Randomized Controlled Trial of Mindfulness-Based Stress Reduction for Prehypertension

Department of Psychology, PO Box 5190, Kent, OH 44242. .
Psychosomatic Medicine (Impact Factor: 3.47). 10/2013; 75(8):721-728. DOI: 10.1097/PSY.0b013e3182a3e4e5
Source: PubMed


Mindfulness-based stress reduction (MBSR) is an increasingly popular practice demonstrated to alleviate stress and treat certain health conditions. MBSR may reduce elevated blood pressure (BP). Treatment guidelines recommend life-style modifications for BP in the prehypertensive range (systolic BP [SBP] 120-139 mm Hg or diastolic BP [DBP] 80-89 mm Hg), followed by antihypertensives if BP reaches hypertensive levels. MBSR has not been thoroughly evaluated as a treatment of prehypertension. A randomized clinical trial of MBSR for high BP was conducted to determine whether BP reductions associated with MBSR exceed those observed for an active control condition consisting of progressive muscle relaxation (PMR) training.

Fifty-six men (43%) and women (57%) averaging (standard deviation) 50.3 (6.5) years of age (91% white) with unmedicated BP in the prehypertensive range were randomized to 8 weeks of MBSR or PMR delivered in a group format. Treatment sessions were administered by one treatment provider and lasted approximately 2.5 hours each week. Clinic BP was the primary outcome measure. Ambulatory BP was a secondary outcome measure.

Analyses were based on intent to treat. Patients randomized to MBSR exhibited a 4.8-mm Hg reduction in clinic SBP, which was larger than the 0.7-mm Hg reduction observed for PMR (p = .016). Those randomized to MBSR exhibited a 1.9-mm Hg reduction in DBP compared with a 1.2-mm Hg increase for PMR (p = .008). MBSR did not result in larger decreases in ambulatory BP than in PMR.

MBSR resulted in a reduction in clinic SBP and DBP compared with PMR. Trial Registration identifier: NCT00440596.

