In September 2023, NIHR asked Bristol ESG to undertake a systematic review and network meta-analysis of the evidence for stress management and relaxation interventions for people with high blood pressure (hypertension), or those at risk of developing high blood pressure (people with pre-hypertension).
The review was funded by the NIHR Evidence Synthesis Programme (project number: NIHR161214) and is registered with PROSPERO (CRD42023469128).
Project status: completed
You can read some reflections from the team about this work here.
What is the problem?
High blood pressure (or “hypertension”) is a common problem throughout the world. It affects around one in three adults. It can lead to serious illness, such as heart attacks or strokes. Reducing blood pressure helps to lower the chance of these diseases. People often take medication to help lower blood pressure, but other things may help – such as exercise, stopping smoking, and eating a healthy diet. Many people think relaxing or reducing stress might help lower blood pressure, but this is not routinely recommended by healthcare providers.
What did we do?
We searched for studies where relaxation therapies (such as yoga, mindfulness and meditation, amongst other things) were compared with other treatments for high blood pressure. We also looked at studies of relaxation therapies for people with slightly raised blood pressure – sometimes called “pre-hypertension”. We combined the results of these studies to see if any relaxation therapies could help lower blood pressure.
What did we find out?
After three months of follow-up, most relaxation therapies reduced blood pressure. However, we had some concerns about how the studies were conducted, which means we are uncertain about these results. The effect on blood pressure seems to reduce over time, but it’s not clear why this is. It may be because relaxation therapies stop working, or because people stop using them, or for other reasons.
Publication details
Katie E Webster, Monika Halicka, Russell J Bowater, Thomas Parkhouse, Dara Stanescu, Athitya Vel Punniyakotty, Jelena Savović, Alyson Huntley, Sarah Dawson, Christopher E Clark, Rachel Johnson, Julian PT Higgins, Deborah M Caldwell – Effectiveness of stress management and relaxation interventions for management of hypertension and prehypertension: systematic review and network meta-analysis: BMJ Medicine 2025;4:e001098. https://doi.org/10.1136/bmjmed-2024-001098
Contact: bristol-esg@bristol.ac.uk
