Effects of the Mindfulness-Based Blood Pressure Reduction (MB-BP) Program on Depression and Neural Structural Connectivity

Abstract Hypertension-related illnesses are a leading cause of disability and death in the United States, where 46% of adults have hypertension and only half have it controlled. It is critical to reduce hypertension, and either new classes of interventions are required, or we need to develop enhanced approaches to improve medical regimen adherence. The Mindfulness-Based Blood Pressure Reduction program (MB-BP) is showing novel mechanisms and early evidence of efficacy, but the neural correlates are unknown. The objectives of this study were to identify structural neural correlates of MB-BP using diffusion tensor magnetic resonance imaging (DTI) and assess potential correlations with key clinical outcomes. In a subset of participants from a larger randomized controlled trial, MB-BP participants exhibited increased interoception and decreased depressive symptoms compared to controls. Analyses of DTI data revealed significant group differences in several white matter neural tracts associated with the limbic system and/or hypertension. Specific changes in neural structural connectivity were significantly associated with measures of blood pressure, depression anxiety and symptoms, mindfulness, and emotional regulation. It is concluded that MB-BP has extensive and substantial effects on brain structural connectivity which could mediate beneficial changes in depression, interoceptive awareness, blood pressure, and related measures in individuals with hypertension.