Hypertension

Tai Chi and Qigong Reduce Anxiety and Stress in Patients with Diabetes or Hypertension

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graphic file with name 2317-6385-eins-23-eAO1076-gf01.jpg

By John M. de Castro, Ph.D.

 

In today’s Research News article “Effects of Tai Chi and Qigong intervention on anxiety and stress in diabetic and hypertensive Brazilian patients: a randomized controlled trial” (See summary below or view the full text of the study at: https://pmc.ncbi.nlm.nih.gov/articles/PMC12002851/ )  Santos and colleagues examined the effects of a 13 week Tai Chi and Qigong intervention on the psychological health of patients with diabetes or hypertension. They found that Tai Chi and Qigong significantly reduced the levels of anxiety and stress in these patients.

 

Reduce anxiety and stress in patients with diabetes or hypertension with Tai Chi and Qigong.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on the Contemplative Studies Blog  http://contemplative-studies.org

 

Study Summary

 

Santos LRAC, Taíra A, Possobon RF, Meneghim MC, Su CL, Lavin P, Rej S, Ambrosano GMB, Cortellazzi KL. Effects of Tai Chi and Qigong intervention on anxiety and stress in diabetic and hypertensive Brazilian patients: a randomized controlled trial. Einstein (Sao Paulo). 2025 Mar 24;23:eAO1076. doi: 10.31744/einstein_journal/2025AO1076. PMID: 40353827; PMCID: PMC12002851.

 

In Brief

A 13-week Tai Chi/Qigong intervention reduced anxiety and stress in middle-aged and older Brazilian patients with diabetes and hypertension. With significant improvements in the State-Trait Anxiety Inventory and PSS14 scores, this practice shows potential as an effective adjunctive therapy in primary care.

ABSTRACT

Objective:

This study investigated the effects of Tai Chi/Qigong practice over 13 weeks on anxiety and perceived stress levels in middle-aged or older Brazilian hypertensive and diabetic individuals assisted in a primary healthcare setting.

Methods:

Ninety-one patients with diabetes mellitus and/or hypertension diagnosed and followed up at a primary care center were randomized to the Tai Chi/Qigong intervention (n = 45) or waitlist (n = 46) group for 13 weeks. Outcome measures were collected at baseline and at 6 and 13 weeks for anxiety (State-Trait Anxiety Inventory [STAI]) and stress (Perceived Stress Scale – PSS14). The primary endpoint of the study was 13 weeks. We used a linear mixed-effects model to analyze the primary and secondary outcomes, considering the treatment group and time as covariates and treating the subject as a random effect.

Results:

Of the included 91 participants, 53 completed the 6-week assessment, and 42 completed the 13-week assessment. After 13 weeks, the Tai Chi/Qigong Group had lower scores for anxiety (STAI Estimate = -6.421; SD = 2.679; 95% confidence interval (95%CI) = [-11.615,-1.224]; p = 0.018) and stress (PSS14 Estimate = -9.290; SD= 2.262; 95%CI= [-13.678,-4.906]; p<0.001).

Conclusion:

A 13-week Tai Chi/Qigong intervention was efficacious in lowering anxiety and perceived stress scores in middle-aged and older patients with diabetes mellitus and hypertension and can potentially be used in primary care centers as an adjunct therapy.

 

Highlights

A 13-week Tai Chi/Qigong program significantly reduced anxiety and stress in Brazilian patients with diabetes and hypertension.

Tai Chi/Qigong offers an effective complementary therapy to improve health outcomes in primary care settings.

This study highlights the potential of Tai Chi/Qigong for enhancing mental and physical well-being in chronic disease management.

 

Promoting Spirituality Improves Blood Pressure in Hypertensive Patients

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Spirituality, religion linked to heart health among Black Americans | National Institutes of Health (NIH)

By John M. de Castro, Ph.D.

 

In today’s Research News article “Spirituality-Based Intervention in Hypertension: EFfects on Blood PrEssure and EndotheliaL Function-FEEL Trial Results” (See summary below or view the full text of the study at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11759529/) Teixeira and colleagues compared the effectiveness of an online based spirituality intervention to a routine care control condition on patients with hypertension. Hey found that the spirituality intervention produced significant reductions in systolic blood pressure and flow mediated dilation.

