Effects of the Mindfulness-Based Blood Pressure Reduction (MB-BP) program on depression and neural structural connectivity

Polcari, Justin J.; Cali, Ryan J.; Nephew, Benjamin C.; Lu, Senbao; Rashkovskii, Mikhail; Wu, Julianne; Saadeh, Frances; Loucks, Eric B.; King, Jean A.

doi:10.1016/j.jad.2022.05.059

Cited by 8 publications

(12 citation statements)

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“…37 The improvements in these regions were correlated with interoceptive awareness measured via the MAIA instrument, further supporting the role of interoception in the effect of MB-BP on hypertension-related well-being. 37 The results from focus groups and in-depth interviews of MB-BP participants suggested an ordering of mechanisms, where self-awareness often came first, a The 6-dimension mean excludes "not distracting"…”

Section: Discussionmentioning

confidence: 58%

“…Recent mechanistic findings from the MB-BP study, using diffusion tensor magnetic resonance imaging, demonstrated that regions of the brain typically damaged by hypertension had either significantly greater connectivity via improved mean diffusivity in the right fornix, or significantly lessened damage by lower radial diffusivity in the left cingulum, in MB-BP vs control . The improvements in these regions were correlated with interoceptive awareness measured via the MAIA instrument, further supporting the role of interoception in the effect of MB-BP on hypertension-related well-being . The results from focus groups and in-depth interviews of MB-BP participants suggested an ordering of mechanisms, where self-awareness often came first, followed by strategies to regulate attention or emotion regulation .…”

Section: Discussionmentioning

confidence: 80%

“…However, the observed effects of MB-BP on the MAIA domain of attention regulation in this study, which includes elements of attention control, are promising. Furthermore, the effects of MB-BP on depression symptoms and perceived stress reported elsewhere 10,37 suggest that MB-BP may engage emotion regulation pathways. Mechanistic evidence of MB-BP is emerging.…”

Section: Discussionmentioning

confidence: 92%

“…Emotion regulation can be applied to dietary behaviors, such as via (1) decreased reactivity to externally and internally initialized cravings, (2) self-kindness and compassion for one’s body and mind, and (3) lowering psychological distress, which can undermine treatment adherence . Recent mechanistic findings from the MB-BP study, using diffusion tensor magnetic resonance imaging, demonstrated that regions of the brain typically damaged by hypertension had either significantly greater connectivity via improved mean diffusivity in the right fornix, or significantly lessened damage by lower radial diffusivity in the left cingulum, in MB-BP vs control . The improvements in these regions were correlated with interoceptive awareness measured via the MAIA instrument, further supporting the role of interoception in the effect of MB-BP on hypertension-related well-being .…”

Section: Discussionmentioning

confidence: 99%

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Adapted Mindfulness Training for Interoception and Adherence to the DASH Diet

