Mindfulness-Based Interventions for Adults with Cardiovascular Disease: A Systematic Review and Meta-Analysis
Open accessAbstract
Background: Individuals with cardiovascular disease (CVD) report psychological distress and poor physical functioning and may benefit from mindfulness training. Purpose: To examine the effects of mindfulness-based interventions (MBIs) on psychological and physiological measures in adults with CVD using meta-analysis. Methods: Comprehensive searches identified studies that (a) evaluated MBIs in adults with CVD or who had experienced a cardiac event, (b) included a comparison condition, and (c) assessed psychological (e.g., anxiety and depression) or physiological (e.g., systolic or diastolic blood pressure [BP]) outcomes. Independent raters coded methodological (e.g., design and quality) and intervention features (e.g., intervention content) as potential moderators. Weighted mean effect sizes (d+), using full information maximum likelihood estimation, were calculated. Results: Of the 1,507 records reviewed, 16 studies met inclusion criteria (N = 1,476; M age = 56 years; 40% women). Compared to controls, participants who received an MBI reported greater improvements in psychological outcomes (i.e., anxiety, depression, distress, and perceived stress: d+s = 0.49 to 0.64). MBI recipients also reduced their systolic (d+ = 0.89, 95% confidence interval [CI] = 0.26, 1.51; k = 7) but not diastolic (d+ = 0.07, 95% CI = −0.47, 0.60; k = 6) BP relative to controls. Conclusions: MBIs demonstrated favorable effects on psychological and physiological outcomes among adults with CVD. Future research should investigate if such benefits lead to improvements in disease outcomes in studies with longer follow-ups.
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In non-pregnant adults with hypertension, mindfulness training reduces blood pressure and increases interoception.
“While recent evidence indicates that MT reduces blood pressure and increases interoception in non-pregnant adults with hypertension,14,25”
From Prenatal Mindfulness Training and Interoceptive Awareness in Pregnant People at Risk for Hypertensive Disorders. (2024) · cites this paper as [25]
The Discussion reports that mindfulness-based interventions lowered systolic blood pressure relative to controls in adults with cardiovascular disease, but found no significant between-group change in diastolic blood pressure. The Methods lists the outcomes assessed and does not include interoception; the findings are not specifically established for adults with hypertension. Page numbers are unavailable in our copy. (LLM, conf=0.89)
Experimental — accuracy not yet measuredPrevious meta-analyses of mindfulness-based interventions included randomized controlled trials with predominantly normotensive participants, diverse mindfulness program durations, nonmindfulness meditation techniques, and non-randomized studies, and their results were heterogeneous and difficult to interpret.
“these meta-analyses included randomized controlled trials (RCTs) with predominantly normotensive participants (ie, BP <130/80 mm Hg), included RCTs that investigated mindfulness programs of diverse duration (ie, ranging from a 1-day workshop to >10 weeks programs), included RCTs that used nonmindfulness meditation techniques and included non-RCTs; the majority of the results were, therefore,”
From Effect and Acceptability of Mindfulness-Based Stress Reduction Program on Patients With Elevated Blood Pressure or Hypertension: A Meta-Analysis of Randomized Controlled Trials (2020) · cites this paper as [20]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredReduction in office BP by MBIs was also reported by other systematic reviews.
“Despite differences in the MBIs and populations included, reduction in office BP by MBIs was also reported by other systematic reviews. 18-23”
From Effect and Acceptability of Mindfulness-Based Stress Reduction Program on Patients With Elevated Blood Pressure or Hypertension: A Meta-Analysis of Randomized Controlled Trials (2020) · cites this paper as [20]
The Discussion (page unavailable) reports that MBIs reduced systolic BP relative to controls in adults with cardiovascular disease. The Synthesis of Results (page unavailable) says the pooled studies included one using 24-hour ambulatory monitoring, and it does not report an office-BP-only effect; it also found no significant improvement in diastolic BP. Thus the review supports a reduction in systolic BP, but not the more specific claim of reduced office BP. (LLM, conf=0.85)
Experimental — accuracy not yet measuredMindfulness skills may offer a coping strategy that can be employed to manage forms of emotional arousal, such as stress and anxiety, thus reducing blood pressure via autonomic nervous system modulation.
“Mindfulness skills may offer a coping strategy that can be employed to manage forms of emotional arousal, such as stress and anxiety,33 thus reducing blood pressure via autonomic nervous system modulation.25,31”
From Prenatal Mindfulness Training and Interoceptive Awareness in Pregnant People at Risk for Hypertensive Disorders. (2024) · cites this paper as [25]
A recent systematic review including 16 studies concluded that mindfulness-based interventions led to greater improvements in negative psychological outcomes (eg, less anxiety, depression, stress) and reduced systolic blood pressure.
“A recent systematic review including 16 studies concluded that mindfulness-based interventions led to greater improvements in negative psychological outcomes (eg, less anxiety, depression, stress) and reduced systolic blood pressure. 219”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [219]
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Self-citation
- Authors
- Scott-Sheldon, L. A. J., Gathright, E. C., Donahue, M. L., Balletto, B., Feulner, M. M., DeCosta, J., Cruess, D. G., Wing, R. R., Carey, M. P., & Salmoirago-Blotcher, E.
- Affiliations
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Providence, RI, USA
- Brown University (US)
- Miriam Hospital (US)
- University of Connecticut (US)
- ORCID
- Venue
- Annals of Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-06-05
- Volume
- 54
- Issue
- 1
- Pages
- 67-73
- ISSN
- 0742-5554 (ISSN-L)
- 0883-6612
- 1532-4796
- PMC
- PMC6922300
- OpenAlex
- W2948213764
- Cited by
- 145
- References
- 55
- Citations by year
- 2026: 24 · 2025: 24 · 2024: 29 · 2023: 21 · 2022: 22 · 2021: 17 · 2020: 8
- FWCI
- 1.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Annals of Behavioral Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Complementary and Integrative Health
- National Institutes of Health (R01AT008815, T32 HL076134)
- National Heart, Lung, and Blood Institute
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- mindfulness-based interventions, cardiovascular disease, anxiety, depression, psychological distress, perceived stress, blood pressure, systolic blood pressure, diastolic blood pressure, cardiac events, psychological outcomes, physiological outcomes
- MeSH terms
- Psychological Distress, Anxiety, Blood Pressure, Cardiovascular Diseases, Depression, Humans, Stress, Psychological, Treatment Outcome, Mindfulness
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