Roughly a third of all adults in the United States have high blood pressure, a major risk factor for heart disease and stroke. It’s a condition that can be largely controlled with diet, exercise and medication, yet the Centers for Disease Control and Prevention estimates that only about half of the 75 million people who have high blood pressure manage to keep it in check. In November, Eric Loucks, director of the Mindfulness Center at the Brown University School of Public Health, and colleagues published a study in Plos One, a science journal, that put forward a possible solution: an eight-week mindfulness-based program.

Their experiment seemed to show that such intervention could help those with high blood pressure lower it substantially and maintain that improvement for at least a year. Funded by the Science of Behavior Change program at the National Institutes of Health, it was also more evidence that the medical establishment is starting to consider mindfulness — originally an Eastern spiritual practice that Western marketers have co-opted in recent years to sell everything from yoga leggings to Ford Explorers — a legitimate form of treatment. The Plos One paper was one of more than 7,000 studies published last year that included the word “mindfulness,” according to the U.S. National Library of Medicine; in 2007, roughly 70 scientific articles were published on therapeutic uses of the practice, JAMA noted the following year. “The fact that almost every single day there’s a study coming out showing the benefits of mindfulness training creates this level of confidence that this is valuable,” says Michael Mrazek, director of research at the University of California’s Center for Mindfulness and Human Potential.

But in order for physicians to be able to “prescribe” mindfulness as a therapy, it would help to be able to quantify it. Compared with a pill, say, mindfulness — often described as the practice of paying attention to your present experience without judging it, sometimes but not always through techniques like meditation — is far more difficult to define. What constitutes a “dose”? And how can you be sure people are getting it? Despite the growing excitement about the potential for mindfulness to treat or supplement therapies for almost any health problem imaginable — including depression, smoking and chronic pain — without the same risk of side-effects that many pharmaceuticals have, studies on its impact have generally returned mixed results, perhaps in part because they have been experimenting with slightly different versions of it in different contexts.

Loucks and his colleagues wondered whether a mindfulness regimen designed specifically to reduce blood pressure would work better than general mindfulness programs, which previous studies have shown to have mixed results when it comes to lowering blood pressure. They started with one of the most widely used mindfulness curriculums, a program called Mindfulness-Based Stress Reduction, first developed in the late 1970s at the University of Massachusetts to help hospital patients manage chronic pain. Participants typically take a group class two and a half hours a week for eight weeks, in which they learn to train their attention on their present experience with equanimity by using techniques such as yoga and meditation; they are also supposed to practice mindfulness skills at home for at least 45 minutes, six days a week, and take part in an orientation session and a daylong retreat. Loucks focused each weekly mindfulness session on a behavior that contributes to high blood-pressure, like inactivity or eating too much sugar and salt. One week, participants practiced mindfully eating something sweet or salty in class: Loucks asked them to describe how they felt emotionally and physically before, during and after taking a bite; then they did the same for foods from a variation on the Mediterranean diet.

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