 

Spirituality improved blood pressure in patients with hypertension.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on the Contemplative Studies Blog  http://contemplative-studies.org

 

Study Summary

 

Teixeira MEF, Barroso WKS, Brandão AA, et al. Spirituality-Based Intervention in Hypertension: EFfects on Blood PrEssure and EndotheliaL Function-FEEL Trial Results. Glob Heart. 2025;20(1):6. Published 2025 Jan 21. doi:10.5334/gh.1390

 

Abstract

Background:

Emerging evidence suggests that spirituality improves patient outcomes, however, this has undergone only limited evaluation in randomized trials. Hypertension is a major cause of cardiovascular morbidity and mortality worldwide.

Objectives:

To evaluate whether a spirituality-based intervention, compared to a control group, can reduce blood pressure (BP) and improve endothelial function after 12 weeks in patients with mild or moderate hypertension (HTN).

Methods:

Open randomized controlled trial of adults with stage I or II hypertension. Following baseline evaluation, including lifestyle questionnaires, and measurements of office and central blood pressure (BP), home blood pressure monitoring (HBPM) and flow mediated dilation (FMD), patients were randomized to a spirituality-based intervention, which included training for forgiveness, gratitude, optimism, and life purpose delivered by daily WhatsApp communications, or to the control group (CG). Main outcomes were between group difference in change from baseline to 12 weeks in office and central BP, HBPM and FMD, using t-tests, analyses of covariance (ANCOVA) adjusting for baseline differences, and, in addition, missing data imputation as a sensitivity analysis.

Results:

Fifty-one patients were randomized to spirituality-based intervention and 49 to control group. Baseline characteristics were well balanced between groups. Spirituality training, compared with control, improved 7.6 mmHg office systolic blood pressure (SBP), 4.1 mmHg central SBP and 4.1 percentage points FMD. Compared to control group, t-test demonstrated statistical significance for office SBP (–7.04 mmHg, p = 0.047) and FMD (7.46 percentage points, p < 0.001), and ANCOVA adjustment for baseline differences showed statistical significance for central SBP (–6.99 mmHg, p = 0.038) and FFMD (7.95 percentage points, p < 0.001) There was no significant effect on HBPM.

Conclusion:

A spirituality-based intervention was associated with improved control of office SBP and FMD. These findings will be prospectively evaluated in a nationwide larger and well-powered RCT.

 

Improve Psychological Well-Being in Patients with Diabetes or Hypertension with Tai Chi and Qigong

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graphic file with name 2317-6385-eins-23-eAO1076-gf01.jpg

By John M. de Castro, Ph.D.

 

In today’s Research News article “Effects of Tai Chi and Qigong intervention on anxiety and stress in diabetic and hypertensive Brazilian patients: a randomized controlled trial” (See summary below or view the full text of the study at: https://pmc.ncbi.nlm.nih.gov/articles/PMC12002851/ ) Santos and colleagues examined the psychological impact of Tai Chi and Qigong practice on patients with diabetes and/or hypertension. They found that the practices significantly reduced anxiety and stress in the patients.

 

Tai Chi and Qigong practice reduces anxiety and stress in patients with diabetes and/or hypertension.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on the Contemplative Studies Blog  http://contemplative-studies.org

 

Study Summary

 

Santos LRAC, Taíra A, Possobon RDF, et al. Effects of Tai Chi and Qigong intervention on anxiety and stress in diabetic and hypertensive Brazilian patients: a randomized controlled trial. Einstein (Sao Paulo). 2025;23:eAO1076. Published 2025 Mar 17. doi:10.31744/einstein_journal/2025AO1076

 

In Brief

A 13-week Tai Chi/Qigong intervention reduced anxiety and stress in middle-aged and older Brazilian patients with diabetes and hypertension. With significant improvements in the State-Trait Anxiety Inventory and PSS14 scores, this practice shows potential as an effective adjunctive therapy in primary care.

ABSTRACT

Objective:

This study investigated the effects of Tai Chi/Qigong practice over 13 weeks on anxiety and perceived stress levels in middle-aged or older Brazilian hypertensive and diabetic individuals assisted in a primary healthcare setting.

