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

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.