery Untari .
Mir .
Yeh .
Yeh .
Autogenic Training Mindfulness Meditation Elderly Taiwan Usual care
2,043
Elderly Taiwan Usual care
2,058
Elderly Indonesia
Adult
Indonesia
Usual care
Adult
Japan
Usual care
3,720
Adult
Iran
Usual care
3,337
Adult
Korea
Usual care
3,171
Elderly Indonesia
3,670
Elderly Indonesia
Usual care
Elderly Indonesia
Usual care
1,852
Adult
Malaysia
Usual care
4,820
2,522
3,720
2,453
Source: Scunder Data 2026 Table 1 B.
Characteristics of Physical Exercise Studies Control
Type
Weight
(%)
Brazil
Usual care
3,862
India
Usual care
3,041
India
Usual care
2,940
India
Usual care
2,747
India
Usual care
3,152
Adult
Indonesia
Usual care
2,167
Elderly Thailand
2,788
Elderly Multicountry Usual care
3,252
Young
India
2,155
Tai Chi Adult China Li .
Aerobic Exercise Adult China Cohen .
Yoga Therapy Adult America Zhang .
Tai Chi Training Adult China Loh .
Progressive Muscle Relaxation* Adult Taiwan Author (Yea.
Intervention Rodrigues .
Saptarisi .
Saptarisi .
Physical Exercise Saptarisi .
Salt Reduction Saptarisi .
Yoga Riyanto .
Isometric Handgrip Exercise Sarinukul .
Stepping Exercise Lovez .
Cohen .
Li .
Sodium Restriction Education Community-based Intervention Multicomponent Training Yoga (Cardiac Autonomic Functio.
Populasi
Country Adult
Young
Young
Young
Young
Usual care
Usual care
4,532
4,514
4,189
3,655
3,267
Source: Scunder Data 2026 The characteristics of the study in Table 1A indicate that relaxation methods are more widely used among older adults than among other age groups.
This pattern suggests that relaxation methods are considered more clinically appropriate for older adults, who generally have limited physical activity and a higher risk of side The diversity of relaxation Journal Educational of Nursing (JEN) Vol.
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Wahidin | Comparative Analysis Of The Effectiveness Of Relaxation Techniques And Physical Exercise On Controlled Blood Pressure: A Meta-Analysis.
interventionsAifrom touch and breathing mindfulness-based approachesAi demonstrates the flexibility of applying these methods across a variety of nursing and community health service contexts.
The consistency in the use of a control group in the form of usual care or no intervention also strengthens the relevance of relaxation methods as an additional intervention that is realistic and easily integrated into clinical practice.
In contrast, the study characteristics in Table 1B indicate that physical exercise is used across a broader age range, from young adults to older adults.
The variety of physical exercises used reflects a range of approaches to improving cardiovascular function, but it can also lead to variation in responses between individuals.
The dependence of physical exercise on participantsAo intensity, duration, and functional capacity may explain the heterogeneity of effects observed in the Nonetheless, these findings confirm that physical exercise remains an essential part of blood pressure management, especially as a supportive intervention tailored to the individualAos physical abilities and clinical condition.
The overall pooled analysis showed that non-pharmacological significantly reduced blood pressure.
total of 33 studies met the inclusion criteria and were included in the metaanalysis.
The overall pooled analysis demonstrated that non-pharmacological interventions significantly reduced blood pressure compared with control conditions (SMD = Oe0.
95% CI: Oe0.
894 to Oe0.
p < 0.
, with substantial heterogeneity across studies (IA = 74.
12%).
The overall forest plot is presented in Figure 1.
2 Overall Effectiveness of NonPharmacological Interventions Figure 1.
Forest Plot Effectiveness of Non-Pharmacological Interventions on Blood Pressure Lowering Figure 1 shows that the overall nonpharmacological intervention resulted in a statistically significant reduction in blood pressure compared with the control group.
Most studies reported effect measures that lowered blood pressure, indicating a consistent and beneficial direction of the Combined effect measures from randomized-effects models showed that the interventionAos benefits remained significant despite variation in study Journal Educational of Nursing (JEN) Vol.