Loucks,

Kronish,

Saadeh

et al. 2023

JAMA Netw Open

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ImportanceHypertension is a major cause of cardiovascular disease, and although the Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP), adherence is typically low. Mindfulness training adapted to improving health behaviors that lower BP could improve DASH adherence, in part through improved interoceptive awareness relevant to dietary consumption.ObjectiveTo evaluate the effects of the Mindfulness-Based Blood Pressure Reduction (MB-BP) program on interoceptive awareness and DASH adherence.Design, Setting, and ParticipantsParallel-group, phase 2, sequentially preregistered randomized clinical trials were conducted from June 1, 2017, to November 30, 2020. Follow-up was 6 months. Participants with elevated unattended office BP (≥120/80 mm Hg) were recruited from the population near Providence, Rhode Island. Of 348 participants assessed for eligibility, 67 did not meet inclusion criteria, 17 declined, and 63 did not enroll prior to study end date. In total, 201 participants were randomly assigned, 101 to the MB-BP program and 100 to the enhanced usual care control group, with 24 (11.9%) unavailable for follow-up. Outcome assessors and the data analyst were blinded to group allocation. Analyses were performed using intention-to-treat principles from June 1, 2022, to August 30, 2023.InterventionsThe 8-week MB-BP program was adapted for elevated BP, including personalized feedback, education, and mindfulness training directed to hypertension risk factors. Both MB-BP and control groups received home BP monitoring devices with instructions and options for referral to primary care physicians. The control group also received educational brochures on controlling high BP.Main Outcomes and MeasuresThe primary outcome was Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire scores (range 0-5, with higher scores indicating greater interoceptive awareness), and the secondary outcome was DASH adherence scores assessed via a 163-item Food Frequency Questionnaire (range 0-11, with higher scores indicating improved DASH adherence), all compared using regression analyses.ResultsAmong 201 participants, 118 (58.7%) were female, 163 (81.1%) were non-Hispanic White, and the mean (SD) age was 60.0 (12.2) years. The MB-BP program increased the MAIA score by 0.54 points (95% CI, 0.35-0.74 points; P &lt; .001; Cohen d = 0.45) at 6 months vs control. In participants with poor baseline DASH adherence, the MB-BP program also significantly increased the DASH score by 0.62 points (95% CI, 0.13-1.11 points; P = .01; Cohen d = 0.71) at 6 months vs controls. The intervention was also associated with a 0.34-point improvement in the DASH diet score in all MB-BP participants from baseline (95% CI, 0.09-0.59 points; P = .01; Cohen d = 0.27), while the control group showed a −0.04 point change in DASH diet score from baseline to 6 months (95% CI, −0.31 to 0.24 points; P = .78; Cohen d = −0.03).Conclusions and RelevanceA mindfulness program adapted to improving health behaviors to lower BP improved interoceptive awareness and DASH adherence. The MB-BP program could support DASH dietary adherence in adults with elevated BP.Clinical Trial RegistrationClinicalTrials.gov Identifiers: NCT03859076 and NCT03256890

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Adapted Mindfulness Training for Interoception and Adherence to the DASH Diet

Loucks,

Kronish,

Saadeh

et al. 2023

JAMA Netw Open

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“…Emosi yang stabil kemudian akan memengaruhi penurunan tekanan darah (Liu et al, 2020). Studi dari Polcari et al (2021) mengungkapkan, melalui terapi mindfulness terdapat suatu perubahan spesifik dari konektivitas struktur syaraf dalam sistem limbik otak yang ternyata membantu menurunkan tekanan darah serta menurunkan tingkat kecemasan dan depresi.…”

Section: Berbasis Digital Menurunkan Tekanan Darahunclassified

Terapi Psikologis Berbasis Online Untuk Menurunkan Tekanan Darah Pada Klien Dengan Hipertensi : Studi Literatur

Handoyo

2022

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Psychological therapy is one of the most important aspects of management to reduce stress and control blood pressure for clients with hypertension. However, the implementation of psychological therapy faces challenges in being able to be given online in order to meet dynamic health services in the transitional era of the COVID-19 pandemic-endemic. The aim of this study was to explore various types of psychological therapies that can be implemented online-based to reduce blood pressure for hypertensive clients. This study was a traditional literature review that elaborates on previous research articles for thematic analysis. Article search was conducted in a semi-structured approach using predefined keywords and three academic databases: Scopus, PubMed, and CINAHL. The search results obtained six articles that form four themes: 1) Digital-Based Meditation Lowers Blood Pressure; 2) Digital-Based Mindfulness Lowers Blood Pressure; 3) General Therapeutic Lowering Blood Pressure; 4) Empowering Mind and Behavior by Online-Based Lowering Blood Pressure. Types of psychological therapy that are proven to reduce blood pressure in clients with hypertension including: meditation, mindfulness therapy, behavioral therapy, and counseling centered on client empowerment. Health workers who act as therapists (such as family/community nurses) need to consider the appropriate duration, type, and implementation strategy if they want to develop online-based psychological therapy applications for hypertensive clients.

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