Mindful meditation shows promise for BP lowering in CKD



ATLANTA – Mindfulness meditation may improve blood pressure in hypertensive patients with chronic kidney disease, according to findings from a small randomized study.

This study involved 15 patients who had stage 3 chronic kidney disease and hypertension. Compared with a control condition involving blood pressure education, mindfulness meditation was associated with significantly greater reductions in systolic blood pressure (–10.2 vs. –0.8 mm Hg), diastolic blood pressure (–6.4 vs. –1.8 mm Hg), and mean arterial pressure (–7.7 vs. –1.4 mm Hg), Dr. Jeanie Park reported at Kidney Week 2013, sponsored by the American Society of Nephrology.


Fifteen minutes of 'mindfulness' meditation was associated with reductions in systolic blood pressure, diastolic blood pressure, and mean arterial pressure, said Dr. Jeanie Park.

Mindfulness meditation – a "type of meditation that is focused on awareness of sensations of the present moment without any type of cognitive elaboration of those sensations, without judgment, without trying to modify those sensations" – also was associated with a significantly greater reduction in muscle sympathetic nerve activity as measured using microneurography (–10.7 vs. 1.9 bursts/min), said Dr. Park of Emory University, Atlanta.

Study participants were male veterans who completed two study visits, undergoing – in randomized crossover fashion – 14 minutes of guided mindfulness meditation at one visit, and 14 minutes of a control condition involving blood pressure education at one visit.

Because a lower breathing rate was observed during mindfulness meditation, a subset of the patients completed a third visit in which they used controlled breathing as a second control measure. During this visit, they lowered their breathing rate to the same rate achieved during mindfulness meditation.

"What we saw was that during mindfulness meditation, there was a significant reduction in sympathetic nerve activity compared with the control, but during controlled breathing ... there was no difference in sympathetic activity. This suggests that slow breathing by itself is not sufficient to lower blood pressure and sympathetic activity, and that there is something unique about mindfulness meditation that might be modulating sympathetic activity and blood pressure in our patients," Dr. Park said.

Although mindfulness meditation has been shown in prior studies to have "modest but meaningful" effects in patients with high blood pressure, the current findings are among the first to demonstrate an association between mindfulness meditation and decreased blood pressure in hypertensive patients with chronic kidney disease. The effect appeared to be mediated by an acute reduction in sympathetic nervous system activity, Dr. Park said.

Chronic kidney disease is characterized by chronic sympathetic nervous system overactivity, which contributes to hypertension and mortality, she explained.

"In clinical practice, we aim to counteract sympathetic activity to lower blood pressure. We do this using antihypertensive medications such as beta-blockers and [clonazepam], but the problem with these medications is that oftentimes their use is limited due to their side effects ... so there certainly is a need to investigate alternative or additive therapies to counteract sympathetic activity and lower blood pressure in our patient group," she said.

The findings of this study suggest that mindfulness meditation may have real physiological effects on autonomic control, and may prove useful as a complementary therapy in chronic kidney disease patients, she concluded, noting that future studies are needed to determine whether long-term reductions in blood pressure can be achieved by using mindfulness meditation.

Dr. Park reported having no disclosures.

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