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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    • "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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    • "Mindfulness is defined as bringing one's awareness to moment-to-moment experiences without judgment (Kabat-Zinn 1994). Mindfulness training decreases blood pressure (Nyklicek et al. 2013; Hughes et al. 2013) and is efficacious in treating pain syndromes (Greeson 2009; Reiner et al. 2013). A consequence of mindfulness training is the realization that most thoughts and emotions fluctuate or are transient (Baer 2003) and that these momentary experiences can be simply acknowledged as mental phenomena rather than reality and allowed to pass. "
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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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