FEEL Study: Focus on Spirituality, Gratitude Can Lead to Decrease in BP, Increase in FMD

Twelve weeks of daily smartphone messages, designed to cultivate spirituality and promote reflection, was associated with a reduction in systolic blood pressure (BP) and improvement in flow-mediated dilation (FMD), according to the FEEL study presented during the Clinical and Investigative Horizons session at ACC.24.

The noninferiority trial, conducted in Brazil, randomized 100 adults with stage 1 and 2 hypertension either to usual care or usual care plus the spirituality intervention. Patients in the intervention group received daily WhatsApp messages and videos encouraging reflection and focusing on optimism, gratitude and forgiveness; occasionally they were asked to complete brief tasks, such as writing messages of gratitude.

At baseline and at 12 weeks, all participants completed assessments of lifestyle habits, medication use, BP and FMD. Participants also recorded their BP at home over a five-day period at the start and end of the study. Individuals with medication changes during the study were excluded from the analysis.

The primary endpoint of change in office systolic BP was a 7.6 mm Hg reduction in the intervention group compared with 0.55 mm Hg reduction in the control group. Percentage change in FMD, a co-primary endpoint, increased by 4.12% in the intervention group compared with a decrease of 3.34% in the control group.

"This 7 mm Hg drop [in systolic BP] is a larger reduction than has been seen with other nonpharmacological interventions and may even outperform some drugs," said Maria Emília Teixeira, MD, PhD, the study's lead author. "With this significant level of reduction in [BP], you would potentially be able to live longer with a lower chance of heart attack, kidney diseases, stroke or disability later in life." Larger studies are needed to confirm the observed benefits.

Resources

Clinical Topics: Prevention, Hypertension, Vascular Medicine

Keywords: ACC Annual Scientific Session, ACC24, Hypertension, Stress Reduction