Mindfulness based interventions for blood pressure reduction: systematic and umbrella review of existing...

This umbrella review summarizes the effectiveness of mindfulness-based interventions (MBIs) for lowering blood pressure (BP) and evaluates the methodological quality and certainty of existing meta-analyses using AMSTAR 2 and GRADE. Meta-analyses of randomized controlled trials (RCTs) involving adults with or without hypertension were identified through comprehensive searches conducted from database inception. Two reviewers independently performed study selection, data extraction, and quality assessment. From 1324 records, 11 systematic reviews and meta-analyses met inclusion criteria. These included 2-16 primary RCTs with sample sizes ranging from 101-767 participants and examined heterogeneous populations, including individuals with elevated BP, established hypertension, or broader cardiometabolic risks. Most reviews reported systolic and diastolic BP reductions following MBIs, although pooled effects showed substantial heterogeneity and wide confidence intervals. Reporting of adverse events was limited, and only two reviews noted the lack of long-term follow-up evidence. Methodological quality was rated low or critically low in all reviews, except the Cochrane review which was high-quality and reported systolic BP reductions of -6.08 mmHg (95% CI: -12.79-0.63) and diastolic reductions of -5.18 mmHg (95% CI: -10.65-0.29) compared with active controls. Against inactive controls, systolic BP decreased by -6.62 mmHg (95% CI: -13.15--0.10) and diastolic by -3.35 mmHg (95% CI: -5.86--0.8). Overall, current evidence suggests MBIs may modestly reduce BP, potentially within clinically meaningful ranges. High-quality, adequately powered RCTs are needed to determine whether MBIs should be recommended as routine treatments for hypertension.