High blood pressure in old age: experiences in rural areas and challenges for nursing

Authors

Keywords:

hypertension; life-changing events; aging; elderly; rural environment

Abstract

Introduction: High blood pressure is more prevalent in the aging stage, when patients face difficulties due to physiological and emotional changes. The greater assiduity and austerity of timely preventive measures can be very useful.

Objective: To interpret the experiences of patients with hypertension during senescence in rural areas, as well as the challenges for nursing.

Methods: A qualitative, exploratory study with a phenomenological-hermeneutic design was conducted with 15 patients over 60 years of age from the Peruvian highlands. Data were collected through semi-structured interviews; the interview guide had content validity. The subcategories and categories that explain the phenomenon studied were generated through inductive coding and are presented in a semantic network.

Results: The resulting categories were: unpleasant experiences in the course of the disease and emotional tendency for a favorable coping of it; the subcategories were: global modifications due to the disease, limitations in performing activities, ineffective adherence to therapeutic measures, attitude to contribute to control, family accompaniment and support, desire to improve daily life and belief in God as emotional support. Other studies agree that the internalization of the disease will facilitate the active participation of patients to assume changes in their daily lives and adapt to the new reality.

Conclusion: Patients expressed dissatisfaction with the effects caused by arterial hypertension in the different spheres of their lives; however, they are ready to contribute and receive the necessary support to improve their living conditions.

Downloads

Download data is not yet available.

References

1. Toba A, Ishikawa J. Current topics of frailty in association with hypertension and other medical conditions. Hypertens Res. 2023;46(5):1188-94. DOI: 10.1038/s41440-023-01200-6.

2. Pan Q, Zhang C, Yao L, et al. Factors Influencing Medication Adherence in Elderly Patients with Hypertension: A Single Center Study in Western China. Patient Prefer Adherence. 2023;17:1679-88. DOI: 10.2147/PPA.S418246.

3. Natale P, Ni JY, Martinez-Martin D, et al. Perspectives and Experiences of Self-monitoring of Blood Pressure Among Patients With Hypertension: A Systematic Review of Qualitative Studies. Am J Hypertens. 2023;36(7):372-84. DOI: 10.1093/ajh/hpad021.

4. Huang KY, Chang CH, Yu KC, et al. Assessment of quality of life and activities of daily living among elderly patients with hypertension and impaired physical mobility in home health care by antihypertensive drugs plus acupuncture: A CONSORT-compliant, randomized controlled trial. Medicine (Baltimore). 2022;101(11):e29077. DOI: 10.1097/MD.0000000000029077.

5. Glock H, Borgström Bolmsjö B, Milos Nymberg V, et al. 'In the end, I'm the one who has to do the job': Participant experience of a lifestyle intervention for patients with hypertension. Scand J Prim Health Care. 2023;41(4):457-68. DOI: 10.1080/02813432.2023.2271042.

6. Wang X, Dai M, Xu J. Association of living alone and living alone time with hypertension among Chinese men aged 80 years and older: a cohort study. Front Public Health. 2024;11:1274955. DOI: 10.3389/fpubh.2023.1274955.

7. Berry RK, Peck JL. Holistic Hypertension Management. Holist Nurs Pract. 2023;37(5):253-9. DOI: 10.1097/HNP.0000000000000604.

8. Liu F, Song T, Yu P, et al. Efficacy of an mHealth App to Support Patients' Self-Management of Hypertension: Randomized Controlled Trial. J Med Internet Res. 2023;25:e43809. DOI: 10.2196/43809.

9. Huang X, Xu N, Wang Y, et al. The effects of motivational interviewing on hypertension management: A systematic review and meta-analysis. Patient Educ Couns. 2023;112:107760. DOI: 10.1016/j.pec.2023.107760.

10. Angeli F, Reboldi G, Verdecchia P. Target pressorio nel paziente iperteso anziano. G Ital Cardiol (Rome). 2023;24(4):305-9. DOI: 10.1714/4004.39821.

11. Woods SB, Hiefner AR, Udezi V, et al. 'They should walk with you': the perspectives of African Americans living with hypertension and their family members on disease self-management. Ethn Health. 2023;28(3):373-98. DOI: 10.1080/13557858.2022.2040958.

12. Banner M, McDonald K, Walker LO. Qualitative Research on Self-Transcendence in Older Adults: A Scoping Review. J Gerontol Nurs. 2023;49(9):43-8. DOI: 10.3928/00989134-20230816-04.

13. Öhlén J, Friberg F. Empirical Phenomenological Inquiry: Guidance in Choosing Between Different Methodologies. Glob Qual Nurs Res. 2023;10:23333936231173566. DOI: 10.1177/23333936231173566.