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Wahidin | Comparative Analysis Of The Effectiveness Of Relaxation Techniques And Physical Exercise On Controlled Blood Pressure: A Meta-Analysis.
characteristics, intervention types, and The width of the confidence interval varied between studies, reflecting differences in sample size and study Design, but the direction of the main effect did not change.
These findings indicate that non-pharmacological interventions are clinically effective and can be incorporated into comprehensive blood pressure management.
3 Subgroup Analysis by Age Subgroup analysis by age showed that older adults experienced the most significant reduction.
Subgroup analysis by age revealed that the greatest reduction in blood pressure was observed among older adults (SMD = Oe1.
, followed by adults (SMD = Oe0.
and young adults (SMD = Oe0.
These findings indicate nonpharmacological interventions increases with age.
The age-based subgroup analysis is illustrated in Figure 2.
Figure 2.
Forest Plot Subgroup Analysis by Age Group Figure 2 shows differences in the non-pharmacological interventions on blood pressure reduction across age groups.
The elderly group showed the most significant decrease in blood pressure, followed by the adult group, while the younger adult group showed a negligible effect.
These differences suggest that responses to nonpharmacological interventions tend to be more favorable among older people.
4 Subgroup Analysis by Intervention Type When analyzed by intervention type, relaxation techniques were more effective.
Relaxation techniques produced a greater reduction in blood pressure (SMD = Oe0.
than physical exercise (SMD = Oe0.
, and both effects were statistically significant .
< 0.
The comparative effectiveness of intervention types is shown in Figure 3.
Journal Educational of Nursing (JEN) Vol.
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Wahidin | Comparative Analysis Of The Effectiveness Of Relaxation Techniques And Physical Exercise On Controlled Blood Pressure: A Meta-Analysis.
Figure 3.
Forest Plot Subgroup Analysis by Intervention Type Figure 3 shows that both relaxation methods and physical exercise are effective in lowering blood pressure.
Pressure, but with different magnitudes of The relaxation method showed a larger and more consistent effect size than Clinically, relaxation method offers an advantage because it engages the autonomic nervous systemAos regulatory mechanisms, allowing it to lower blood pressure more reliably and more quickly.
Physical exercise still provides significant benefits, primarily through cardiovascular adaptation, but its effectiveness is more influenced by exercise intensity, duration, and the individualAos physical ability.
Therefore, relaxation methods can be the primary intervention for patients with limited physical activity.
In contrast, physical exercise can be used as a supportive approach, depending on the patientAos clinical condition.
5 Publication Bias Assessment Publication bias was assessed using a funnel plot.
The funnel plot showed a relatively symmetrical distribution of studies around the pooled effect size, suggesting that publication bias was unlikely to influence the results substantially (Figure .
Figure 4.
Publication Bias Assessment Funnel plot On Included Studies Journal Educational of Nursing (JEN) Vol.
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Wahidin | Comparative Analysis Of The Effectiveness Of Relaxation Techniques And Physical Exercise On Controlled Blood Pressure: A Meta-Analysis.
Figure 4 shows the funnel plot used to assess potential publication bias among the studies included in this meta-analysis.
In general, the distribution of study points on the funnel plot appears relatively symmetrical around the combined effect size, especially at the top of the graph, where studies with large sample sizes and high precision are represented.
At the bottom of the funnel plot, points are more widely dispersed, a common feature of studies with small sample sizes and lower precision.
This pattern reflects reasonable variation in effect and does not automatically indicate publication bias.
No patterns of extreme asymmetry or systematic emptiness were found on either side of the funnel plot, indicating the dominance of significant outcomes or the omission of studies with little or no significant effect.
Based on visual inspection of the funnel plot, the risk of publication bias in this metaanalysis was rated as low to moderate.
was not expected to materially affect the studyAos main conclusions.
These findings support the stability and reliability of the meta-analysis results.
DISCUSSION
The findings in Figure 1 showed that the non-pharmacological intervention significantly lowered blood pressure compared with the control group (SMD = Oe0.
95% CI: Oe0.
894 to Oe0.
Most studies reported effects that lowered blood pressure, indicating the consistency of the beneficial effect.
The observed in this meta-analysis reflects the inherent diversity of non-pharmacological interventions and study populations.
Variations in intervention modalities .
breathing-based relaxation, massage, mindfulness, aerobic exercise, and mindAe body exercis.
