Primary hypertension is a health problem that can increase the risk of cardiovascular complications. This condition occurs when blood pressure is excessively high and can become a major risk factor for heart disease and vascular disorders. One nonpharmacological intervention that may help lower blood pressure is isometric handgrip exercise. This study aims to describe the implementation of isometric handgrip exercise in reducing blood pressure among patients with primary hypertension at TK II Putri Hijau Hospital, Medan. The method used was descriptive with a case study approach through the nursing care process, which included assessment, nursing diagnosis, intervention, implementation, and evaluation. The subjects in the case study consisted of two patients with primary hypertension who met the inclusion criteria: patients with primary hypertension, patients aged 18 years, patients willing to participate as respondents, and patients with grade II hypertension with a nursing diagnosis of ineffective peripheral tissue perfusion. The intervention was conducted for three days, once daily, with a duration of three minutes using both hands alternately. Blood pressure was measured before and after the intervention. The results of the case study showed a reduction in blood pressure in both patients. In the first patient, blood pressure on the first day decreased from 162/87 mmHg before the intervention to 155/87 mmHg after the intervention, while on the third day it decreased from 140/90 mmHg to 136/88 mmHg. In the second patient, blood pressure on the first day decreased from 163/103 mmHg before the intervention to 158/98 mmHg after the intervention, while on the third day it decreased from 140/90 mmHg to 136/86 mmHg. In addition to the reduction in blood pressure, the patients reported feeling more relaxed, feeling lighter, and experiencing less fatigue during activities. The case study concludes that the implementation of isometric handgrip exercise can help lower blood pressure in patients with primary hypertension and can be used as one of the nonpharmacological therapies under the guidance of nurses.