14. Ray MA, Locsin RC. Toward an adequate understanding of phenomenological and hermeneutic-phenomenological nursing research. Nurs Health Sci. 2023;25(1):3-8. DOI: 10.1111/nhs.13015.

15. Demirel C, Kiliç SP. The effects of education based on the Roy adaptation model on medication adherence and psychosocial adjustment in hypertensive patients. J Vasc Nurs. 2024;42(2):89-98. DOI: 10.1016/j.jvn.2024.01.003.

16. Özler N, Malkoç M, Angin E. The relationship between physical activity level and balance parameters, muscle strength, fear of falling in patients with hypertension. Medicine (Baltimore). 2023;102(48):e36495. DOI: 10.1097/MD.0000000000036495.

17. Dich N, Rod NH, Doan SN. Both High and Low Levels of Negative Emotions Are Associated with Higher Blood Pressure: Evidence from Whitehall II Cohort Study. Int J Behav Med. 2020;27(2):170-8. DOI: 10.1007/s12529-019-09844-w.

18. Peña-Valenzuela AN, Ruiz-Cervantes W, Barrios-Olán C, et al. Relación médico-paciente y adherencia terapéutica en pacientes con hipertensión arterial. Rev Med Inst Mex Seguro Soc [Internet]. 2023 [citado 05/03/2025];61(1):55-60. Disponible en: https://pubmed.ncbi.nlm.nih.gov/36542507/

19. Hwang M, Chang AK. The effect of nurse-led digital health interventions on blood pressure control for people with hypertension: A systematic review and meta-analysis. J Nurs Scholarsh. 2023;55(5):1020-35. DOI: 10.1111/jnu.12882.

20. Rogers D, Calleja P, Byrne AL, et al. Exploring the Role and Skill Requirements of Registered Nurses Working in Rural and Remote Areas. A Scoping Review. J Clin Nurs. 2025;34(8):3051-71. DOI: 10.1111/jocn.17689.

21. Lenssen E, Nagtegaal I, van Oostveen C, et al. Exploring nurses' leadership and resilience in a complex daily work environment: a qualitative study. BMC Nurs. 2025;24(1):173. DOI: 10.1186/s12912-025-02761-2.

22. Abalos JB, Saito Y, Ramos MA Jr, et al. Prevalence, Awareness, Treatment, and Control of Hypertension Among Older Adults in the Philippines. J Gerontol A Biol Sci Med Sci. 2024;79(2):glad155. DOI: 10.1093/gerona/glad155.

23. Zhang X, Zheng Y, Qiu C, et al. Well-being mediates the effects of social support and family function on self-management in elderly patients with hypertension. Psychol Health Med. 2020;25(5):559-71. DOI: 10.1080/13548506.2019.1687919.

24. Ribeiro AMVB, Vilasbôas ALQ, de Almeida PF. Experiences of access and use of primary health care by users with systemic arterial hypertension. Rev Esc Enferm USP. 2024;58:e20240109. DOI: 10.1590/1980-220X-REEUSP-2024-0109en.

25. Boima V, Yorke E, Ganu V, et al. Coping strategies and resilience among patients with hypertension in Ghana. Front Psychol. 2023;13:1038346. DOI: 10.3389/fpsyg.2022.1038346.

26. Adoma PO, Ansah EW, Apaak D, et al. Coping with hypertensive treatment at Bono Regional Hospital in Sunyani, Ghana: a prospective observational cohort study. Pan Afr Med J. 2023;45:185. DOI: 10.11604/pamj.2023.45.185.39994.

27. Kent BV, Upenieks L, Kanaya AM, et al. Religion/Spirituality and Prevalent Hypertension among Ethnic Cohorts in the Study on Stress, Spirituality, and Health. Ann Behav Med. 2023;57(8):649-61. DOI: 10.1093/abm/kaad007.

28. Jung SY, Moon KJ. Factors affecting self-care among community-dwelling hypertensive older adults: A cross-sectional study. Nurs Open. 2023;10(6):3892-905. DOI: 10.1002/nop2.1647.

29. Maceira D, Quintero REP, Suarez P, et al. Primary health care as a tool to promote equity and sustainability; a review of Latin American and Caribbean literature. Int J Equity Health. 2024;23(1):91. DOI: 10.1186/s12939-024-02149-9.

Published

2025-11-19

How to Cite

1.
Pérez-Ortiz KE, Castañeda-Sigueñas L, Asenjo-Alarcón JA. High blood pressure in old age: experiences in rural areas and challenges for nursing. Rev Méd Electrón [Internet]. 2025 Nov. 19 [cited 2026 Apr. 3];47:e6547. Available from: https://revmedicaelectronica.sld.cu/index.php/rme/article/view/6547

Issue

Section

Research article