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Impact of 12-Month Smartphone Breathing Meditation Program upon Systolic Blood Pressure among Non-Medicated Stage 1
Jessica Chandler1, Luke Sox1, Vanessa Diaz2
1College of Nursing, Medical University of South Carolina, Charleston, WV 29425, USA.
Insights
A smartphone app using breathing meditation significantly lowered systolic blood pressure in adults with stage 1 hypertension. This study suggests the Tension Tamer app is a promising, scalable first-line treatment for hypertension management.
Area of Science:
- Cardiovascular Medicine
- Digital Health
- Behavioral Science
Background:
- Hypertension (HTN) affects approximately 50% of adults, increasing stroke and cardiovascular disease risk.
- Recent guidelines lowered hypertension cutoffs, impacting more individuals needing management.
- Chronic stress is a known risk factor for hypertension and cardiovascular disease.
Purpose of the Study:
- To examine the impact of a breathing meditation smartphone app (Tension Tamer, TT) on stage 1 hypertension.
- To analyze changes in resting systolic blood pressure (SBP) and diastolic blood pressure.
- To assess adherence to the TT protocol and perceived stress levels.
Main Methods:
- A 12-month randomized controlled trial involving 30 adults with stage 1 systolic hypertension.
- Participants were assigned to either the TT app or a smartphone-delivered lifestyle education control group.
- Intervention involved twice-daily sessions of guided breathing or walking, with decreasing duration over 12 months.
Main Results:
- The TT group demonstrated significantly greater reductions in systolic blood pressure compared to the control group at 3, 6, and 12 months.
- Specific SBP reductions for the TT group were -8.0 mmHg at 3 months, -10.0 mmHg at 6 months, and -11.6 mmHg at 12 months.
- A significant group x time interaction effect was observed for SBP (p<.01).
Conclusions:
- The Tension Tamer app proved beneficial in reducing systolic blood pressure in adults with stage 1 hypertension.
- The app may represent a promising and scalable first-line intervention for managing stage 1 hypertension.
- Further research is planned with an efficacy RCT for uncontrolled stage 1 hypertension patients.
Abstract:
(1) Background: Hypertension (HTN) affects ~50% of adults and is a major risk factor for stroke and cardiovascular disease. In 2017, the SPRINT trial outcomes led to lowering of HTN cutoffs by the American College of Cardiology (ACC) and American Heart Association (AHA). The Joint National Committee (JNC8) and National High BP Education Program recommend that lifestyle modifications be used as first-line HTN treatment. Chronic stress is a risk factor for HTN and cardiovascular disease. A recently completed 12 month randomized controlled trial (RCT) of a breathing meditation smart phone app (Tension Tamer, TT) involving JNC8 designated pre-HTN adults provided an opportunity to examine its impact upon individuals now classified as having stage 1 HTN. The TT app captures continuous real-time heart rate (HR) from a user's fingertip placed over a video camera lens during sessions. Users receive immediate feedback graphs after each session, showing their HR changes. They also receive motivational and social reinforcement SMS text messages the following day based upon levels of adherence. We conducted ancillary analyses of a 2-arm, 12-month, small-scale efficacy RCT among a subgroup of our total sample of participants, who are now classified as having stage 1 non-medicated systolic HTN. Primary outcome was change in resting systolic blood pressure (SBP). Secondary outcomes were change in resting diastolic blood pressure, adherence to the TT protocol, and perceived stress levels. (2) Methods: 30 adults (mean age: 45.0 years; 15 males; 16 White; 14 Black) with ACC/AHA 2017 defined systolic HTN (130-139 mmHg) on 3 consecutive sessions (mean SBP: 132.6 mmHg) were randomly assigned to TT or lifestyle education program delivered via smartphone (SPCTL). Each group received a twice-daily dosage schedule of TT or walking (month 1: 15 min; months 2 and 3: 10 min; months 4-12: 5 min). (3) Results: Mixed modeling results revealed a significant group x time effect for SBP (p<.01). The TT group showed greater SBP reductions at months 3 (-8.0 vs. -1.9), 6 (-10.0 vs. -0.7), and 12: (-11.6 vs. -0.4 mmHg; all p-values <0.04). (4) Conclusion: The TT app was beneficial in reducing SBP levels among adults with stage 1 systolic HTN. The TT app may be a promising, scalable first-line tactic for stage 1 HTN. Preparations are underway for an efficacy RCT involving uncontrolled stage 1 HTN patients.
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Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.