Effect of Combined Isometric Handgrip Exercise and Dhikr Therapy on Blood Pressure Among Older Adults with Hypertension: A Quasi-Experimental Study

Abstract

Hypertension is a major public health problem among older adults and a leading risk factor for cardiovascular disease. Although pharmacological therapy remains the primary treatment, complementary non-pharmacological interventions that integrate physical exercise and spiritual care may enhance blood pressure control. However, evidence regarding the combined use of isometric handgrip exercise and Islamic dhikr therapy is still limited. This study aimed to determine the effect of combined isometric handgrip exercise and dhikr therapy on blood pressure among older adults with hypertension. A quasi-experimental study with a one-group pretest–posttest design was conducted among 40 older adults with hypertension at Merdeka Primary Health Center. Participants were selected using purposive sampling according to the predefined eligibility criteria and the sample size was estimated using the Slovin formula to obtain a representative sample from the accessible population. Participants received combined isometric handgrip exercise and guided dhikr therapy for five consecutive days. Blood pressure was measured before and after the intervention using a calibrated digital sphygmomanometer. Data normality was assessed using the Shapiro–Wilk test, followed by the Wilcoxon Signed-Rank Test for statistical analysis. The mean systolic blood pressure decreased from 146.50 mmHg to 123.25 mmHg, while the mean diastolic blood pressure decreased from 100.00 mmHg to 80.75 mmHg after the intervention. The average reductions were 23.25 mmHg for systolic and 19.25 mmHg for diastolic blood pressure. Statistical analysis demonstrated significant differences between pre- and post-intervention measurements for both systolic and diastolic blood pressure (p < 0.001). Combined isometric handgrip exercise and dhikr therapy significantly reduced blood pressure among older adults with hypertension. This intervention may be an effective complementary nursing strategy in primary healthcare setting.