Review Links Mindfulness and Gratitude Practices to Heart Health Gains

Simple practices such as mindfulness, gratitude journaling and optimism training may improve several markers of heart health within weeks, according to a review of 18 randomized controlled trials led by Rosalba "Rose" Hernandez, a professor of social work at the University of Illinois Urbana-Champaign. The trials tested positive psychology and mindfulness programs, which were consistently associated with improvements in blood pressure, inflammation and other cardiovascular risk factors.

Programs varied widely in delivery -- phone sessions, journaling with brief check-ins, apps and text messages, in-person groups, or hybrid formats -- but most combined weekly sessions with at-home activities. The majority lasted six to 12 weeks. Studies generally enrolled 50 to 200 adults who already had elevated cardiovascular risk, such as uncontrolled hypertension or heart failure. Participants were usually in their late 50s to mid-60s, and where gender was reported, women made up 35-55% of participants.

In hypertension and postacute coronary syndrome patients, eight-week mindfulness-based programs reduced systolic blood pressure and lowered inflammatory markers such as high-sensitivity C-reactive protein and fibrinogen, Hernandez said. A 12-week spirituality-based digital intervention achieved one of the largest effects, cutting systolic blood pressure by 7.6 points and central systolic pressure, measured in the aorta, by 4.1 points.

Programs with more frequent contact tended to produce the most reliable physiological benefits, the review found. The strongest behavioral changes came from an eight-week WhatsApp-based program pairing weekly sessions with daily microtasks that encouraged more activity, better diet and medication adherence. Another program using motivational interviewing raised cardiac patients' daily steps by 1,800 and improved medication adherence; mindfulness programs improved activity and diet but not adherence. The most consistent "dose," Hernandez said, was daily practice reinforced by weekly sessions over eight to 12 weeks.

The study was published in the journal Cardiology Clinics. Co-authors included University of South Florida social work professor Soonhyung Kwon, Northwestern University Feinberg School of Medicine's Alyssa M. Vela and Stanford Medicine's Katharine S. Edwards.