<![CDATA[Hypertension remains a major contributor to cardiovascular morbidity and mortality, while evidence on pharmacist-led care in hospital and hospital-linked settings is fragmented. This systematic review and meta-analysis evaluated the effects of clinical pharmacist-led interventions on blood pressure and related outcomes in adults with hypertension. PubMed and Scopus were searched through 23 November 2025. Five studies were included: three randomized controlled trials, one quasi-randomized controlled trial, and one nonrandomized before-after study. Interventions comprised structured education, medication review and optimization, medication therapy management, home blood pressure monitoring, and follow-up. Narrative findings generally favored pharmacist-led care for blood pressure, medication adherence, hypertension knowledge, and resolution of drug-related problems. Two controlled trials, one randomized and one quasi-randomized, contributed to the exploratory meta-analysis. Pharmacist-led interventions reduced systolic blood pressure by a pooled mean difference of -5.27 mmHg (95% CI -7.23 to -3.31; I² = 0%). The pooled diastolic blood pressure effect favored intervention but was not statistically significant (mean difference -4.21 mmHg; 95% CI -9.80 to 1.38; I² = 85.1%). Interpretation is limited by the small number of pooled studies, heterogeneous interventions, attrition, and risk of bias. Pharmacist-led interventions may improve systolic blood pressure and medication-management outcomes, but additional rigorously designed trials with standardized interventions and outcome reporting are needed.]]>
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