Department of Epidemiology, Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
J Urban Health. 2012 Apr;89(2):308-16. doi: 10.1007/s11524-011-9654-6.
Hypertension affects a large proportion of urban African-American older adults.While there have been great strides in drug development, many older adults do not have access to such medicines or do not take them. Mindfulness-based stress reduction (MBSR)has been shown to decrease blood pressure in some populations. This has not been tested in low-income, urban African-American older adults. Therefore, the primary purpose of this pilot study was to test the feasibility and acceptability of a mindfulness-based program for low income, minority older adults provided in residence. The secondary purpose was to learn if the mindfulness-based program produced differences in blood pressure between the intervention and control groups. Participants were at least 62 years old and residents of a low-income senior residence. All participants were African-American, and one was male.Twenty participants were randomized to the mindfulness-based intervention or a social support control group of the same duration and dose. Blood pressure was measured with the Omron automatic blood pressure machine at baseline and at the end of the 8-week intervention. A multivariate regression analysis was performed on the difference in scores between baseline and post-intervention blood pressure measurements, controlling for age,education, smoking status, and anti-hypertensive medication use. Effect sizes were calculated to quantify the magnitude of the relationship between participation in the mindfulness-based intervention and the outcome variable, blood pressure. Attendance remained 980%in all 8 weeks of both the intervention and the control groups. The average systolic blood pressure decreased for both groups post-intervention. Individuals in the intervention group exhibited a 21.92-mmHg lower systolic blood pressure compared to the social support control group post-intervention and this value was statistically significant(p=0.020). The average diastolic blood pressure decreased in the intervention group postintervention,but increased in the social support group. Individuals in the intervention group exhibited a 16.70-mmHg lower diastolic blood pressure compared to the social support group post-intervention, and this value was statistically significant (p=0.003).Older adults are at a time in life when a reflective, stationary intervention, delivered in residence, could be an appealing mechanism to improve blood pressure. Given our preliminary results, larger trials in this hypertensive study population are warranted.
高血压影响了很大一部分城市非裔美国老年人群体。虽然在药物开发方面已经取得了很大进展,但许多老年人无法获得这些药物,或者他们并不服用这些药物。基于正念的减压(MBSR)已被证明可以降低某些人群的血压。但这在低收入的城市非裔美国老年人群体中尚未得到测试。因此,这项初步研究的主要目的是测试在居住环境中为低收入的少数族裔老年人提供的基于正念的方案的可行性和可接受性。次要目的是了解基于正念的方案是否会导致干预组和对照组之间的血压差异。参与者年龄至少为 62 岁,并且是低收入老年住所的居民。所有参与者都是非裔美国人,其中一名是男性。20 名参与者被随机分配到基于正念的干预组或社会支持对照组,干预时间和剂量相同。在基线和 8 周干预结束时,使用欧姆龙自动血压计测量血压。对基线和干预后血压测量之间差值的分数进行多元回归分析,控制年龄、教育程度、吸烟状况和抗高血压药物的使用情况。计算效应大小以量化参与基于正念的干预与血压这一结果变量之间的关系程度。在所有 8 周的干预组和对照组中,出勤率均保持在 98%。两组的收缩压在干预后均有所下降。与社会支持对照组相比,干预组的收缩压平均降低了 21.92mmHg,这一数值具有统计学意义(p=0.020)。干预组的舒张压在干预后下降,但社会支持组的舒张压上升。与社会支持组相比,干预组的舒张压平均降低了 16.70mmHg,这一数值具有统计学意义(p=0.003)。老年人正处于人生的一个阶段,此时他们可能会喜欢接受一种反思性、静态的干预措施,这种措施可以通过居住环境来改善血压。鉴于我们的初步结果,有必要在这一高血压研究人群中开展更大规模的试验。