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Available from: David M Fresco, Oct 09, 2015
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    • "More recently, investigations have continued finding reductions in physiological parameters such as heart rate and blood pressure occur during the acute meditation practice (Telles et al., 1995; Barnes et al., 1999; Solberg et al., 2004) as well as following practice over longer periods of time (Barnes et al., 2004; Harinath et al., 2004). Similar effects have also been reported for more secular and abbreviated protocols such as an 8 week training in Mindfulness Based Stress Reduction, which incorporates instruction in meditation as well as teaches cognitive and other approaches to enhance stress reduction (Hughes et al., 2013). Although the notion that meditation results in physiologically quiescent states is well established, the extent to which meditative practices exert such effects is unknown. "
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    ABSTRACT: Meditation is commonly thought to induce physiologically quiescent states, as evidenced by decreased autonomic parameters during the meditation practice including reduced heart rate, respiratory rate, blood pressure, skin conductance, and increased alpha activity in the electroencephalogram. Preliminary empirical support for this idea was provided in a case report by Dimsdale and Mills (2002), where it was found that meditation seemed to regulate increased levels of cardiovascular arousal induced by bolus isoproterenol infusions. In that study, while meditating, a self-taught meditator exhibited unexpected decreases in heart rate while receiving moderate intravenous doses of the beta adrenergic agonist isoproterenol. This effect was no longer observed when the individual received isoproterenol infusions while not meditating. The current study was designed to explore this phenomenon empirically in a group of formally trained meditators. A total of 15 meditators and 15 non-meditators individually matched on age, sex, and body mass index were recruited. Participants received four series of infusions in a pseudorandomized order: isoproterenol while meditating (or during a relaxation condition for the non-meditators), isoproterenol while resting, saline while meditating (or during a relaxation condition for the non-meditators), and saline while resting. Heart rate was continuously measured throughout all infusions, and several measures of heart rate were derived from the instantaneous cardiac waveform. There was no evidence at the group or individual level suggesting that meditation reduced the cardiovascular response to isoproterenol, across all measures. These results suggest that meditation is not associated with increased regulation of elevated cardiac adrenergic tone.
    Frontiers in Psychology 07/2015; 6:924. DOI:10.3389/fpsyg.2015.00924 · 2.80 Impact Factor
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    • "It has been shown that meditation, in short-term trainings and longterm practice, prevents elevated baseline blood pressure and heart rate in healthy individuals and reduces them in hypertensive patients (Anderson et al., 2008; Ankad et al., 2011; Astin et al., 2003; Barnes et al., 2004; Goldstein et al., 2012; Hughes et al., 2013; Nidich et al., 2009), and also decreases symptoms of angina pectoris, cholesterol levels, myocardial ischemia and left ventricular hypertrophy in patients (Barnes et al., 2012; Barnes and Orme-Johnson, 2012; Schneider et al., 2006; Walton et al., 2004). In this regard, the main aim of the present study was to investigate the possible psychophysiological mechanism of beneficial effects of long-term meditation practice on the cardiovascular system. "
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    ABSTRACT: Meditation has been found to be an efficient strategy for coping with stress in healthy individuals and in patients with psychosomatic disorders. The main objective of the present study was to investigate the psychophysiological mechanisms of beneficial effects of meditation on cardiovascular reactivity. We examined effects of long-term Sahaja Yoga meditation on cardiovascular reactivity during affective image processing under "unregulated" and "emotion regulation" conditions. Twenty two experienced meditators and 20 control subjects participated in the study. Under "unregulated" conditions participants were shown neutral and affective images and were asked to attend to them. Under "emotion regulation" conditions they down-regulated negative affect through reappraisal of negative images or up-regulated positive affect through reappraisal of positive images. Under "unregulated" conditions while anticipating upcoming images meditators vs. controls did not show larger pre-stimulus total peripheral resistance and greater cardiac output for negative images in comparison with neutral and positive ones. Control subjects showed TPR decrease for negative images only when they consciously intended to reappraise them (i.e. in the "emotion regulation" condition). Both meditators and controls showed comparable cardiovascular reactivity during perception of positive stimuli, whereas up-regulating of positive affect was associated with more pronounced cardiac activation in meditators. The findings provide some insight into understanding the beneficial influence of meditation on top-down control of emotion and cardiovascular reactivity. Copyright © 2015. Published by Elsevier B.V.
    International journal of psychophysiology: official journal of the International Organization of Psychophysiology 01/2015; 95(3). DOI:10.1016/j.ijpsycho.2015.01.002 · 2.88 Impact Factor
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    • "For example, a well-designed study of 52 patients with hypertension randomized participants to contemplative meditation practice or a no-treatment control and found decreases in heart rate, and both systolic and diastolic blood pressure as measured during 24-hour ambulatory monitoring and in reaction to mental stress testing [90]. As well, a recent study comparing the effects of MBSR to progressive muscle relaxation in 56 prehypertensive adults found that MBSR produced significant reductions in SBP and DBP compared to the relaxation control group [91]. "
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    ABSTRACT: Research on mindfulness-based interventions (MBIs) for treating symptoms of a wide range of medical conditions has proliferated in recent decades. Mindfulness is the cultivation of nonjudgmental awareness in the present moment. It is both a practice and a way of being in the world. Mindfulness is purposefully cultivated in a range of structured interventions, the most popular of which is mindfulness-based stress reduction (MBSR), followed by mindfulness-based cognitive therapy (MBCT). This paper begins with a discussion of the phenomenological experience of coping with a chronic and potentially life-threatening illness, followed by a theoretical discussion of the application of mindfulness in these situations. The literature evaluating MBIs within medical conditions is then comprehensively reviewed, applying a levels of evidence rating framework within each major condition. The bulk of the research looked at diagnoses of cancer, pain conditions (chronic pain, low back pain, fibromyalgia, and rheumatoid arthritis), cardiovascular disease, diabetes, human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), and irritable bowel syndrome. Most outcomes assessed are psychological in nature and show substantial benefit, although some physical and disease-related parameters have also been evaluated. The field would benefit from more adequately powered randomized controlled trials utilizing active comparison groups and assessing the moderating role of patient characteristics and program "dose" in determining outcomes.
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