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

Abstract

Abstract 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). Methods 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. Results 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. Conclusion 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