Spirituality-Based Intervention in Hypertension: EFfects on Blood PrEssure and EndotheliaL Function—FEEL Trial Results
Background: Emerging evidence suggests that spirituality improves patient outcomes, however, this has undergone only limited evaluation in randomized trials. Hypertension is a major cause of cardiovascular morbidity and mortality worldwide. Objectives: To evaluate whether a spirituality-based interv...
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Ubiquity Press
2025-01-01
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| Series: | Global Heart |
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| Online Access: | https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1390 |
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| author | Maria Emília Figueiredo Teixeira Weimar Kunz Sebba Barroso Andréa Araújo Brandão Ana Luiza Lima Sousa Roberto Esporcatte Mário Henrique Elesbão de Borba Ana Clara Neri Ávila Baleeiro Beatriz Caldas Gonçalves Enzo Inumaru Enzo Mata de Sousa Giovana Barros Leal Henrique Soares de Araújo Pereira Farias Juliana Alves de Souza Lure Emilly Barreto da Silva Matheus Canguçu de Paiva Queiroz Frederico Rafael Moreira Priscila Valverde de Oliveira Vitorino John Eikelboom Álvaro Avezum |
| author_facet | Maria Emília Figueiredo Teixeira Weimar Kunz Sebba Barroso Andréa Araújo Brandão Ana Luiza Lima Sousa Roberto Esporcatte Mário Henrique Elesbão de Borba Ana Clara Neri Ávila Baleeiro Beatriz Caldas Gonçalves Enzo Inumaru Enzo Mata de Sousa Giovana Barros Leal Henrique Soares de Araújo Pereira Farias Juliana Alves de Souza Lure Emilly Barreto da Silva Matheus Canguçu de Paiva Queiroz Frederico Rafael Moreira Priscila Valverde de Oliveira Vitorino John Eikelboom Álvaro Avezum |
| author_sort | Maria Emília Figueiredo Teixeira |
| collection | DOAJ |
| description | Background: Emerging evidence suggests that spirituality improves patient outcomes, however, this has undergone only limited evaluation in randomized trials. Hypertension is a major cause of cardiovascular morbidity and mortality worldwide. Objectives: To evaluate whether a spirituality-based intervention, compared to a control group, can reduce blood pressure (BP) and improve endothelial function after 12 weeks in patients with mild or moderate hypertension (HTN). Methods: Open randomized controlled trial of adults with stage I or II hypertension. Following baseline evaluation, including lifestyle questionnaires, and measurements of office and central blood pressure (BP), home blood pressure monitoring (HBPM) and flow mediated dilation (FMD), patients were randomized to a spirituality-based intervention, which included training for forgiveness, gratitude, optimism, and life purpose delivered by daily WhatsApp communications, or to the control group (CG). Main outcomes were between group difference in change from baseline to 12 weeks in office and central BP, HBPM and FMD, using t-tests, analyses of covariance (ANCOVA) adjusting for baseline differences, and, in addition, missing data imputation as a sensitivity analysis. Results: Fifty-one patients were randomized to spirituality-based intervention and 49 to control group. Baseline characteristics were well balanced between groups. Spirituality training, compared with control, improved 7.6 mmHg office systolic blood pressure (SBP), 4.1 mmHg central SBP and 4.1 percentage points FMD. Compared to control group, t-test demonstrated statistical significance for office SBP (–7.04 mmHg, p = 0.047) and FMD (7.46 percentage points, p < 0.001), and ANCOVA adjustment for baseline differences showed statistical significance for central SBP (–6.99 mmHg, p = 0.038) and FFMD (7.95 percentage points, p < 0.001) There was no significant effect on HBPM. Conclusion: A spirituality-based intervention was associated with improved control of office SBP and FMD. These findings will be prospectively evaluated in a nationwide larger and well-powered RCT. |
