BACKGROUND AND AIMS: HTN affects nearly 50% of U.S. adults and is the leading modifiable cardiovascular risk factor. A healthy diet and exercise can improve BP control, but adherence to these interventions is low. We tested whether a multimodal mind-body program, Mindful Awareness Practices (MAP) could improve BP and lifestyle behaviors associated with HTN when compared to a Health Promotion Program (HPP). METHODS: Adults with BP > 120/80 were randomized to MAP or HPP. Outcome measurements of BP, self-reported diet, and exercise were analyzed with intent-to-treat group comparisons using repeated measures linear mixed models. RESULTS: There was an MAP-HPP between-group difference in interactions of time-by-systolic BP (p = 0.005) and time-by-diastolic BP (p = 0.003). The mean drops in SBP from baseline to week 13 for the MAP group was 19 mm Hg (138 +/- 15 mm Hg to 119 +/- 6 mm Hg) compared to 7 mm Hg (134 +/- 18 mm Hg to 127 +/- 22 mm Hg) in the HPP group. Similarly, a greater reduction in DBP was observed in the MAP group compared to the HPP group, 12 mm Hg (89 mm Hg +/- 11 to 77 +/- 7 mm Hg) and 1 mm Hg (81 +/- 16 mm Hg to 80 +/- 18 mm Hg), respectively. Mediational analysis of the MAP group showed the total effect of mindfulness practice minutes on SBP with indirect effect (ab) of -0.057 was significant, resulting in a 40% lower SBP for total effect (c) compared to direct (c') effect alone. The mediational model suggests MAP has a modest positive influence on participants initiating lifestyle behavior change, which partially explains the greater reduction in BP by the MAP group. CONCLUSION: Our findings suggest a multimodal mind-body program involving mindfulness practice may improve BP control in adults with HTN.

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