Is Mindfulness-Based Stress Reduction Effective for People with Hypertension? A Systematic Review and Meta-Analysis of 30 Years of Evidence

Abstract

Background: Hypertension is among the most important risk factors for cardiovascular diseases, which are considered high mortality risk medical conditions. To date, several studies have reported positive effects of mindfulness-based stress reduction (MBSR) interventions on physical and psychological well-being in other medical conditions, but no meta-analysis on MBSR programs for hypertension has been conducted. Objectives: The objective of this study was to determine the effectiveness of MBSR programs for hypertension. Methods: A systematic review and meta-analysis of randomized controlled trials examining the effects of MBSR on systolic and diastolic blood pressure (BP), anxiety, depression, and perceived stress in people with hypertension or pre-hypertension was conducted. The PubMed/MEDLINE and PsycINFO databases were searched in November 2020 to identify relevant studies. Results: Six studies were included. The comparison of MBSR versus control conditions on diastolic BP was associated with a statistically significant mean effect size favoring MBSR over control conditions (MD = −2.029; 95% confidence interval (CI): −3.676 to −0.383, p = 0.016, k = 6; 22 effect sizes overall), without evidence of heterogeneity (I2 = 0.000%). The comparison of MBSR versus control conditions on systolic BP was associated with a mean effect size which was statistically significant only at a marginal level (MD = −3.894; 95% CI: −7.736–0.053, p = 0.047, k = 6; 22 effect sizes overall), without evidence of high heterogeneity (I2 = 20.772%). The higher the proportion of participants on antihypertensive medications was, the larger the effects of MBSR were on systolic BP (B = −0.750, z = −2.73, p = 0.003). Conclusions: MBSR seems to be a promising intervention, particularly effective on the reduction of diastolic BP. More well-conducted trials are required.

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“…Several different definitions of mindfulness share one common element: the non-judgemental attitude toward one's inner experience (21,22). Recent evidence showed the potentially protective role of mindfulness skills against the development and maintenance of psychological distress during the pandemic, but not only, in various populations [e.g., (23)(24)(25)]. Previous evidence suggested that CHS people show lower mindfulness skills, as compared with those not reporting such symptoms (26).…”

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Mindfulness-based intervention in patients with persistent pain in chest (MIPIC) of non-cardiac cause: a feasibility randomised control study

“… 55 There is also an indication of improved myocardial and endothelial function from meditation practice in patients with microvascular angina, 56 and reduction in markers of inflammation. 57 58 MBIs have been shown to reduce hypertension in a recent meta-analysis, 59 contribute to weight loss and blood-sugar levels 60 61 and reduce smoking. 62 …”