The effects of multimodal lifestyle interventions on blood pressure, body weight, and waist circumference in hypertensive patients: a network meta-analysis

Objective: To employ a network meta-analysis methodology to compare the effects of different lifestyle interventions on weight control and blood pressure in hypertensive patients, thereby providing evidence-based guidance for nursing practice. Methods: A systematic search was conducted across PubMed, Web of Science, the Cochrane Library, Embase, the Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP Database, up to February 2025, concerning the effects of different lifestyle interventions on body weight in hypertensive patients. Study selection, data extraction, and methodological quality assessment adhered to evidence-based research standards using a network meta-analysis approach within a frequency framework. Statistical analysis was performed using Stata 16.0 software. Results: Twenty studies involving 5,248 hypertensive patients were included, with interventions covering four fundamental lifestyle modifications and their combined protocols. The overall quality of the included literature was high. Results from the network meta-analysis indicated that, compared with routine care, single or combined interventions based on telemedicine support, dietary modification, exercise, or peer support all helped obese hypertensive patients achieve weight loss and improve blood pressure control. After comprehensively evaluating the overall improvement in patients' weight and blood pressure status, combined interventions integrating diet, exercise, and peer support may represent one of the more suitable management strategies. Conclusion: Management programmes incorporating telemedicine, dietary intervention, exercise intervention, or peer support all contribute to achieving weight loss and blood pressure reduction goals in obese hypertensive patients. Among these, combined interventions integrating diet, exercise, and peer support may represent a favorable option. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024575811, identifier CRD42024575811.