Mindfulness: Why the Brain Matters to the Heart

As mindfulness is increasingly being implemented and adapted, more knowledge about its effectiveness and working mechanism is needed. In a meta-review (a review of reviews) we found that the 8-week trainings MBSR (Mindfulness Based Stress Reduction) and MBCT (Mindfulness Based Cognitive Therapy) significantly improve anxiety, depression, and stress in a multitude of chronic diseases. For the working mechanism we assessed brain scans: a review and data from the Rotterdam Study show differences in activity, connectivity and structure in the prefrontal cortex, amygdala, and hippocampus, indicating that the training teaches a different automatic reaction pattern that is visible in the brain. Following the rationale that stress affects blood pressure and other cardiovascular risk factors, an RCT was performed in which online mindfulness was offered to heart patients. As primary outcome measure for heart functioning an exercise test was chosen (the six-minute walk test). One year after inclusion the mindfulness group walked 18 meter further compared to the control group. This indicates application possibilities for this patient population when the training is intensified. An adaptation of the 8-week protocol was tested in Borderline personality disorder (Mindfulness Based Emotion Regulation Therapy), which showed that patients could handle their emotions better. In another study we used Experience Sampling Method (ESM) to measure how affect and mindfulness interact: mindfulness and positive affect create an upward spiral, which could explain the found effectivity. Concluding, mindfulness training seems a suitable supplement to chronic care