Online mindfulness as a promising method to improve exercise capacity in heart disease: 12-month follow-up of a randomized controlled trial
Rinske A. Gotink, John O. Younge, Machteld F. Wery, Elisabeth M. W. J. Utens, Michelle Michels, Dimitris Rizopoulos, Liesbeth F. C. van Rossum, Jolien W. Roos‐Hesselink, M. G. Myriam Hunink
PLoS One May 9, 2017 DOI: 10.1371/journal.pone.0175923 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 324 |
| Population | Patients with heart disease (mean age 43.2 years, 53.7% male) |
| Duration | 3-month intervention, 12-month follow-up |
| Measures | 6 minute walk test (6MWT), blood pressure, heart rate, respiratory rate, NT-proBNP, cortisol levels, SF-36, HADS, PSS, PSSS12 |
| Topics | Meditation |
| Citations | 52 |
| Key findings | At 12-month follow-up, online mindfulness training showed a trend toward improved exercise capacity (6MWT: 17.9 meters, p = 0.055) and small significant improvements in exercise capacity, systolic blood pressure, mental functioning, and depressive symptomatology compared with usual care; all other outcomes did not change significantly. In an as-treated analysis, systolic blood pressure decreased by 5.5 mmHg. |
Abstract
There is increasing evidence that mindfulness can reduce stress, and thereby affect other psychological and physiological outcomes as well. Earlier, we reported the direct 3-month results of an online modified mindfulness-based stress reduction training in patients with heart disease, and now we evaluate the effect at 12-month follow-up. 324 patients (mean age 43.2 years, 53.7% male) were randomized in a 2:1 ratio to additional 3-month online mindfulness training or to usual care alone. The primary outcome was exercise capacity measured with the 6 minute walk test (6MWT). Secondary outcomes were blood pressure, heart rate, respiratory rate, NT-proBNP, cortisol levels (scalp hair sample), mental and physical functioning (SF-36), anxiety and depression (HADS), perceived stress (PSS), and social support (PSSS12). Differences between groups on the repeated outcome measures were analyzed with linear mixed models. At 12-months follow-up, participants showed a trend significant improvement exercise capacity (6MWT: 17.9 meters, p = 0.055) compared to UC. Cohen's D showed significant but small improvement on exercise capacity (d = 0.22; 95%CI 0.05 to 0.39), systolic blood pressure (d = 0.19; 95%CI 0.03 to 0.36), mental functioning (d = 0.22; 95%CI 0.05 to 0.38) and depressive symptomatology (d = 0.18; 95%CI 0.02 to 0.35). All other outcome measures did not change statistically significantly. In the as-treated analysis, systolic blood pressure decreased significantly with 5.5 mmHg (p = 0.045; d = 0.23 (95%CI 0.05-0.41)). Online mindfulness training shows favorable albeit small long-term effects on exercise capacity, systolic blood pressure, mental functioning, and depressive symptomatology in patients with heart disease and might therefore be a beneficial addition to current clinical care. TRIAL REGISTRATION: www.trialregister.nl NTR3453.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 13
- A Framework for the Empirical Investigation of Mindfulness Meditative Development Mindfulness April 13, 2023
- Mindfulness-Based Interventions for Physical and Psychological Wellbeing in Cardiovascular Diseases: A Systematic Review and Meta-Analysis Brain Sciences May 29, 2021
- Meditation for the primary and secondary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews February 15, 2024
- Online mindfulness interventions in the care of people with physical and mental health conditions: a scoping review. BMJ Open July 18, 2025
- Mindful Jazz and Preferred Music Interventions Reduce Pain Among Patients With Chronic Pain and Anxiety: A Pilot Randomized Controlled Trial. Cureus March 1, 2025
and 8 more in the library
Cites 11
- Mindfulness: A proposed operational definition. Clinical Psychology Science and Practice 2004
- Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology Science and Practice 2003
- Meditation Programs for Psychological Stress and Well-being JAMA Internal Medicine January 6, 2014
- Standardised Mindfulness-Based Interventions in Healthcare: An Overview of Systematic Reviews and Meta-Analyses of RCTs PLoS One April 16, 2015
- Effects of Brief and Sham Mindfulness Meditation on Mood and Cardiovascular Variables The Journal of Alternative and Complementary Medicine July 28, 2010
and 6 more in the library