Methods:

Ninety-one patients with diabetes mellitus and/or hypertension diagnosed and followed up at a primary care center were randomized to the Tai Chi/Qigong intervention (n = 45) or waitlist (n = 46) group for 13 weeks. Outcome measures were collected at baseline and at 6 and 13 weeks for anxiety (State-Trait Anxiety Inventory [STAI]) and stress (Perceived Stress Scale – PSS14). The primary endpoint of the study was 13 weeks. We used a linear mixed-effects model to analyze the primary and secondary outcomes, considering the treatment group and time as covariates and treating the subject as a random effect.

Results:

Of the included 91 participants, 53 completed the 6-week assessment, and 42 completed the 13-week assessment. After 13 weeks, the Tai Chi/Qigong Group had lower scores for anxiety (STAI Estimate = -6.421; SD = 2.679; 95% confidence interval (95%CI) = [-11.615,-1.224]; p = 0.018) and stress (PSS14 Estimate = -9.290; SD= 2.262; 95%CI= [-13.678,-4.906]; p<0.001).

Conclusion:

A 13-week Tai Chi/Qigong intervention was efficacious in lowering anxiety and perceived stress scores in middle-aged and older patients with diabetes mellitus and hypertension and can potentially be used in primary care centers as an adjunct therapy.

 

Yoga is Associated with Lower Rates of Multimorbidity in Adults over 45

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Flexibility exercises, like yoga, can help maintain mobility as you age.

By John M. de Castro, Ph.D.

 

In today’s Research News article “Association between yoga and multimorbidity: a nationwide study of 279,885 middle-aged and older adults” (See summary below or view the full text of the study at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11884150/ ) Wang and colleagues examined practice of yoga and the likelihood of adults over 45 years of age having multiple diseases, including obesity, diabetes, hyperlipidemia, and hypertension. They found that the higher the duration and frequency of yoga practice the less the likelihood that the adult will have multiple diseases simultaneously.

 

Yoga practice is associated with lower risk of multimorbidity in older adults.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on the Contemplative Studies Blog  http://contemplative-studies.org

 

Study Summary

 

Wang K, Wang P, Li Y, Wang C, Veldheer S, Wang F, Na M, Sun L, Gao X. Association between yoga and multimorbidity: a nationwide study of 279,885 middle-aged and older adults. BMC Public Health. 2025 Mar 6;25(1):888. doi: 10.1186/s12889-025-22035-5. PMID: 40050815; PMCID: PMC11884150.

Abstract

Background

The health benefits of exercise have been well-established, but the specific role of yoga in multimorbidity was less understood. This study aimed to examine the association between yoga and multimorbidity in comparison with other exercises or non-exercise.

Methods

This cross-sectional study pooled nationally representative surveys from Behavioral Risk Factor Surveillance System (BRFSS) (2015, 2017, and 2019), and classified 279,885 participants aged 45 + years as yoga practitioners, other exercisers, and non-exercisers. Multinominal and binary logistic regressions were separately used for association of yoga with multimorbidity (coexistence of ≥ 2 conditions) and individual chronic conditions. Potential effect modification by age, sex, education level, and race/ethnicity was examined. We further assessed the dose-response association of duration and frequency of yoga practice with multimorbidity.

Results

The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for yoga practitioners (n = 5081) vs. other exercisers (n = 192,718) were 0.69 (95% CI 0.55–0.86) for coexistence of two conditions, and 0.72 (95%CI 0.58–0.89) for coexistence of ≥ 3 conditions. The associations were stronger (ORs ranged from 0.43 to 0.52; P < 0.0001 for all) when comparing yoga practitioners with non-exercisers (n = 82,086), which were more pronounced in women relative to men (P-interaction < 0.05). Increased duration or frequency of yoga practice was associated with lower odds of multimorbidity in a dose-response manner (P for trend<0.0001 for all). Similar inverse associations were observed between yoga and individual chronic conditions.

Conclusion

Yoga was associated with lower odds of multimorbidity in middle-aged and older adults, relative to other exercises or non-exercise.

 

Spirituality Reduces Blood Pressure in Hypertensive Patients

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What is Spirituality? | Read & Be Well | Canyon Ranch

By John M. de Castro, Ph.D.

