Hearts and minds

By Tucker Farzad, high school student, Lipscomb Academy, Nashville, TN and Neda Gould, PhD, Johns Hopkins Medicine

While the link between psychological well-being and improved cardiovascular health has been previously established, a recent review  not only emphasizes this relationship, but also addresses an important question related to the frequency and duration of these practices needed to see benefits—in general, 8-12 weeks of structured mindfulness/positive psychology sessions and daily practice. While enrolling in formal programs may be ideal, we offer some simple strategies to get you and your patients started.

The impact blood pressure of positive psychology and mindfulness practices

Positive psychology and mindfulness interventions are believed to improve cardiovascular health through a few mechanisms. Physiologically, these practices can result in stress reduction, which can reduce blood pressure and possibly decrease inflammation. From a psychological standpoint, these practices can decrease symptoms of depression, which negatively impacts cardiovascular health. From a behavioral standpoint, these practices build greater awareness of activities that can be helpful and harmful to our well-being, allowing us to make important lifestyle changes.

Mindfulness-Based Stress Reduction Programs

Positive psychology and mindfulness practices are distinct but with significant overlap. You can start with these simple practices and gradually build toward a more structured program, such as the Mindfulness-Based Stress Reduction Program, which is offered at Johns Hopkins Medicine (in-person and virtually) and through a variety of other organizations nationally and internationally.

Of course, mindfulness and gratitude practices and programs should be integrated into traditional cardiovascular care alongside medication adherence and healthy lifestyle habits, supporting health and well-being from a truly comprehensive perspective. As organizations, we should also think broadly and strategically about how to implement these programs more effectively within hospital systems.

Positive psychology practices to try yourself and share with patients:

1. When you wake up, write down three things you’re grateful for. Every night before bed, take a few minutes to reflect on your day and write down three things that went well.

2. Engage in a “Best Positive Self Exercise.” Spend 10-15 minutes once a week writing a paragraph envisioning your best life where everything goes as you hoped and all your goals are achieved. Spend time visualizing this in detail. Then begin to break down your goals into actionable items.

3. Perform 1-3 small acts of kindness every day, such as holding the door for somebody, treating someone to lunch, or even just giving someone a compliment.

Mindfulness practices to try yourself and share with patients:

1. Pause during the day and take a few deep breaths. Allow these breaths to bring you back into this moment.

2. Eat a meal or snack mindfully. Slow down, notice, and savor.

3. Use loving-kindness practices. Sit down and get comfortable, close your eyes and repeat phrases like these to yourself: “May I be safe. May I be happy. May I be healthy.”

4. Use a grounding practice throughout the day: Identify five things that you can see, four things that you can physically feel, three things that you can hear, two things that you can smell, and one thing that you can taste.

5. Practice square breathing. Visually picture a box in your mind with four equal sides. Spend four seconds on each side by 1) inhaling slowly through your nose 2) holding your breath gently 3) exhaling out your mouth 4) holding your breath gently. Repeat this cycle a few times.

Additional mindfulness practices can be found here.

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.