Mindfulness effects on lifestyle behavior and blood pressure: A randomized controlled trial

Author: Eunjoo An1, Michael R Irwin2,3, Lynn V Doering4, Mary-Lynn Brecht4, Karol E Watson5, Elizabeth Corwin1, Paul M Macey3,4
1 School of Nursing Columbia University New York New York.
2 Department of Psychiatry and Biobehavioral Sciences David Geffen School of Medicine at UCLA Los Angeles CA.
3 Brain Research Institute University of California Los Angeles California.
4 School of Nursing UCLA California.
5 David Geffen School of Medicine at UCLA Los Angeles CA.
Conference/Journal: Health Sci Rep
Date published: 2021 Jun 5
Other: Volume ID: 4 , Issue ID: 2 , Pages: e296 , Special Notes: doi: 10.1002/hsr2.296. , Word Count: 275

Background and aims:
HTN affects nearly 50% of U.S. adults and is the leading modifiable cardiovascular risk factor. A healthy diet and exercise can improve BP control, but adherence to these interventions is low. We tested whether a multimodal mind-body program, Mindful Awareness Practices (MAP) could improve BP and lifestyle behaviors associated with HTN when compared to a Health Promotion Program (HPP).

Adults with BP >120/80 were randomized to MAP or HPP. Outcome measurements of BP, self-reported diet, and exercise were analyzed with intent-to-treat group comparisons using repeated measures linear mixed models.

There was an MAP-HPP between-group difference in interactions of time-by-systolic BP (P = 0.005) and time-by-diastolic BP (P = .003). The mean drops in SBP from baseline to week 13 for the MAP group was 19 mm Hg (138 ± 15 mm Hg-119 ± 6 mm Hg) compared to 7 mm Hg (134 ± 18 mm Hg-127 ± 22 mm Hg) in the HPP group. Similarly, a greater reduction in DBP was observed in the MAP group compared to the HPP group, 12 mm Hg (89 mm Hg ± 11-77 ± 7 mm Hg) and 1 mm Hg (81 ± 16 mm Hg-80 ± 18 mm Hg), respectively. Mediational analysis of the MAP group showed the total effect of mindfulness practice minutes on SBP with indirect effect (ab) of -.057 was significant, resulting in a 40% lower SBP for total effect (c) compared to direct (c') effect alone. The mediational model suggests MAP has a modest positive influence on participants initiating lifestyle behavior change, which partially explains the greater reduction in BP by the MAP group.

Our findings suggest a multimodal mind-body program involving mindfulness practice may improve BP control in adults with HTN.

Keywords: blood pressure; diet; exercise; hypertension; lifestyle behavior; meditation; mindfulness.

PMID: 34136657 PMCID: PMC8178963 DOI: 10.1002/hsr2.296