Impact of the Mindfulness-Based Blood Pressure Reduction (MB-BP) Program on Cardiovascular Health: A Randomized Clinical Trial

BACKGROUND: Mindfulness-based interventions may improve cardiovascular health (CVH) by supporting behavioral change across multiple risk factors. This study evaluated the impact of Mindfulness-Based Blood Pressure Reduction (MB-BP), a mindfulness program targeting hypertension-related behaviors, on CVH using the American Heart Association's Life's Essential 8 framework. METHODS: This secondary analysis of a preregistered, parallel-group, phase 2 randomized clinical trial evaluated the effects of MB-BP on CVH in 201 participants with elevated office BP (≥120/80 mmHg). The MB-BP group (n=101) received an 8-week program focused on mindfulness training and education targeting diet, physical activity, medication adherence, alcohol use, and stress, whereas the control group (n=100) received enhanced usual care. CVH was assessed using available Life's Essential 8 components: systolic blood pressure, body mass index (BMI), diet (DASH adherence), physical activity, smoking, and sleep duration. Generalized estimating equations evaluated intervention effects through six months. RESULTS: At 6 months follow-up, MB-BP participants significantly improved composite CVH scores compared to controls (standardized mean difference: 0.144; 95% CI: 0.023-0.266). Non-significant improvements were observed across most CVH components in MB-BP vs. control, including systolic blood pressure (−4.95 mmHg), DASH diet score (+0.27), physical activity (+47.9 MET-min/week), sleep duration (+0.34 hours/night), and BMI (−0.28 kg/m ² ). No significant changes were observed for smoking, likely due to the low baseline prevalence. CONCLUSIONS: MB-BP led to modest but clinically significant improvements in CVH, driven by multiple Life's Essential 8 components. These findings suggest that MB-BP may be an effective behavioral intervention to support CVH and reduce risk for cardiovascular disease.