Mindfulness-Based Interventions for Adults with Cardiovascular Disease: A Systematic Review and Meta-Analysis

Abstract

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.

A systematic review and meta‐analysis of mindfulness‐based interventions for patients with coronary heart disease

“…This review suggests that MBIs tend to mitigate depression and stress in patients with CHD compared with inactive controls. These findings are in line with that from previous systematic reviews of MBIs in cardiovascular disease (Scott‐Sheldon et al., 2020), heart disease (Zuraida & Syahrul, 2019) and vascular disease (Abbott et al., 2014). However, inconsistently with these reviews, there was no significant effect on anxiety in our meta‐analysis.…”

“…MBIs have established effectiveness in improving psychological and physical outcomes and QoL in both healthy and clinical populations including people with cancer, diabetes and vascular disease (Abbott et al., 2014; Creswell, 2017; Noordali et al., 2017; Schell et al., 2019). Furthermore, systematic reviews of MBIs among patients with heart diseases, including mixed cardiovascular diseases, heart failure and CHD, showed promising benefits in reducing depression, anxiety and stress and systolic blood pressure (BP), but the effects on other cardiovascular risk factors were inconsistent or rarely assessed (Scott‐Sheldon et al., 2020; Zuraida & Syahrul, 2019).…”

“…The positive effects across a wide range of populations suggest that MBIs might benefit people with CHD in managing distress and illness. Prior published reviews on this topic did not focus exclusively on patients with CHD (Abbott et al., 2014; Scott‐Sheldon et al., 2020; Zuraida & Syahrul, 2019); did not assess effects on all cardiovascular risk factors (Abbott et al., 2014; Scott‐Sheldon et al., 2020; Zuraida & Syahrul, 2019) or QoL (Scott‐Sheldon et al., 2020; Zuraida & Syahrul, 2019); did not use a comprehensive search strategy (Zuraida & Syahrul, 2019); or did not perform meta‐analysis to offer a quantitative synthesis (Zuraida & Syahrul, 2019). Therefore, the current systematic review is necessary to systematically synthesize evidence to assess the effects of MBIs on health outcomes exclusively for patients with CHD.…”

Examining the Associations between Psychological Flexibility, Mindfulness, Psychosomatic Functioning, and Anxiety during the COVID-19 Pandemic: A Path Analysis

“…In contrast, distress can contribute to reduced activation in these areas and in the amygdala and hippocampus [ 23 ]. Studies concerning mindfulness-based interventions, for instance, mindfulness-based stress reduction (MBSR) [ 24 ] or mindfulness-based cognitive therapy (MBCT) [ 25 ], have brought evidence that mindfulness techniques can reduce symptoms of both anxiety [ 26 , 27 ] and depression [ 28 , 29 ] that are related to somatic symptoms [ 30 ] such as cardiovascular disease [ 31 ] or cancer [ 32 ].…”

Impact of mind‐body treatment interventions on quality of life in neurofibromatosis patients: A systematic review and meta‐analysis

“…These include mind‐body therapies (MBTs), a collection of “healing techniques that enhance the mind's interactions with bodily function,” which often include mindfulness and meditation‐based practice 10 . The effectiveness of MBT is well‐demonstrated in many areas—including psychiatric conditions, 11 acute and chronic pain, 12,13 cancer, 14 cardiovascular health, 15 and everyday wellness 16 —and is also being increasingly used to manage dermatologic diseases. Indeed, the past 5 years has seen a rise of mind‐body therapies aimed towards boosting QoL among NF patient populations 17‐26 …”