| format | Article |
| id | doaj-art-3e9a1f8dc64749a6a6de096a05d8cb0a |
| institution | Kabale University |
| issn | 2211-8179 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | Global Heart |
| spelling | doaj-art-3e9a1f8dc64749a6a6de096a05d8cb0a2025-02-11T05:32:44ZengUbiquity PressGlobal Heart2211-81792025-01-012016610.5334/gh.13901371Spirituality-Based Intervention in Hypertension: EFfects on Blood PrEssure and EndotheliaL Function—FEEL Trial ResultsMaria Emília Figueiredo Teixeira0https://orcid.org/0000-0002-4785-9651Weimar Kunz Sebba Barroso1https://orcid.org/0000-0002-1265-1930Andréa Araújo Brandão2https://orcid.org/0000-0002-7040-396XAna Luiza Lima Sousa3https://orcid.org/0000-0002-7566-3541Roberto Esporcatte4https://orcid.org/0000-0002-9040-5794Mário Henrique Elesbão de Borba5https://orcid.org/0000-0002-0020-5183Ana Clara Neri Ávila Baleeiro6https://orcid.org/0009-0003-3794-5593Beatriz Caldas Gonçalves7https://orcid.org/0009-0000-9100-0003Enzo Inumaru8https://orcid.org/0009-0003-4793-9584Enzo Mata de Sousa9https://orcid.org/0009-0002-8552-0226Giovana Barros Leal10https://orcid.org/0009-0001-0376-7202Henrique Soares de Araújo Pereira Farias11https://orcid.org/0009-0003-9201-8952Juliana Alves de Souza12https://orcid.org/0009-0004-0036-8187Lure Emilly Barreto da Silva13https://orcid.org/0009-0009-8062-0720Matheus Canguçu de Paiva Queiroz14https://orcid.org/0009-0002-9292-3568Frederico Rafael Moreira15Priscila Valverde de Oliveira Vitorino16https://orcid.org/0000-0002-5487-4649John Eikelboom17https://orcid.org/0000-0003-4126-1285Álvaro Avezum18https://orcid.org/0000-0002-3073-6890Hypertension Unit, Cardiology Section, Medical School, Federal University of Goiás; Health Science Post Graduation, Federal University of Goiás; Spirituality and Cardiovascular Medicine Department, Brazilian Cardiology Society – DEMCA/SBCHypertension Unit, Cardiology Section, Medical School, Federal University of Goiás; Health Science Post Graduation, Federal University of Goiás; Spirituality and Cardiovascular Medicine Department, Brazilian Cardiology Society – DEMCA/SBC; Medical School, Federal University of Goiás; Albert Einstein Hospital, Goiânia, GoiásDepartment of Chest Diseases, University of the State of Rio de JaneiroHypertension Unit, Cardiology Section, Medical School, Federal University of Goiás; Health Science Post Graduation, Federal University of Goiás; School of Nursing, Federal University of GoiásSpirituality and Cardiovascular Medicine Department, Brazilian Cardiology Society – DEMCA/SBC; Department of Chest Diseases, University of the State of Rio de JaneiroSpirituality and Cardiovascular Medicine Department, Brazilian Cardiology Society – DEMCA/SBC; Cardio Clínica do Vale, Lajeado, RSMedical student, School of Medical and Life Sciences, Pontifical Catholic University of GoiásMedical student, Medical School, Federal University of GoiásMedical student, Medical School, Federal University of GoiásMedical student, Medical School, Federal University of GoiásMedical student, Medical School, University Center of MineirosMedical student, Medical School, Federal University of GoiásMedical student, Medical School, University Center of MineirosMedical student, Medical School, University Center of MineirosMedical student, Medical School, Federal University of GoiásInternational Research Center, Hospital Alemão Oswaldo CruzSchool of Social and Health Sciences, Pontifical Catholic University of GoiásPopulation Health Research Institute, McMaster UniversitySpirituality and Cardiovascular Medicine Department, Brazilian Cardiology Society – DEMCA/SBC; International Research Center, Hospital Alemão Oswaldo CruzBackground: Emerging evidence suggests that spirituality improves patient outcomes, however, this has undergone only limited evaluation in randomized trials. Hypertension