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A systematic review and meta-analysis of mindfulness-based stress reduction for arterial hypertension

Journal of Human Hypertension volume 37, pages 161–169 (2023)Cite this article

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Abstract

Arterial hypertension is a major public health issue. Non-pharmacological approaches like Mindfulness-Based Stress Reduction (MBSR) might be a promising addition to conventional therapy. This systematic review and meta-analysis aim to evaluate the effects of MBSR on systolic (SBP) and diastolic blood pressure (DBP) among individuals with prehypertension or hypertension. We searched Medline/PubMed, Scopus and the Cochrane Central Register of Controlled Trials (CENTRAL) for randomized controlled trials (RCTs) from their inception until August 1st 2021. RCTs were included that compared MBSR to any control intervention in participants with diagnosed prehypertension (120–139/80–89 mmHg) or hypertension (≥140/≥90 mmHg). Mean differences (MD) and 95% confidence intervals (CI) were calculated. Risk of Bias was assessed using the Cochrane tool. Seven RCTs with 429 participants were included. Very low quality of evidence was found for positive effects of MBSR on SBP (MD = −11.26 mmHg, 95%CI = −20.24 to −2.29, p = 0.01) but no evidence for effects on DBP levels (MD = −3.62 mmHg, 95%CI = −8.52 to 1.29, p = 0.15) compared to waitlist control. Compared to active control, very low quality of evidence was found for positive effects on DBP (MD = −5.51 mmHg, 95%CI = −10.93 to −0.09, p = 0.05) but no effects on SBP levels (MD = −4.33 mmHg, 95%CI = −12.04 to 3.38, p = 0.27). Overall, the studies showed a high degree of heterogeneity. The effects found were robust against selection, detection, and attrition bias. Only one RCT reported safety data. MBSR may be an option for lowering blood pressure in people with prehypertension to hypertension. More and larger high-quality studies are needed to substantiate our findings.

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Fig. 1: Flow Chart of the study selection process.
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The dataset generated and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This research received no specific funding. WKK-H was supported by a scholarship by the Karl and Veronica Carstens-Foundation, grant number KVC 0/113/2020; HC was supported by Erich Ruthenfußer Stiftung.

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Authors and Affiliations

  1. Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany

    Christoph Geiger, Gustav Dobos & Wiebke Kathrin Kohl-Heckl

  2. Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany

    Holger Cramer

  3. Bosch Health Campus, Stuttgart, Germany

    Holger Cramer

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  1. Christoph Geiger
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WKK and CG were responsible for material preparation, analysis, interpreting the results, and writing the report. WKK and CG also conducted the data collection and analysis. HC and GD contributed to writing the report and supported the interpretation of the results. HC also reviewed the report. All authors read and approved the final manuscript.

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Correspondence to Wiebke Kathrin Kohl-Heckl.

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Geiger, C., Cramer, H., Dobos, G. et al. A systematic review and meta-analysis of mindfulness-based stress reduction for arterial hypertension. J Hum Hypertens 37, 161–169 (2023). https://doi.org/10.1038/s41371-022-00764-z

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