Effects of mindfulness-based interventions on negative emotions in patients with hypertension: a systematic review and meta-analysis

Background Psychological distress is common in hypertension and may impair disease management. Mindfulness-based interventions have been proposed to improve emotional and health-related outcomes, but evidence in this population remains limited. Methods This systematic review and meta-analysis followed PRISMA guidelines. PubMed, Embase, Web of Science, the Cochrane Library, and CNKI were searched up to December 31, 2025, for randomized controlled trials of mindfulness interventions in adults with hypertension. Continuous outcomes were pooled as standardized mean differences (SMDs) with 95% confidence intervals (CIs) using fixed- or random-effects models. Risk of bias was assessed with the Cochrane tool, and the certainty of evidence was evaluated using the GRADE approach. Results Nine trials with 780 participants were included. Mindfulness interventions significantly reduced depressive symptoms (SMD = −1.19, 95% CI: −1.74 to −0.64) and anxiety (SMD = −1.43, 95% CI: −2.48 to −0.39). Perceived stress was also reduced (SMD = −0.53, 95% CI: −0.82 to −0.24). Systolic (SMD = −2.10, 95% CI: −3.81 to −0.38) and diastolic blood pressure (SMD = −1.55, 95% CI: −2.69 to −0.42) were modestly reduced. Risk of bias was generally low to moderate. According to GRADE, the certainty of evidence was moderate for depression, systolic and diastolic blood pressure, and low for anxiety, perceived stress, and quality of life. Conclusions Mindfulness-based interventions improve psychological outcomes in hypertension and may modestly lower blood pressure, supporting their use as a complementary strategy in hypertension management. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/ , PROSPERO CRD420261328666