What if managing your high blood pressure was as easy as chanting “ommm”?

A new study published in Journal of Alternative and Complementary Medicine from researchers at Massachusetts General Hospital, the Benson-Henry Institute for Mind Body Medicine at Mass General, and Beth Israel Deaconess Medical Center has found a possible explanation for why performing activities such as yoga and meditation can help patients reduce their high blood pressure without medication.

Treating high blood pressure

High blood pressure – or hypertension – is a major risk factor for heart attack and stroke that affects as many as 100 million Americans and 1 billion people worldwide.

High blood pressure can damage the cells lining the interior of the arteries and potentially lead to an aneurysm, or a rupture of the arterial wall, as well as contribute to numerous other health disorders, such as stroke, risk of dementia and heart failure.

“Traditionally, hypertension is treated with pharmacologic therapy, but not all patients respond to drug therapy, and many experience treatment-limiting side effects,” explained Randall Zusman, MD, director of the Division of Hypertension at the MGH Corrigan Minehan Heart Center and co-senior author of the paper. “In these patients, alternative strategies are invaluable.”

The relaxation response

Years of research has shown that the relaxation response could perhaps serve as an alternative to drug therapies and help reduce blood pressure in people with hypertension.

First described more than four decades ago by Herbert Benson, MD, director emeritus of the Benson Henry Institute and a co-author of the current study, the relaxation response is characterized by a set of measurable changes to the body, including decreased breathing and heart rates, which can result from practicing mind-body techniques such as meditation and yoga.

How this response acts in the body to lower blood pressure has remained unclear.

Investigating the link

To better understand the connection, the research team enrolled 58 people who had been diagnosed with Stage 1 hypertension (the second highest category for high blood pressure).

Participants were either not taking medications to control their blood pressure or had tapered off them under medical supervision for five weeks prior to beginning the study. Participants also filled out questionnaires about stress, depression and anxiety.

Over the next eight weeks, participants attended weekly training sessions during which they were guided through a sequence of mind-body interventions designed to elicit the relaxation response, including diaphragmatic breathing, mantra repetition and mindfulness meditation.

Participants were also given an audio CD that guided them through the same sequence for use at home once a day.

Changes in blood pressure and gene expression

After the eight weeks of training, patients filled out the same stress, depression and anxiety questionnaires and had blood drawn for gene expression testing along with blood pressure measurement.

Overall, 13 of the 24 participants who completed the eight-week intervention experienced a drop in blood pressure from “Stage 1 hypertension” to “elevated blood pressure”. The research team referred to this group as responders.

In comparing blood samples taken at baseline and after the intervention, the investigators saw changes in the expression of 1,711 of responders’ genes that hadn’t changed in non-responders.

Additionally, reduced blood pressure was related to changes observed in the expression of genes involved in immune regulatory pathways, metabolism and glucose metabolism, cardiovascular system development and circadian rhythm.

“Our results suggest that the relaxation response reduced blood pressure – at least in part – by altering expression of genes in a select set of biological pathways,” co-first author John Denninger, MD, PhD, director of research at the Benson-Henry Institute, noted.

“Importantly, the changes in gene expression associated with this drop in blood pressure are consistent with the physical changes in blood pressure and inflammatory markers that one would anticipate and hope to observe in patients successfully treated for hypertension.”

This study provides insight into alternative treatments for high blood pressure and adds to the growing list of benefits associated with practices like yoga and meditation.

About the Mass General Research Institute
Research at Massachusetts General Hospital is interwoven through more than 30 different departments, centers and institutes. Our research includes fundamental, lab-based science; clinical trials to test new drugs, devices and diagnostic tools; and community and population-based research to improve health outcomes across populations and eliminate disparities in care.
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