Efficacy of mental and physical training on blood pressure and resting heart rate among physically inactive young adults with elevated blood pressure: a randomized controlled trial

Physically inactive adults with elevated blood pressure (BP) are at an increased risk of developing hypertension and cardiovascular comorbidity. Lifestyle-based non-pharmacological interventions are therefore essential. While mindfulness meditation and aerobic exercise independently improve BP, limited evidence exists on their combined effect—mental and physical training (MAPT). This study examined the effectiveness of MAPT on systolic BP (SBP), diastolic BP (DBP), and resting heart rate (RHR) among young adults with elevated BP. In a single-blinded randomized controlled trial, 58 young adults with elevated BP were allocated to 4 groups: mental training (MT, n = 14; mindfulness-based stress reduction), physical training (PT, n = 15; aerobic exercise at 40–60% heart rate reserve), MAPT (n = 15; combined MT and PT), and an active control group following the DASH diet (n = 14). Interventions were conducted 3 times weekly for 6-weeks. Outcomes were measured at baseline and post-intervention. Data were analyzed using two-way repeated measures ANOVA to examine time, group, and group-by-time interaction effects. Participants had a mean age of 20.2 ± 1.7 years and BMI of 22.4 ± 1.8; 43% reported a family history of hypertension. Significant SBP reductions were observed in MT ( p = 0.002; ηp 2 = 0.17), PT ( p = 0.003; ηp 2 = 0.15), and MAPT ( p < 0.001; ηp 2 = 0.67), with MAPT demonstrating the largest effect. DBP decreased significantly in MT ( p = 0.006; ηp 2 = 0.13), PT ( p = 0.002; ηp 2 = 0.17), and MAPT ( p < 0.001; ηp 2 = 0.31), though no significant group-by-time interaction was found. RHR declined significantly in PT ( p < 0.001; ηp 2 = 0.28) and MAPT ( p < 0.001; ηp 2 = 0.56). MAPT showed greater SBP reduction than MT ( p = 0.04, 95% CI = − 9.62 to − 0.18) and DASH ( p = 0.05, 95% CI = − 9.42 to 0.02), and greater RHR reduction than DASH ( p = 0.03, 95% CI = − 14.08 to − 0.60). Integrating mindfulness with aerobic exercise improves SBP and RHR, though no significant differences emerged for DBP. MAPT appears to be a novel and potentially beneficial non-pharmacological intervention for managing BP and RHR in young adults with elevated BP. Trial registration This study was registered prospectively (09/05/2022) on clinicaltrials.gov with the registration no. NCT05533268 ( https://clinicaltrials.gov/study/NCT05533268 ).