Aims <p>Hypertension is one of the most serious public health problems, with prevalence increasing with age. Patient education can play a major role in the treatment and management of blood pressure. Therefore, the present study aimed to compare the effect of group training and telenursing on medication and dietary adherence and blood pressure control among elderly with hypertension.</p> Methods and results <p>The present clinical trial study was conducted on 90 older adults with hypertension in Abdanan, Ilam province, in 2023.Participants were selected based on the inclusion and exclusion criteria and randomly assigned to three groups: group training, telenursing, and control. The data collection tools included a demographic form and the Hill-Bone Adherence to High Blood Pressure Therapy Scale. The data were analyzed in SPSS software (version 25) using relevant statistical tests. A p-value less than 0.05 was considered statistically significant. The mean age of research participants was 65.18 ± 3.97 years. Systolic and diastolic blood pressure in group training and telenursing groups displayed a significant decrease in the second and third stages of the research (<i>P</i> &lt; 0.05). Moreover, medication and dietary adherence in the intervention groups was statistically significant in the second and third stages (<i>P</i> &lt; 0.05).</p> Conclusion <p>As evidenced by the results of this study, group training and telenursing led to a marked improvement in medication and dietary adherence, as well as blood pressure control, in patients. Therefore, it is recommended to distance yourself from routine training techniques and follow newer and more flexible methods, such as telenursing and group training.</p> Trial registration <p>The article has been approved in Iranian Registry of Clinical Trials at 20,220,716. IRCT20220130053886N1.</p>