 

In today’s Research News article “Spirituality-Based Intervention in Hypertension: EFfects on Blood PrEssure and EndotheliaL Function—FEEL Trial Results” (See summary below or view the full text of the study at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11759529/) Teixeira and colleagues trained hypertensive patients in spirituality including training in forgiveness, gratitude, optimism, and life purpose. Compared to an untrained control group, the training resulted in significant decreases in systolic blood pressure.

 

So, improve hypertension with spirituality.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on the Contemplative Studies Blog  http://contemplative-studies.org

 

Study Summary

 

Teixeira MEF, Barroso WKS, Brandão AA, Sousa ALL, Esporcatte R, de Borba MHE, Baleeiro ACNÁ, Gonçalves BC, Inumaru E, de Sousa EM, Leal GB, de Araújo Pereira Farias HS, de Souza JA, da Silva LEB, de Paiva Queiroz MC, Moreira FR, de Oliveira Vitorino PV, Eikelboom J, Avezum Á. Spirituality-Based Intervention in Hypertension: EFfects on Blood PrEssure and EndotheliaL Function—FEEL Trial Results. Glob Heart. 2025 Jan 21;20(1):6. doi: 10.5334/gh.1390. PMCID: PMC11759529.

 

Abstract

Background:

Emerging evidence suggests that spirituality improves patient outcomes, however, this has undergone only limited evaluation in randomized trials. Hypertension is a major cause of cardiovascular morbidity and mortality worldwide.

Objectives:

To evaluate whether a spirituality-based intervention, compared to a control group, can reduce blood pressure (BP) and improve endothelial function after 12 weeks in patients with mild or moderate hypertension (HTN).

Methods:

Open randomized controlled trial of adults with stage I or II hypertension. Following baseline evaluation, including lifestyle questionnaires, and measurements of office and central blood pressure (BP), home blood pressure monitoring (HBPM) and flow mediated dilation (FMD), patients were randomized to a spirituality-based intervention, which included training for forgiveness, gratitude, optimism, and life purpose delivered by daily WhatsApp communications, or to the control group (CG). Main outcomes were between group difference in change from baseline to 12 weeks in office and central BP, HBPM and FMD, using t-tests, analyses of covariance (ANCOVA) adjusting for baseline differences, and, in addition, missing data imputation as a sensitivity analysis.

Results:

Fifty-one patients were randomized to spirituality-based intervention and 49 to control group. Baseline characteristics were well balanced between groups. Spirituality training, compared with control, improved 7.6 mmHg office systolic blood pressure (SBP), 4.1 mmHg central SBP and 4.1 percentage points FMD. Compared to control group, t-test demonstrated statistical significance for office SBP (–7.04 mmHg, p = 0.047) and FMD (7.46 percentage points, p < 0.001), and ANCOVA adjustment for baseline differences showed statistical significance for central SBP (–6.99 mmHg, p = 0.038) and FFMD (7.95 percentage points, p < 0.001) There was no significant effect on HBPM.

Conclusion:

A spirituality-based intervention was associated with improved control of office SBP and FMD. These findings will be prospectively evaluated in a nationwide larger and well-powered RCT.

Reduce Hypertension with Mindfulness

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Reduce Hypertension with Mindfulness

 

By John M. de Castro, Ph.D.

 

“High blood pressure is a silent killer. It can strike without warning, but with proper care and lifestyle changes, it can be controlled.” – Dr. David B. Ryder

 

High Blood Pressure (Hypertension) is an insidious disease because there are no overt symptoms. The individual feels fine. But it can be deadly as more than 360,000 American deaths, roughly 1,000 deaths each day, had high blood pressure as a primary or contributing cause. In addition, hypertension markedly increases the risk heart attack, stroke, heart failure, and kidney disease.  It is also a very common disorder with about 70 million American adults (29%) having high blood pressure and only about half (52%) of people with high blood pressure have their condition under control. Treatment frequently includes antihypertensive drugs. But these medications often have adverse side effects. So, patients feel lousy when taking the drugs, but fine when they’re not. So, compliance is a major issue with many patients not taking the drugs regularly or stopping entirely. Obviously, there is a need for alternative to drug treatments for hypertension. Mindfulness practices have been shown to aid in controlling hypertension.

