From social support to hypertension control: The mediating role of resilience and self-management

Hypertension remains the leading modifiable risk factor for cardiovascular disease and premature death worldwide, yet global control rates remain poor. While social support has long been associated with better chronic disease outcomes, the psychological and behavioral pathways through which it translates into blood pressure control are not fully understood. This literature review synthesizes empirical and review evidence published between 2021 and 2026 on the relationships among social support, psychological resilience, self-management, and hypertension control. A structured, thematically organized search of peer-reviewed, open-access literature was conducted, informed by the reporting principles of the PRISMA 2020 statement. Fifty-one sources meeting pre-specified eligibility criteria were retained for narrative-thematic synthesis. Findings indicate that social support exerts both direct and indirect effects on hypertension self-management and blood pressure control, with psychological resilience and self-management behavior functioning as sequential mediators consistent with the Individual and Family Self-Management Theory. Effects vary with family structure, culture, socioeconomic status, and access to digital health tools. An integrative conceptual model linking these constructs is proposed. The review identifies a need for longitudinal and experimental studies that jointly target resilience-building and self-management skills to improve hypertension control, particularly in low- and middle-income and rural settings.