Randomized controlled trial of mindfulness-based stress reduction for prehypertension

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: MBSR resulted in a reduction in clinic SBP and DBP compared with PMR. Trial Registration ClinicalTrials.gov identifier: NCT00440596.

Keywords: MBSR; blood pressure; clinical trial; meditation; mindfulness; prehypertension.

Conflict of interest statement

Conflicts of interest: None declared.

Figures

Figure 1

CONSORT Chart

Figure 2

Patient accrual from recruiting efforts and eligibility screening

Figure 3. Change in clinic Blood Pressure by Treatment (Intent-to-treat)

Mean change in clinic systolic and diastolic blood pressure from pretreatment to posttreatment. Error bars represent the standard error of the mean. PMR = progressive muscle relaxation. MBSR = mindfulness-based stress reduction.