Key result
Guided forest bathing reduces perceived stress by ~2.5 points and lowers diastolic BP.
Why the study?
Pharmacotherapy adherence in arterial hypertension remains suboptimal, and although guidelines recommend adjunctive stress-reduction interventions, evidence for mindfulness- and nature-based approaches in older hypertensive populations is limited.
Do a mindfulness-based living course or guided forest bathing improve perceived stress, self-efficacy, quality of life, blood pressure, and serum cortisol in older women with treated arterial hypertension?
Do a mindfulness-based living course or guided forest bathing improve perceived stress, self-efficacy, quality of life, blood pressure, and serum cortisol in older women with treated arterial hypertension?
In older women with treated hypertension, both mindfulness and guided forest bathing improved self-assessed health and reduced serum cortisol, with forest bathing additionally reducing perceived stress and diastolic blood pressure.
Hypothesis-generating for stress-reduction adjuncts in older hypertensive women; leaves open effects on cardiovascular outcomes.
Background Arterial hypertension (AH) is the leading modifiable cardiovascular risk factor, yet pharmacotherapy adherence remains suboptimal. ESH guidelines recommend adjunctive lifestyle interventions including stress reduction, but evidence for mindfulness- and nature-based approaches in older hypertensive populations is limited. Within the University of Rijeka project No. uniri-iskusni-biomed-23-181, we evaluated a mindfulness-based living course (MBLC) and guided forest bath (Shinrin-yoku, SY) among older women with treated AH in Rijeka, Croatia. Methods A quasi-experimental pre-post study enrolled 63 women aged ≥60 with diagnosed AH: MBLC (n = 21, 8 weekly workshops), SY (n = 20, 3 guided forest sessions) and a comparison group (n = 22, usual care). Outcomes at baseline (T0) and post-intervention (T1) included perceived stress (PSS-10), chronic disease self-efficacy (SEMCD-6), HRQoL (EQ-5D-5L, EQ-VAS), blood pressure, and serum cortisol. Two-way repeated-measures ANOVA with LSD correction was used; groups were balanced at baseline. Results Mean age was 73.3 years. A significant time×group interaction emerged for perceived stress (p = 0.002, η²=0.185): SY reduced PSS-10 (16.4→13.9, p = 0.002) while comparison did not. Both interventions improved self-assessed health (EQ-VAS: MBLC p = 0.022; SY p = 0.005; interaction p = 0.006, η²=0.157) and reduced cortisol (MBLC p = 0.016; SY p = 0.006; time effect p = 0.002, η²=0.158), with no change in the comparison group. SY also improved self-efficacy (p = 0.008) and diastolic BP (p = 0.019). No significant effects were found for systolic BP or heart rate. Conclusions Forest bath showed the most consistent short-term improvements across psychological, subjective health, and physiological outcomes. Both interventions reduced cortisol and improved self-assessed health, supporting non-pharmacological, person-centred approaches in AH management for older women. Larger randomised trials with longer follow-up are needed. Key messages • Forest bathing reduced stress, self-efficacy, and diastolic BP in older hypertensive women. • Mind-body interventions complement pharmacotherapy and suit community-based hypertension care.
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Vasiljev et al. (2026) studied Arterial hypertension (n=63). Mindfulness-based living course (MBLC) and guided forest bath (Shinrin-yoku, SY) vs. Usual care was evaluated on Perceived stress (PSS-10), chronic disease self-efficacy (SEMCD-6), HRQoL (EQ-5D-5L, EQ-VAS), blood pressure, and serum cortisol (η²=0.185, p=0.002). Guided forest bathing significantly reduced perceived stress (PSS-10 from 16.4 to 13.9, p=0.002) and diastolic BP (p=0.019), while both interventions improved EQ-VAS and cortisol vs usual care.
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