Mindfulness for Hypertension Management: Mapping Evidence and Gaps in Medication Adherence
Ady Irawan. AM1*, Kusumaningtyas Siwi Artini2, Agung Widiastuti3, Anggie Pradana Putri4

1Program Studi Doktor Keperawatan, Universitas Jenderal Soedirman, Indonesia- Progam Studi Pendidikan Profesi Ners, Universitas Duta Bangsa Surakarta, Indonesia- Himpunan Perawat Holistik Indonesia, Indonesia- Global Lubna Jaya Co., Indonesia
2Progam Studi Farmasi, Universitas Duta Bangsa Surakarta, Indonesia
3Progam Studi Pendidikan Profesi Ners, Universitas Duta Bangsa Surakarta, Indonesia
4Program Studi D3 Keperawatan, STIKES Mamba^ul ^Ulum Surakarta, Indonesia

Abstract

Background: Hypertension affects 1,28 billion adults globally and remains the leading risk factor for cardiovascular disease, stroke, and kidney failure. Despite widely available therapies, only one in three patients achieve adequate control, largely due to poor medication adherence and insufficient self-management. Mindfulness-based interventions (MBIs) have been widely studied for stress and lifestyle behaviors, yet their contribution to antihypertensive medication adherence remains poorly understood.
Purpose: This scoping review sought to map and synthesize evidence on mindfulness interventions for hypertension. Guided by the PCC framework, the research question was: ^What is known about the role of mindfulness interventions in improving medication adherence and self-management among adults with hypertension?^
Methods: The review was conducted in accordance with PRISMA and guided by the PCC framework. Inclusion criteria: (1) peer-reviewed studies published in English between 2015-2025- (2) adult participants with hypertension or elevated blood pressure- (3) interventions or assessments involving mindfulness- (4) outcomes on medication adherence, self-management, or blood pressure- and (5) quantitative, qualitative, or review designs. Exclusion criteria were protocols, commentaries, and studies unrelated to adherence or self-management. Four databases (PubMed, Scopus, CINAHL, Web of Science) were systematically searched. From 246 records identified, 18 full texts were screened, and 5 studies met inclusion criteria. Data were charted for study design, intervention, adherence/self-management measures, and blood pressure outcomes.
Results: Two RCTs of Mindfulness-Based Blood Pressure Reduction (MB-BP- n=200 each) improved interoceptive awareness, DASH diet adherence, and reduced systolic blood pressure, but did not directly measure medication adherence. One cross-sectional study (n=68) showed higher mindfulness scores predicted better adherence (MMAS-8). A systematic review/meta-analysis (12 RCTs) confirmed blood pressure reductions and improved self-regulation but lacked adherence-specific endpoints. A narrative review suggested feasibility of mindfulness to support adherence and self-management.
Conclusion: The novelty of this review lies in demonstrating that direct evidence linking mindfulness to antihypertensive medication adherence is almost absent, despite consistent benefits for lifestyle self-management. This critical gap highlights the need for rigorous, culturally adapted trials with validated adherence measures. The impact extends to advancing precision in mindfulness research and guiding integration of low-cost, holistic interventions into community health nursing to overcome persistent barriers in hypertension control.

Keywords: mindfulness, hypertension, medication adherence, self-adherence, community health nursing

Topic: Nursing Care and Technology Development