Objective To study the effect of life guidance combined with diversified ecological nutritional care and health education on self-care ability and blood pressure in patients with hypertension Methods A total of 100 patients with hypertension treated in our hospital from January 2023 to March 2024 were selected and randomly divided into control group (receiving routine nursing care) and observation group (receiving life guidance combined with diversified ecological nutritional care and health education). The intervention effect was compared between the two groups. Results Compared with the control group, the observation group had significantly lower blood pressure (P <0.05), significantly higher self-care ability and self-management ability scores (P <0.05), a significantly better disease coping method (P <0.05), and significantly higher quality of life scores in various dimensions (P <0.05). Conclusion For patients with hypertension, life guidance combined with diversified ecological nutritional care and health education can effectively control blood pressure, enhance self-care and management abilities, help improve the disease coping method, and improve the quality of life, so it merits broader application.