OBJECTIVE: To assess the effectiveness of aerobic exercise combined with systematic nursing care on the psychological well-being and pregnancy outcomes of patients with gestational hypertension. METHODS: A study was conducted on 200 patients with gestational hypertension treated from May 2023 to May 2024. Patients were assigned to an observation group (n=110), which received aerobic exercise and systematic nursing care, or a control group (n=90), which received standard care. Both groups were monitored until delivery. Pre- and post-intervention comparisons included scores for negative emotions, blood pressure, pregnancy outcomes, neonatal weight, Apgar scores, delivery methods, and patient satisfaction with nursing care. The systolic-to-diastolic peak (S/D) ratio in umbilical blood flow and heat shock protein 70 (HSP70) levels were analyzed, with ROC analysis used to evaluate their predictive value for adverse pregnancy outcomes. Logistic regression was employed to identify independent risk factors for low Apgar scores in neonates. RESULTS: Following the intervention, the observation group showed significantly better blood pressure control and greater reductions in negative emotions compared to the control group (both P<
0.05). The incidence of adverse pregnancy outcomes was significantly lower, and the rate of vaginal delivery was higher in the observation group (both P<
0.05). Patients with adverse outcomes had significantly elevated S/D ratios and serum HSP70 levels (both P<
0.05). The area under the ROC curve (AUC) for predicting pregnancy outcomes was 0.733 for the S/D ratio, 0.817 for HSP70, and 0.916 when combined, indicating strong predictive value. Neonates in the observation group had higher birth weights and Apgar scores (both P<
0.05). Patient satisfaction with nursing care was also significantly higher in the observation group (P<
0.05). CONCLUSION: Combining aerobic exercise with systematic nursing care is effective in improving psychological health, pregnancy outcomes, quality of life, and patient satisfaction in patients with gestational hypertension.