Spiritually Based Interventions for High Blood Pressure: A Systematic Review and Meta-analysis

Roghayeh Khabiri, Leila Jahangiry, Mehdi Abbasian, Fatollah Majidi, Mahdieh Abbasalizad Farhangi, Homayoun Sadeghi-bazargani, Koen Ponnet
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Abstract

This systematic review and meta-analysis aimed to evaluate the effectiveness of spiritually based interventions on blood pressure (BP) among adults. A systematic search was performed using the PubMed, Scopus, and Cochrane databases to identify studies evaluating spiritual interventions, including meditation, transcendental meditation, mindfulness meditation, and yoga, for high BP among adults up to January 1, 2022. The inclusion criteria were (a) randomized controlled trials (RCTs), (b) studies in English or Persian, (c) studies conducted among adults (≥ 18 years), and (d) studies reporting systolic or diastolic BP. Given the high heterogeneity of these studies, a random effect model was used to calculate the effect sizes for the RCTs. In total, the systematic review included 24 studies and the meta-analysis included 23 studies. As some of studies reported two or more outcome measurements, separate estimates of each outcome were extracted for that study (24 datasets). Fifteen trials reported the mean (SD) systolic blood pressure (SBP), and 13 trials reported the mean (SD) diastolic blood pressure (DBP). In addition, 13 studies reported means (SDs) and six trials reported mean changes in DBP. A significant decrease was found in systolic BP following intervention ((WMD (weighted mean difference) = − 7.63 [− 9.61 to − 5.65; P < 0.001]). We observed significant heterogeneity among the studies (I2 = 96.9; P < 0.001). A significant decrease was observed in DBP following the interventions (WMD = − 4.75 [− 6.45 to − 3.05; P < 0.001]). Spiritually based interventions including meditation and yoga had beneficial effects in reducing both SBP and DBP. Reducing BP can be expected to reduce the risk of cardiovascular diseases.

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高血压的精神干预:系统回顾与元分析
本系统综述和荟萃分析旨在评估精神干预对成人血压(BP)的有效性。我们使用 PubMed、Scopus 和 Cochrane 数据库进行了系统性检索,以确定截至 2022 年 1 月 1 日对成人高血压进行精神干预的评估研究,包括冥想、超验冥想、正念冥想和瑜伽。纳入标准为:(a) 随机对照试验 (RCT);(b) 英语或波斯语研究;(c) 成人(≥ 18 岁)研究;(d) 报告收缩压或舒张压的研究。鉴于这些研究的异质性较高,因此采用随机效应模型来计算 RCT 的效应大小。系统综述共纳入 24 项研究,荟萃分析共纳入 23 项研究。由于部分研究报告了两种或两种以上的结果测量值,因此对该研究的每种结果都提取了单独的估计值(24 个数据集)。15 项试验报告了收缩压(SBP)的平均值(标清),13 项试验报告了舒张压(DBP)的平均值(标清)。此外,13 项研究报告了平均值(标度),6 项试验报告了 DBP 的平均值变化。发现干预后收缩压明显下降(WMD(加权平均差)= - 7.63 [- 9.61 to - 5.65; P < 0.001])。我们观察到研究之间存在明显的异质性(I2 = 96.9; P < 0.001)。干预后观察到 DBP 明显下降(WMD = - 4.75 [- 6.45 to - 3.05; P <0.001])。包括冥想和瑜伽在内的精神干预对降低 SBP 和 DBP 均有益处。降低血压有望减少心血管疾病的风险。
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