Mindfulness training provides a fresh perspective to managing hypertension and was associated with a clinically significant reduction in systolic BP in a study.
About 46% of Americans have hypertension, among whom more than 75% do not have it under control. “Hypertension is a primary cause of cardiovascular disease, which is the leading killer in the United States and worldwide,” says Eric B. Loucks, PhD. “Effective lifestyle interventions and treatments for hypertension are available, but despite these options, blood pressure (BP) control has worsened over time. This suggests there’s a need to either improve adherence to available evidence‐based treatments or consider new approaches.”
Mindfulness training has emerged as a promising strategy to improve adherence to evidence‐based regimens for hypertension. “Mindfulness helps train people to use their self-awareness skills, place their attention where they choose to, and regulate their emotions,” explains Dr. Loucks. During training, patients are taught to maintain their attention during an immediate experience and remember to bring their wisdom into the present moment. Their wisdom can include knowledge about how evidence‐based practices can improve well‐being, such as diet, physical activity, and antihypertensive medication adherence.
An Alternative Approach to Enhancing BP Control
Previous research on the impact of mindfulness‐based programs on BP control has been limited by small sample sizes, modest generalizability, and short‐term follow‐up. To address this knowledge gap, Dr. Loucks and colleagues published a study in the Journal of the American Heart Association that compared the effects of Mindfulness‐Based Blood Pressure Reduction (MB‐BP), a multimodal intervention that was adapted for elevated BP, with enhanced usual care on unattended office systolic BP.
“The MB‐BP program combines mindfulness training with other strategies used to reduce BP, such as encouraging people to continue taking prescribed antihypertensive medications and educating them about habits that contribute to elevated BP,” says Dr. Loucks.
Mindfulness Training Reduces Office Systolic BP
For the study, 201 patients with elevated unattended office BP (<120/88 mm Hg) were randomly assigned to either an 8‐week MB‐BP (n=101) intervention group or enhanced usual care control group (n=100). Approximately 59% of the study participants were women, 81% were non-Hispanic White, and the average age was 59.5. The primary outcome was a change in unattended office systolic BP at 6 months.
The MB‐BP program was associated with a 5.9 mm Hg reduction in systolic BP from baseline and outperformed the control group by 4.5 mm Hg at 6 months (Figure). The MB-BP-induced improvements in sedentary activity, DASH dietary patterns, and mindfulness were factors that potentially impacted the observed differences.
A Fresh Perspective for Addressing Poorly Controlled BP
“Mindfulness training provides a fresh perspective to managing hypertension and fits into current standards of care,” Dr. Loucks says. “The MP-BP approach was associated with a clinically significant reduction in systolic BP that was comparable to what’s been seen with many behavioral interventions for BP. Of note, some MP-BP participants reduced their antihypertensive use during the study and used behaviors, such as changes in diet and physical activity, to decrease BP. However, our program was not designed to get people off their medications. It’s intended to encourage people to explore their readiness to change hypertension risk factors and to use mindfulness to engage with using whatever tools work, including medication and healthy lifestyle changes, to bring their BP down.”
In future research, Dr. Loucks and his team are exploring a grant to study effects of MB-BP in a group medical visit setting of people with hypertension. “We’ll need to establish the level of interest from patients and determine how reimbursement would work for such an approach,” he says, adding that physicians interested in exploring group medical visits for MB-BP can connect with him at eric.loucks@brown.edu.