is a major cause of cardiovascular morbidity and mortality worldwide. Objectives: To evaluate whether a spirituality-based intervention, compared to a control group, can reduce blood pressure (BP) and improve endothelial function after 12 weeks in patients with mild or moderate hypertension (HTN). Methods: Open randomized controlled trial of adults with stage I or II hypertension. Following baseline evaluation, including lifestyle questionnaires, and measurements of office and central blood pressure (BP), home blood pressure monitoring (HBPM) and flow mediated dilation (FMD), patients were randomized to a spirituality-based intervention, which included training for forgiveness, gratitude, optimism, and life purpose delivered by daily WhatsApp communications, or to the control group (CG). Main outcomes were between group difference in change from baseline to 12 weeks in office and central BP, HBPM and FMD, using t-tests, analyses of covariance (ANCOVA) adjusting for baseline differences, and, in addition, missing data imputation as a sensitivity analysis. Results: Fifty-one patients were randomized to spirituality-based intervention and 49 to control group. Baseline characteristics were well balanced between groups. Spirituality training, compared with control, improved 7.6 mmHg office systolic blood pressure (SBP), 4.1 mmHg central SBP and 4.1 percentage points FMD. Compared to control group, t-test demonstrated statistical significance for office SBP (–7.04 mmHg, p = 0.047) and FMD (7.46 percentage points, p < 0.001), and ANCOVA adjustment for baseline differences showed statistical significance for central SBP (–6.99 mmHg, p = 0.038) and FFMD (7.95 percentage points, p < 0.001) There was no significant effect on HBPM. Conclusion: A spirituality-based intervention was associated with improved control of office SBP and FMD. These findings will be prospectively evaluated in a nationwide larger and well-powered RCT.https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1390spiritualityhypertensionpulse wave velocityvascular endotheliumrandomized controlled trial |
| spellingShingle | Maria Emília Figueiredo Teixeira Weimar Kunz Sebba Barroso Andréa Araújo Brandão Ana Luiza Lima Sousa Roberto Esporcatte Mário Henrique Elesbão de Borba Ana Clara Neri Ávila Baleeiro Beatriz Caldas Gonçalves Enzo Inumaru Enzo Mata de Sousa Giovana Barros Leal Henrique Soares de Araújo Pereira Farias Juliana Alves de Souza Lure Emilly Barreto da Silva Matheus Canguçu de Paiva Queiroz Frederico Rafael Moreira Priscila Valverde de Oliveira Vitorino John Eikelboom Álvaro Avezum Spirituality-Based Intervention in Hypertension: EFfects on Blood PrEssure and EndotheliaL Function—FEEL Trial Results Global Heart spirituality hypertension pulse wave velocity vascular endothelium randomized controlled trial |
| title | Spirituality-Based Intervention in Hypertension: EFfects on Blood PrEssure and EndotheliaL Function—FEEL Trial Results |
| title_full | Spirituality-Based Intervention in Hypertension: EFfects on Blood PrEssure and EndotheliaL Function—FEEL Trial Results |
| title_fullStr | Spirituality-Based Intervention in Hypertension: EFfects on Blood PrEssure and EndotheliaL Function—FEEL Trial Results |
| title_full_unstemmed | Spirituality-Based Intervention in Hypertension: EFfects on Blood PrEssure and EndotheliaL Function—FEEL Trial Results |
| title_short | Spirituality-Based Intervention in Hypertension: EFfects on Blood PrEssure and EndotheliaL Function—FEEL Trial Results |
| title_sort | spirituality based intervention in hypertension effects on blood pressure and endothelial function feel trial results |
| topic | spirituality hypertension pulse wave velocity vascular endothelium randomized controlled trial |
| url | https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1390 |
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