DOI: 10.3886/e131103v1
title: Mindfulness practice improves health behavior and lowers blood pressure in hypertension

description: 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 low to these interventions is low. We tested whether a Mindful Awareness Program (MAP) could improve BP and lifestyle behaviors associated with HTN and compared to a Health Promotion Program (HPP). Adults with BP &gt;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. This study included adults (MAP n=20, HPP n=16) with BP of &gt;120/80, mean age of 60.8±11.5 years. There was a MAP-HPP between-group difference in interactions of time-by-systolic BP (p=0.005) and time-by-diastolic BP (p=0.003). The twelve-week SBP reduction for MAP was 19 mmHg (138±15mmHg–119±6mmHg) compared to 7mmHg (134±18mmHg–127±22mmHg) for HPP. MAP showed a DBP 12mmHg reduction (89±11mmHg–77±7 mmHg) and HPP showed 1mmHg reduction (81±16 mmHg–80±18 mmHg). The MAP group showed a greater reduction in BP at the end of 12 weeks compared to the HPP group. 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 mindfulness practice has a modest positive influence on lifestyle behavior change, which partially explains the greater reduction in BP by the MAP group. Our findings suggest mindfulness practice may improve BP control in adults with HTN.
description: Response Rates: Enrollment was throughout the University of California, Los Angeles (UCLA), UCLA medical center, and the greater Los Angeles area. There were 46 adults randomized of the 82 that were assessed for eligibility. The remainder 36 adults were excluded for the following reasons: 7 did not meet inclusion criteria, 5 declined to participate, and 24 did not complete the screening process The intervention group had 26 adults and the attention-control group had 20 adults. The final analysis consisted of 20 participants in the intervention group and 16 participants (ID CON15 removed from analysis) in the attention-control group.
description: Presence of Common Scales: The Rapid Eating and Activity Assessment for Patients questionnaire, a 30-item Likert-type scale was used to collect diet and exercise behavior. Brief Medication Questionnaire for medication adherence intake. Also, a Likert-type scale. Blood pressure measurements were taken using the blood pressure monitor (Omron 3 series). The mindfulness practice minutes were logged in daily practice minutes.
description: on-site questionnaire; other; All were self-reported questionnaires. Blood pressure measurements are separated by systolic and diastolic blood pressure readings. Mindfulness practice was recorded in minutes.
description: Adult noninstitutionalized population with high blood pressure in the greater Los Angeles, CA area. Smallest Geographic Unit: Los Angeles County
description: This study is a convenience sampling, mostly surrounding the UCLA campus and medical sample.