, intervention intensity and duration, as well as differences in study design and baseline blood pressure levels, are likely major contributors to this Furthermore, age-related physiological differences, particularly autonomic nervous system function and vascular elasticity, may influence individual responsiveness to specific interventions, especially among older To address this variability, a random-effects model was applied, and subgroup analyses by age group and intervention type were conducted.
These analyses partially explained the observed heterogeneity by demonstrating more consistent and larger effect sizes for relaxation techniques and among older Rather than undermining the validity of the findings, the heterogeneity highlights the importance of tailoring nonpharmacological individual and population characteristics in clinical practice.
Although effect sizes and confidence interval widths varied across studies, the uniform direction of effect reinforced the The predominance of non-pharmacological interventions provides a meaningful clinical benefit in lowering blood pressure.
The consistency of the direction of effects in most studies suggests that this approach is reliable as part of hypertension management strategies, despite variations in study Design and population The age subgroup analysis in Figure 2 showed a clear difference in effect size.
The elderly group had the most significant reduction in blood pressure (SMD = Oe1.
, followed by adults (SMD = Oe0.
and young adults (SMD = Oe0.
This pattern indicates that the elderly benefit most from nonpharmacological interventions.
Clinically, this can be explained by age-related physiological changes, such as increased sympathetic activity and decreased vascular elasticity.
These changes make older adults more responsive to interventions that focus on stress Journal Educational of Nursing (JEN) Vol.
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Wahidin | Comparative Analysis Of The Effectiveness Of Relaxation Techniques And Physical Exercise On Controlled Blood Pressure: A Meta-Analysis.
regulation and cardiovascular balance.
These gerontological nursing practice, where safe, low-risk interventions are urgently A comparison of the intervention types in Figure 3 shows that the relaxation method produced a larger and more consistent effect size (SMD = Oe0.
than physical exercise (SMD = Oe0.
However, both interventions were equally statistically significant .
< 0.
The difference in magnitude indicates that the relaxation method is more effective at reducing blood pressure than physical The advantage of the relaxation method likely lies in its mechanism of action, which directly modulates the autonomic nervous system, leading to a more sustained decrease in blood pressure .
Physical exercise still provides significant benefits through cardiovascular adaptation, but its effectiveness depends more on exercise intensity, duration, and individualAos Therefore, relaxation methods can be prioritized for patients with limited physical activity, while physical exercise can be used as a supportive intervention depending on clinical conditions .
The results of this meta-analysis non-pharmacological interventions are overall effective in lowering blood pressure, with a statistically significant effect.
These findings confirm the critical role of nonpharmacological approaches as an integral part of hypertension management, particularly in adult and elderly However, further analysis revealed a clear difference in effectiveness between relaxation methods and physical exercise, as shown in the subgroup analysis and study characteristics (Tables 1A and 1B).
Based on subgroup results, the relaxation method produced a greater reduction in blood pressure than physical These findings can be explained by the physiological mechanisms underlying the relaxation method, namely decreased sympathetic nervous system activity and increased parasympathetic dominance .
This autonomic nervous system regulation directly lowers peripheral vascular resistance and heart rate, thereby significantly reducing blood The predominance of relaxation method studies in the elderly population (Table 1A) also reinforces the finding that these interventions are more responsive in older adults who are prone to psychological stress and autonomic dysfunction .
Ae.
In contrast, physical exercise pronounced than the relaxation method.
Physical exercise works through mediumto long-term cardiovascular adaptations, such as increased vascular elasticity, improved endothelial function, and reduced vascular resistance .
, .
, .
However, the variety of exercise types, intensities, and participantsAo fitness levelsAias reflected in the variation in study characteristics in Table 1BAimay contribute to the observed variation in effect size.
Another important finding was the magnitude of the interventionAos effect on the elderly group relative to adults and young adults.
This indicates that older adults have a greater potential response to non-pharmacological particularly relaxation methods.
From a clinical and nursing perspective, this is particularly relevant because older adults often experience limited mobility, comorbidities, and the risk of side effects from pharmacotherapy .
, .
, .
Relatively safe, easy-to-apply, and lowcost relaxation methods are becoming a very strategic alternative in gerontological nursing practice and community health The high heterogeneity in the metaanalysis results reflects variation in study Design, intervention type, duration, and population characteristics.
