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Randomized Controlled Trial of Mindfulness-Based Stress Reduction for Prehypertension

Hughes, Joel W. PhD; Fresco, David M. PhD; Myerscough, Rodney PhD; H. M. van Dulmen, Manfred PhD; Carlson, Linda E. PhD; Josephson, Richard MS, MD

Psychosomatic Medicine:
doi: 10.1097/PSY.0b013e3182a3e4e5
Original Articles

Objective: Mindfulness-based stress reduction (MBSR) is an increasingly popular practice demonstrated to alleviate stress and treat certain health conditions. MBSR may reduce elevated blood pressure (BP). Treatment guidelines recommend life-style modifications for BP in the prehypertensive range (systolic BP [SBP] 120–139 mm Hg or diastolic BP [DBP] 80–89 mm Hg), followed by antihypertensives if BP reaches hypertensive levels. MBSR has not been thoroughly evaluated as a treatment of prehypertension. A randomized clinical trial of MBSR for high BP was conducted to determine whether BP reductions associated with MBSR exceed those observed for an active control condition consisting of progressive muscle relaxation (PMR) training.

Methods: Fifty-six men (43%) and women (57%) averaging (standard deviation) 50.3 (6.5) years of age (91% white) with unmedicated BP in the prehypertensive range were randomized to 8 weeks of MBSR or PMR delivered in a group format. Treatment sessions were administered by one treatment provider and lasted approximately 2.5 hours each week. Clinic BP was the primary outcome measure. Ambulatory BP was a secondary outcome measure.

Results: Analyses were based on intent to treat. Patients randomized to MBSR exhibited a 4.8-mm Hg reduction in clinic SBP, which was larger than the 0.7-mm Hg reduction observed for PMR (p = .016). Those randomized to MBSR exhibited a 1.9-mm Hg reduction in DBP compared with a 1.2-mm Hg increase for PMR (p = .008). MBSR did not result in larger decreases in ambulatory BP than in PMR.

Conclusions: MBSR resulted in a reduction in clinic SBP and DBP compared with PMR.

Trial Registration: identifier: NCT00440596.

Author Information

From the Kent State University (J.W.H., D.M.F., M.H.M.v.D), Kent, Ohio; Summa Health System (J.W.H., R.M.), Akron, Ohio; University of Calgary (L.E.C.), Calgary, Alberta, Canada; Harrington Heart & Vascular Institute (R.J.), University Hospitals Case Medical Center, Cleveland, Ohio; and Department of Medicine (R.J.), Case Western Reserve University School of Medicine, Cleveland, Ohio.

Address correspondence and reprint requests to Joel W. Hughes, PhD, Department of Psychology, PO Box 5190, Kent, OH 44242. E-mail:

Received for publication September 20, 2011; revision received May 31, 2013.

Copyright © 2013 by American Psychosomatic Society

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