Influence of spiritual well-being training on blood pressure control

Background: Spirituality, a comprehensive concept that encompasses personal aspects and interpersonal relationships, has been studied as a protector factor for cardiovascular diseases. As hypertension is the first cause of mortality worldwide, interventions that prove to be beneficial for its control and have few side effects, like human spirituality aspects, should be studied and considered for clinical practice. Methods: Randomized non-inferiority clinical trial with participants comprised of stage 1 and 2 hypertensive adults. After signing informed consent, individuals were randomized for intervention group (IG) ou control group (CG) and underwent a cardiologic consultation, which comprised anamnesis, including lifestyle habits and medications in regular use, measurement of peripheral and central blood pressure, home blood pressure monitoring (HBPM) and flow mediated dilation (FMD). IG received daily on WhatsApp, for 12 weeks, a message containing a video, a reflection message, or a task, all encouraging forgiveness, gratitude, optimism and life purpose. At the end of this period, all participants underwent the same procedures as of the initial visit. Results: Both groups were similar in all demographic aspects, except for the greater presence of women at the IG. Lifestyle habits and regular medications were not modified during the follow-up period. Comparison of the evaluated parameters between both groups demonstrated an improvement of FMD in the IG (increase from 9,8% to 14,3%) and worsening at CG (10,2% to 7,2%), p < 0,001. In addition, the peripheral systolic blood pressure (pSBP) drop was great and statistically significant in IG (7,6 mmHg) in comparison to CG (0,55 mmHg, p 0,848), and this variation was also statistically significant (p 0,047) when evaluated by student’s T test. Conclusion: The tool developed and used in this research allowed participants to work through beneficial feelings and was effective in improving FMD and pSBP to a similar or greater extent than other non-pharmacological measures or even some antihypertensive medications.