 

In today’s Research News article “Effect of Adapted Mindfulness Training in Participants With Elevated Office Blood Pressure: The MB-BP Study: A Randomized Clinical Trial” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381983/ ) Loucks and colleagues recruited adults with elevated blood pressure and randomly assigned them to either enhanced usual care or to receive Mindfulness-Based Blood Pressure Reduction, based upon Mindfulness-Based Stress Reduction (MBSR) program, consisting of 8 weekly 2,5 hour group sessions along with home mindfulness practice. The participants were measured at baseline and at 3 and 6 months later for blood pressure, health behaviors, physical activity, diet, alcohol consumption, antihypertensive medication, perceived stress, and mindfulness.

 

They found that mindfulness training produced a significantly greater reduction in blood pressure at 3 and 6 months. They also found significant reductions in sedentary activity and perceived stress and a significant increase in mindfulness.

 

Hence, mindfulness training was found to be an effective treatment for hypertension.

 

“The secret to managing blood pressure is a healthy lifestyle”– Dr. Andrew Hall

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on the Contemplative Studies Blog  http://contemplative-studies.org

 

Study Summary

 

Loucks EB, Schuman-Olivier Z, Saadeh FB, Scarpaci MM, Nardi WR, Proulx JA, Gutman R, King J, Britton WB, Kronish IM. Effect of Adapted Mindfulness Training in Participants With Elevated Office Blood Pressure: The MB-BP Study: A Randomized Clinical Trial. J Am Heart Assoc. 2023 Jun 6;12(11):e028712. doi: 10.1161/JAHA.122.028712. Epub 2023 May 23. PMID: 37218591; PMCID: PMC10381983.

 

Clinical Perspective

What Is New?

This study represents the first randomized controlled trial of a mindfulness‐based program that has been customized to participants with elevated blood pressure.

What Are the Clinical Implications?

This study demonstrated a clinically significant reduction in systolic blood pressure, with evidence of effects on sedentary activity, Dietary Approaches to Stop Hypertension dietary pattern, and mindfulness.

This program may offer an appealing approach to help control blood pressure of the 46% of Americans with hypertension, of which >75% is uncontrolled.

 

Abstract

Background

Hypertension is a leading risk factor for cardiovascular disease. Despite availability of effective lifestyle and medication treatments, blood pressure (BP) is poorly controlled in the United States. Mindfulness training may offer a novel approach to improve BP control. The objective was to evaluate the effects of Mindfulness‐Based Blood Pressure Reduction (MB‐BP) versus enhanced usual care control on unattended office systolic BP.

Methods and Results

Methods included a parallel‐group phase 2 randomized clinical trial conducted from June 2017 to November 2020. Follow‐up time was 6 months. Outcome assessors and data analyst were blinded to group allocation. Participants had elevated unattended office BP (≥120/80 mm Hg). We randomized 201 participants to MB‐BP (n=101) or enhanced usual care control (n=100). MB‐BP is a mindfulness‐based program adapted for elevated BP. Loss‐to‐follow‐up was 17.4%. The primary outcome was change in unattended office systolic BP at 6 months. A total of 201 participants (58.7% women; 81.1% non‐Hispanic White race and ethnicity; mean age, 59.5 years) were randomized. Results showed that MB‐BP was associated with a 5.9‐mm Hg reduction (95% CI, −9.1 to −2.8 mm Hg) in systolic BP from baseline and outperformed the control group by 4.5 mm Hg at 6 months (95% CI, −9.0 to −0.1 mm Hg) in prespecified analyses. Plausible mechanisms with evidence to be impacted by MB‐BP versus control were sedentary activity (−350.8 sitting min/wk [95% CI, −636.5 to −65.1] sitting min/wk), Dietary Approaches to Stop Hypertension diet (0.32 score [95% CI, −0.04 to 0.67]), and mindfulness (7.3 score [95% CI, 3.0–11.6]).

Conclusions

A mindfulness‐based program adapted for individuals with elevated BP showed clinically relevant reductions in systolic BP compared with enhanced usual care. Mindfulness training may be a useful approach to improve BP.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381983/