Reduce Hypertension with a Mindfulness Smartphone App
By John M. de Castro, Ph.D.
“Investigators found mindfulness was associated with a significant decrease in systolic blood pressure at 1 year and had other gains including better adherence to a recommended diet, lower salt intake, reduced alcohol consumption, and increased physical activity.” – Damian McNamara
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. The vast majority of the mindfulness training techniques, however, require a trained teacher. This results in costs that many patients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, Apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations.
In today’s Research News article “Impact of 12-Month Smartphone Breathing Meditation Program upon Systolic Blood Pressure among Non-Medicated Stage 1 Hypertensive Adults.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7143262/), Chandler and colleagues recruited adults with non-medicated stage 1 systolic hypertension; systolic blood pressure of 121–139 mmHg. They were randomly assigned to receive via smartphone app 3 months of either mindfulness training or health education. The mindfulness training app, Tension Tamer, employed twice daily practice of focused meditation for 10-15 minutes. The health education app, Runkeeper, delivered lifestyle health education messages focusing on exercise. They were measured before during and after training and 3 and 9 months later for systolic and diastolic blood pressure.
They found that the mindfulness trained group had greater reductions in systolic and diastolic blood pressure at the end of training and 9 months later. In addition, a greater proportion of mindfulness trained participants achieved reductions sufficient to remove them from being classified as having stage 1 systolic hypertension.
There were no significant differences found in perceived stress. Even though mindfulness training has been shown in prior studies to reduce perceived stress, it does not appear to be responsible for decrease blood pressure in the present study. Measures of heart rate during the meditation practice revealed significant decreases in heart rate over the session. This suggests that the mindfulness training was successful in reducing blood pressure by increasing relaxation perhaps by increasing the activity of the parasympathetic component of the autonomic nervous system.
So, reduce hypertension with a mindfulness smartphone app.
“mindfulness meditation in combination with conventional medication treatment reduces blood pressure and stress levels, while improving mindfulness and mood more than medication coupled with health education.” – goamra.org
CMCS – Center for Mindfulness and Contemplative Studies
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Chandler, J., Sox, L., Diaz, V., Kellam, K., Neely, A., Nemeth, L., & Treiber, F. (2020). Impact of 12-Month Smartphone Breathing Meditation Program upon Systolic Blood Pressure among Non-Medicated Stage 1 Hypertensive Adults. International journal of environmental research and public health, 17(6), 1955. https://doi.org/10.3390/ijerph17061955
(1) Background: Hypertension (HTN) affects ~50% of adults and is a major risk factor for stroke and cardiovascular disease. In 2017, the SPRINT trial outcomes led to lowering of HTN cutoffs by the American College of Cardiology (ACC) and American Heart Association (AHA). The Joint National Committee (JNC8) and National High BP Education Program recommend that lifestyle modifications be used as first-line HTN treatment. Chronic stress is a risk factor for HTN and cardiovascular disease. A recently completed 12 month randomized controlled trial (RCT) of a breathing meditation smart phone app (Tension Tamer, TT) involving JNC8 designated pre-HTN adults provided an opportunity to examine its impact upon individuals now classified as having stage 1 HTN. The TT app captures continuous real-time heart rate (HR) from a user’s fingertip placed over a video camera lens during sessions. Users receive immediate feedback graphs after each session, showing their HR changes. They also receive motivational and social reinforcement SMS text messages the following day based upon levels of adherence. We conducted ancillary analyses of a 2-arm, 12-month, small-scale efficacy RCT among a subgroup of our total sample of participants, who are now classified as having stage 1 non-medicated systolic HTN. Primary outcome was change in resting systolic blood pressure (SBP). Secondary outcomes were change in resting diastolic blood pressure, adherence to the TT protocol, and perceived stress levels. (2) Methods: 30 adults (mean age: 45.0 years; 15 males; 16 White; 14 Black) with ACC/AHA 2017 defined systolic HTN (130–139 mmHg) on 3 consecutive sessions (mean SBP: 132.6 mmHg) were randomly assigned to TT or lifestyle education program delivered via smartphone (SPCTL). Each group received a twice-daily dosage schedule of TT or walking (month 1: 15 min; months 2 and 3: 10 min; months 4–12: 5 min). (3) Results: Mixed modeling results revealed a significant group x time effect for SBP (p<.01). The TT group showed greater SBP reductions at months 3 (−8.0 vs. −1.9), 6 (−10.0 vs. −0.7), and 12: (−11.6 vs. −0.4 mmHg; all p-values <0.04). (4) Conclusion: The TT app was beneficial in reducing SBP levels among adults with stage 1 systolic HTN. The TT app may be a promising, scalable first-line tactic for stage 1 HTN. Preparations are underway for an efficacy RCT involving uncontrolled stage 1 HTN patients.