A systematic review and meta-analysis of mindfulness-based stress reduction for arterial hypertension.
Christoph Geiger, Holger Cramer, Gustav J Dobos, Wiebke Kathrin Kohl-Heckl
Journal of Human Hypertension March 2023 DOI: 10.1038/s41371-022-00764-z (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review and meta-analysis Randomized Peer reviewed |
|---|---|
| Sample size | 429 |
| Population | Adults with diagnosed prehypertension (120-139/80-89 mmHg) or hypertension (>=140/>=90 mmHg) |
| Intervention | Mindfulness-Based Stress Reduction (MBSR) |
| Topics | Meditation |
| Key findings | Across seven randomized trials, MBSR was associated with lower systolic blood pressure versus waitlist control (mean difference -11.26 mmHg) and lower diastolic blood pressure versus active control (mean difference -5.51 mmHg), but not the reverse comparisons. The authors rate the evidence as very low quality, report high heterogeneity, and conclude that MBSR may be an option for lowering blood pressure but that more and larger high-quality studies are needed. |
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.
Comparable studies
Other systematic reviews and meta-analyses on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations | 2014 | Meta-analysis | n = 3,515 |
| Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects | 2009 | Systematic review and meta-analysis | |
| The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators | 2012 | Meta-analysis | n = 163 |
| Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission | 2016 | Meta-analysis of individual patient data from randomized controlled trials | n = 1,258 |
| Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials | 2011 | Systematic review |
Citations in the library
Cited by 5
- The Effects of Mindfulness-Based Interventions on Physiological Markers of Stress in Older Adults: A Systematic Review and Synthesis Mindfulness December 2, 2025
- Designing a meditation module to affect etiological and preventive factors in primary hypertensive patients-A pilot study. Physiological reports February 1, 2025
- iRest™ Meditation Webinar Series Addresses Depression Symptoms in Older Adults OBM Integrative and Complementary Medicine January 7, 2026
- Mindfulness based interventions for blood pressure reduction: systematic and umbrella review of existing meta-analyses. Journal of Human Hypertension June 30, 2026
- Effectiveness of Mindfulness-Based Stress Reduction (MBSR) Interventions on Mindfulness and Stress Symptoms for Cancer Patients: A Quantitative Assessment OBM Integrative and Complementary Medicine March 13, 2024
Cites 22
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- Is Mindfulness-Based Stress Reduction Effective for People with Hypertension? A Systematic Review and Meta-Analysis of 30 Years of Evidence. International Journal of Environmental Research and Public Health March 11, 2021
and 17 more in the library