Background <p>Hypertension is one of the most common diseases among the elderly, and a lack of control and attention to this condition poses ongoing risks to those affected. Conversely, self-management of this disease can reduce its complications. The family health nurse plays multiple roles, including conducting home visits, collecting evidence, preventing disease, and detecting and treating problems.</p> Methods <p>This study was a randomized controlled trial (RCT) with two groups: intervention and control. It was conducted on 76 elderly individuals aged 60–74 with hypertension in Isfahan, Iran, from August 2023 to March 2024. Interventions based on the family health nurse model were implemented for the intervention group, including four individual and family education sessions, three self-help group sessions, inpatient and outpatient follow-up, and at least two home visit sessions. The control group received routine care from health centers. Data were collected using a two-part questionnaire consisting of a demographic section and the Stanford University Chronic Disease Self-Management Questionnaire. The questionnaire was administered before the intervention, immediately after, and three months following the intervention, along with blood pressure measurements. Data analysis was performed using SPSS version 22 at a significance level of 0.05.</p> Results <p>There was no statistically significant difference between the intervention and control groups in terms of demographics before the intervention (<i>p</i> &gt; 0.05). However, the mean self-management score and its dimensions were significantly higher in the intervention group compared to the control group both immediately after and three months following the intervention (<i>p</i> &lt; 0.001). Additionally, the mean systolic and diastolic blood pressure values differed significantly between the two groups after the intervention and three months later (<i>p</i> &lt; 0.001).</p> Conclusion <p>Implementing the family health nurse model improved self-management of hypertension in the elderly and reduced systolic and diastolic blood pressure in the intervention group compared to the control group. Limitations of the study: It was conducted during two home visits and there was no previous study of family health nurses in Iran.</p> Trial registration <p>The study was registered as a randomized controlled trial in the Clinical Trial Registration Center of Iran (Registration Date: 2023-07-23; Registration Number: IRCT20190806044449N2).&#xa0;<a href="https://irct.behdasht.gov.ir/user/trial/68288/view">https://irct.behdasht.gov.ir/user/trial/68288/view</a>.</p>