Meditation and Blood Pressure

I think it was nearly 25 years ago, while I was still working as a prosecuting attorney, that I had a conversation with my physician. He noticed that my blood pressure was a little higher than it should be, and he suggested that I might want to begin the practice of meditation. My response? Privately, I scoffed. I figured he was one of these guys who was into fringe treatments, and I wanted no part of that. Besides, meditation really did not fit my own self image, which at that time was very much that of a tough, no-nonsense, prosecutor. For some reason (now that I look back on it, I can't figure out what exactly the reason was!), people like me just didn't do meditation, or yoga, or any of "that" stuff...

A lot of years (and, for me, many life changes) have gone by since then. Now, I'm a psychologist, and I have been practicing meditation for about 10 years. I teach meditation, as well, and I keep an eye on the research literature about its apparent health benefits. One wellness-related area in which research is being carried out is on high blood pressure, or hypertension (my doctor may have been on target, and ahead of his time!). Some recent research can be found here and here (specifically, using "Transcendental Meditation," or TM); and also a review indicating that, overall, the evidence indicating that meditation actually significantly lowers blood pressure is not yet very strong. The studies, so far, tend to have various flaws; we will know more when better studies are designed and carried out, but preliminary indications are encouraging.

Why might the practice of meditation lower blood pressure? There are no definitive answers, yet, to this question, but at least a couple of good ideas. Most recently, there has been a new focus on the "slow breathing" aspect of meditation. It's true that, in most schools of meditation, there is no conscious effort made to alter the rate or rhythm of the breath; however, during a typical period of sitting meditation, in most individuals, the breathing naturally slows. Some researchers have honed in on this fact, and have measured what happens to the blood pressure when people deliberately make their breathing slower and deeper (you can use music, or recorded tones, to easily accomplish this) for 10 or 15 minutes per day. They found that blood pressure becomes significantly lower, and actually remains lower throughout the rest of the day. The reason for this is unclear; one hypothesis has to do with the physiology of breathing and its impact on sodium levels in the body. See my earlier post about this, here, and an article, here.

A second idea has to do with the (at least superficial) similarity between "progressive relaxation training" (sometimes used in cognitive-behavioral therapy) and the practice of meditation. Many people (lay and professional, both) tend to confuse the two. Actually, the two practices are quite different in important ways. In progressive relaxation, one systematically engages in a tensing and relaxing of muscles throughout the body; there is little, if any, instruction given about the quality of attention paid to physical sensations, nor do the instructions typically address the issue distractions of attention from the task, and non-judgmental return of attention to a chosen anchor, or focus point. In meditation training, on the other hand, relaxation is not an explicit goal, and one does not deliberately tense or relax the muscles. Rather, the task is to non-judgmentally notice whatever may be present in the moment (and that might include muscular tension, bodily discomfort, etc.) without trying to change it.

However, another persuasive idea as to why meditation lowers blood pressure has more to do with our emotions and thoughts. The practice of meditation is, in part, an exercise in training the attention. A person practices meditation by repeatedly focusing and re-focusing his or her attention to a particular object: that may be the ever-changing sensations of breathing, or the sounds that naturally occur while one is meditating; or on a phrase that one silently repeats (a "mantra," as in TM or Centering Prayer). Upon noticing that s/he has become distracted from a focus on the present moment (whether it be the breath, or physical sensations), s/he simply takes note that attention has been lost, and (compassionately) re-focuses attention on the chosen object. Within any particular session of meditation, this cycle of focusing the attention, losing focus, and re-focusing, may occur a hundred times. And, each time, the act of re-focusing, of bringing attention back to a chosen object, strengthens one's capacity to control where one places one's attention. This is one key, I believe, to the stress-reduction effect, including lowering of blood pressure, of meditation practice. One way to increase your blood pressure, and keep it elevated, is to focus on emotionally unpleasant thoughts: worry about the future (anxiety) and regrets and self-recriminations about the past (depression). Often, we become lost in unpleasant and counterproductive thinking, without even being aware that we have done so, and without understanding that we have any choice in the matter. Meditation teaches us to be more aware of where our attention has gone, and it trains us in the capacity to deliberately (and non-judgmentally) re-focus attention to a chosen object (such as what is going on right now, as opposed to whatever we might fear about the future). This functions as a method of emotional self-regulation, which in turn has a predictable physiological impact on the entire body, including one's blood pressure. This also serves to explain the apparent anti-depressant and anxiety-lowering effects of meditation.