Evaluation of a Mindfulness-Based Intervention Program to Decrease Blood Pressure in Low-Income African-American Older Adults

Abstract

Hypertension affects a large proportion of urban African-American older adults. While there have been great strides in drug development, many older adults do not have access to such medicines or do not take them. Mindfulness-based stress reduction (MBSR) has been shown to decrease blood pressure in some populations. This has not been tested in low-income, urban African-American older adults. Therefore, the primary purpose of this pilot study was to test the feasibility and acceptability of a mindfulness-based program for low income, minority older adults provided in residence. The secondary purpose was to learn if the mindfulness-based program produced differences in blood pressure between the intervention and control groups. Participants were at least 62 years old and residents of a low-income senior residence. All participants were African-American, and one was male. Twenty participants were randomized to the mindfulness-based intervention or a social support control group of the same duration and dose. Blood pressure was measured with the Omron automatic blood pressure machine at baseline and at the end of the 8-week intervention. A multivariate regression analysis was performed on the difference in scores between baseline and post-intervention blood pressure measurements, controlling for age, education, smoking status, and anti-hypertensive medication use. Effect sizes were calculated to quantify the magnitude of the relationship between participation in the mindfulness-based intervention and the outcome variable, blood pressure. Attendance remained 980% in all 8 weeks of both the intervention and the control groups. The average systolic blood pressure decreased for both groups post-intervention. Individuals in the intervention group exhibited a 21.92-mmHg lower systolic blood pressure compared to the social support control group post-intervention and this value was statistically significant (p=0.020). The average diastolic blood pressure decreased in the intervention group postintervention, but increased in the social support group. Individuals in the intervention group exhibited a 16.70-mmHg lower diastolic blood pressure compared to the social support group post-intervention, and this value was statistically significant (p=0.003). Older adults are at a time in life when a reflective, stationary intervention, delivered in residence, could be an appealing mechanism to improve blood pressure. Given our preliminary results, larger trials in this hypertensive study population are warranted.

Mindfulness-Based Interventions for Older Adults: a Review of the Effects on Physical and Emotional Well-Being

“…Teixeira (2010) instructed participants in mindfulness meditation and encouraged them to listen to a guided CD 5 days/week for 4 weeks, but did not include other elements of the MBSR curriculum. Palta and colleagues (2012) used an 8-week MBSR program with shortened weekly sessions called ELDERSHINE (developed and implemented by an interventionist trained through the Center for Mindfulness—University of Massachusetts), consisting of meditation practice, homework review, and didactic training of mindfulness skills to improve social and emotional functioning. Mularski et al (2009) utilized a standard 8-week MBSR program with supplemental relaxation and mindful breathing training.…”

“…Some studies did not provide attendance data; however, those that did reported that participants attended an average of 6-8 of the 8 sessions (Creswell et al 2012; Morone et al, 2008; Splevins et al, 2009). Palta et al (2012) reported that greater than 80% of their participants completed all eight sessions. In a nursing home setting, 75% of participants completed all sessions (Ernst et al, 2008).…”

“…Moving the group to the afternoon also allowed the group leaders to extend the session time from 120 to 150 minutes, after observing that the reduced meeting time was not sufficient for discussion and didactic training. Palta et al (2012) also provided anecdotal reports from participants, including statements that they, “wait the whole week” to attend group and called it a “safety net.”…”

“…Mindfulness-based interventions did not yield significant improvements in physical symptoms related to chronic obstructive pulmonary disease (COPD) (Mularski et al, 2009) or diabetic neuropathic pain (Teixeira, 2010) compared to comparison groups. However, one study found that MBSR participants experienced significantly reduced blood pressure compared to a control group, but with a small sample and effect size (Palta et al, 2012). Morone and colleagues conducted a pair of studies examining MBSR in the context of chronic lower back pain.…”

Mindful Living in Older Age: a Pilot Study of a Brief, Community-Based, Positive Aging Intervention

“…Moreover, most MBIs with older adults studies involve clinical populations, with either mental disorders like depression (Lynch & Bronner, 2006) or physical issues like back pain (Morone et al, 2008). There are exceptions that focus on community populations, but these generally still utilise interventions developed for clinical groups (e.g., MBSR), and are focused on correcting deficits, such as reducing emotional distress (Young & Baime, 2010) or blood pressure (Palta et al, 2012). Morone et al's (2009) mind-body intervention does appear to be designed specifically for older community-dwelling adults, but again, is still somewhat 'deficit focused,' with a homework book entitled 'Keep your brain alive.'…”