Text messages promoting forgiveness, gratitude may improve blood pressure
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Key takeaways:
- Daily smartphone messages designed to cultivate spirituality were linked to lower blood pressure compared with no intervention.
- The intervention was also associated with improved endothelial function.
ATLANTA — Among adults with mild to moderate hypertension, receiving text messages designed to cultivate spirituality was associated with an average 7 mm Hg decrease in systolic BP compared with no intervention, researchers reported.
“We know a lot about diseases and their mechanisms and how to treat with medications. We know about life habits and their influences on hypertension, but something is missing,” Maria Emilia Figueiredo Teixeira, MD, PhD, FESC, cardiologist in the hypertension unit of the Medical School of Federal University of Goiás, Brazil, told Healio. “We are not looking properly at the human side of our patients — their feelings and emotions and how they can affect our health. Studies show there is influence there. We must learn how to assess that.”
The researchers randomly assigned 100 adults with stage I or II hypertension who reported regularly taking antihypertensive medications for at least 30 days to the text message intervention (n = 51; 17.6% men) or to no intervention (n = 49; 40.8% men) for 12 weeks.
Researchers compared BP, central hemodynamic parameters and flow-mediated dilation at baseline and 12 weeks between the intervention and control groups and within each group. Those in the intervention group received a WhatsApp message every morning that included videos, quotes for self-reflection and short tasks, all designed to cultivate feelings of forgiveness, gratitude, optimism and life purpose — these are tenets of spirituality, but do not belong to any one religion, Teixeira said during a presentation at the American College of Cardiology Scientific Session.
“We are not talking about religiosity, which can be defined as how much an individual believes, follows and practices a religion,” Teixeira said during the presentation.
Same-day confirmation of received text messages was provided via read receipts and answers for tasks; there was no conversation between participants and study staff.
At 12 weeks, office systolic BP decreased by a mean of 7.6 mm Hg for the text message group and by 0.55 mm Hg for controls, for a difference of 7.1 mm Hg (P = .047). Central systolic BP fell by a mean of 4.1 mm Hg and increased by 1.38 mm Hg for the intervention and control groups, respectively (P = .078), whereas home-measured systolic BP decreased by 1.44 mm Hg and increased by 0.39 mm Hg in the intervention and control groups, respectively (P = .293). Flow-mediated dilation also improved for the intervention group vs. controls (P < .001).
“Literature shows that forgiveness, gratitude, optimism and life purpose can increase CV health in many ways, such as lowering hypertension prevalence and better BP control through reduced stress, deactivation of the sympathetic system and lower left ventricular workload,” Teixeira said.
Teixeira said further trials are needed to confirm the findings and to consider other hard CV endpoints with a larger group of participants.
“This is a small, pilot study; it is not enough to prove benefits [of spirituality], but it sheds some light on unassessed human feelings,” Teixeira told Healio. “We should learn how to assess that in our patients. If our patients say something — for example, ‘I have a problem with a friend I quarreled with’ — do not ignore that. It could be influencing their health.”
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Teixeira MEF, et al. Clinical and investigative horizons. Presented at: American College of Cardiology Scientific Session; April 6-8, 2024; Atlanta.
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