Mindfulness Based Stress Reduction (MBSR) is a method of using meditation and yoga to cultivate awareness and reduce stress. Studies have shown that MBSR can high blood pressure however, MBSR has never been thoroughly evaluated as a treatment for prehypertension, slightly elevated blood pressure.
Dr. Joel W. Hughes, PhD, of Kent State University and colleagues conducted a randomized clinical trial of MBSR for high blood pressure to determine if reductions in blood pressure were associated with MBSR exceed those observed for an active control condition consisting of progressive muscle relaxation (PMR) training.
The study included 56 men (43%) and women (57%), average age 50.3 years with undedicated blood pressure in the prehypertensive range. The National Heart, Lung, and Blood Institute say normal blood pressure is below 120/80 and classifies prehypertension in the range of 120/80 to 139/89. Prehypertension is getting attention from physicians and medical literature. According to the CDC, almost 30% of American adults have prehypertension.
For the study, patients were randomized into two groups; MBSR, including three main types of mindfulness skills: body scan exercises, sitting meditation, and yoga exercises or PMR (progressive muscle relaxation) in which participants received lifestyle advice plus a muscle-relaxation activity Both treatments were delivered in group format. Treatment sessions were administered by one treatment provider and lasted approximately 2.5 hours each week for eight weeks. Patients in the MBSR group were encouraged to perform mindfulness exercises at home.
Patients in the mindfulness-based intervention group had significant reductions in clinic-based blood pressure measurements, a 4.8-mm Hg. The PMR group only saw a reduction of 0.7-mm Hg.
Diastolic blood pressure, the bottom number, which is also the lower of the two numbers, measures the pressure in the arteries between heartbeats (when the heart muscle is resting between beats and refilling with blood) had seen a reduction in the MBSR group of 1.9-mm Hg, where the PMR group saw a increase of 1.2-mm Hg.
MBSR did not result in larger decreases in ambulatory BP than in PMR. Ambulatory blood pressure is measured over twenty-four hours using auscultatory or oscillometry and requires use of a cuff. The monitor takes blood pressures every 20 minutes (less frequently overnight, eg 1-hourly).
In their conclusion the researchers write “MBSR resulted in a reduction in clinic SBP and DBP compared with PMR.”
According to Dr. Hughes "Mindfulness-based stress reduction is an increasingly popular practice that has been purported to alleviate stress, treat depression and anxiety, and treat certain health conditions.” It has been suggested that MBSR and other types of meditation may be useful in lowering blood pressure. Previous studies have reported small but significant reductions in blood pressure with Transcendental Meditation; the new study is the first to specifically evaluate the blood pressure effects of mindfulness-based intervention in patients with prehypertension.
Even though the blood pressure reductions associated with mindfulness-based interventions are modest, they are similar to many drug interventions and potentially large enough to lead to reductions in the risk of heart attack or stroke. Further studies are needed to see if the blood pressure-lowering effects are sustained over time.
The researchers contend that mindfulness-based interventions may provide a useful alternative to help "prevent or delay" the need for antihypertensive medications in patients with borderline high blood pressure.
This study is published in the October issue of Psychosomatic Medicine: Journal of Biobehavioral Medicine, the official journal of the American Psychosomatic Society.
ClinicalTrials.gov identifier: NCT00440596.