Nonetheless, the consistency of effect direction across Journal Educational of Nursing (JEN) Vol.
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Wahidin | Comparative Analysis Of The Effectiveness Of Relaxation Techniques And Physical Exercise On Controlled Blood Pressure: A Meta-Analysis.
nearly all studies reinforces the validity of the studyAos main findings.
Publication bias assessment using funnel plots also indicates that the meta-analysis results were relatively stable and not dominated by small-sample studies.
The main novelty of this study lies in the comparative meta-analysis approach that directly compares relaxation and physical exercise methods within a single integrated analysis framework.
In contrast to previous meta-analyses that generally assessed the two interventions separately, this study provides more definitive quantitative evidence about which interventions offer greater benefit to specific population groups.
Thus, the results of this study not only contribute to scientific development but also provide practical implications for clinical decision-making and the planning of nursing and public health interventions.
Based on the discussion, it can be concluded that the effectiveness of relaxation methods and physical exercise is influenced not only by the type of intervention but also by participantsAo characteristics, especially in the elderly The relaxation method offers relative advantages for lowering blood pressure because it directly modulates the autonomic nervous system and is easier to apply in older adults with limited physical In contrast, physical exercise still provides significant benefits through cardiovascular adaptation, but its effectiveness depends more on the individualAos intensity, duration, and These underscore the importance of selecting non-pharmacological tailored to population characteristics and health care contexts.
Study Limitations and Potential Confounding Factors Several limitations should be considered when interpreting the findings of this meta-analysis.
First, substantial heterogeneity was observed across studies, which may be attributed to variations in duration, and study design, as well as differences in participant characteristics.
Although a random-effects model and subgroup analyses were applied to address this variability, residual heterogeneity may Second, including both randomized controlled trials and quasi-experimental studies may introduce methodological variability, potentially affecting effect size However, this approach was adopted to capture a broader range of evidence relevant to clinical and community-based nursing practice.
Potential including differences in baseline blood pressure, adherence to interventions, lifestyle behaviors .
uch as diet and physical activity outside the interventio.
, and concurrent non-pharmacological or pharmacological treatments, could not be fully controlled due to limitations in the primary studies.
In addition, publication bias cannot be entirely excluded despite the relatively symmetrical funnel plot.
These limitations highlight the need for future high-quality randomized trials with standardized intervention protocols and more comprehensive reporting to clarify further the comparative effectiveness of non-pharmacological interventions for blood pressure control.
CONCLUSIONS
This meta-analysis demonstrated that both relaxation techniques and physical exercise are effective in lowering blood however, relaxation techniques provide greater and more consistent benefits, particularly among older adults.
This advantage relates to the autonomic nervous systemAos regulatory mechanisms and to the ease and safety of its application in individuals with physical limitations.
Physical exercise remains an essential component of hypertension management because of the long-term cardiovascular adaptation benefits it offers.
However.
Journal Educational of Nursing (JEN) Vol.
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Wahidin | Comparative Analysis Of The Effectiveness Of Relaxation Techniques And Physical Exercise On Controlled Blood Pressure: A Meta-Analysis.
variations in exercise type, intensity, and participant characteristics contribute to differences in the magnitude of the observed effects.
Therefore, physical exercise needs to be tailored to each individual to provide optimal benefits.
The findings of this study confirm that non-pharmacological interventions for blood pressure control should be context- and age-based.
nursing practice and community health services, relaxation methods can be prioritized as a safe, effective, and sustainable strategy for older adults.
At the same time, physical exercise can be used as a complementary approach, depending on individual ability.
Overall, the novelty of this study lies in its comparative meta-analysis approach, which directly compares the effectiveness of relaxation and physical exercise methods within a single analytical The results of this study are expected to serve as the basis for the development of evidence-based nursing practice guidelines and to encourage further research into more optimal combinations of non-pharmacological interventions for hypertension control.
ACKNOWLEDGEMENT
The authors would like to thank all researchers whose studies were included in this meta-analysis, as well as the FIKes of the University of Muhammadiyah Tangerang and STIKes of the Gatot Soebroto Hospital Jakarta.
REFERENCES