International Journal of Behavioral Medicine

, Volume 22, Issue 4, pp 540–550 | Cite as

Positive Associations of Dispositional Mindfulness with Cardiovascular Health: the New England Family Study

  • Eric B. LoucksEmail author
  • Willoughby B. Britton
  • Chanelle J. Howe
  • Charles B. Eaton
  • Stephen L. Buka



Mindfulness (the ability to attend nonjudgmentally to one’s own physical and mental processes) is receiving substantial interest as a potential determinant of health. However, little is known whether mindfulness is associated with cardiovascular health.


The aim of this study is to evaluate whether dispositional mindfulness is associated with cardiovascular health.


Study participants (n = 382) were from the New England Family Study, born in Providence, RI, USA, with mean age 47 years. Dispositional mindfulness was assessed using the Mindful Attention Awareness Scale (MAAS). Cardiovascular health was assessed based on American Heart Association criteria. Cross-sectional multivariable-adjusted log binomial regression analyses were performed.


Analyses demonstrated that those with high vs. low MAAS had prevalence ratio (PR) for good cardiovascular health of 1.83 (95 % confidence interval (CI) 1.07, 3.13), adjusted for age, gender, and race/ethnicity. There were significant associations of high vs. low mindfulness with nonsmoking (PR = 1.37, 95 % CI 1.06, 1.76), body mass index <25 kg/m2 (PR = 2.17, 95 % CI 1.16, 4.07), fasting glucose <100 mg/dL (PR = 1.47, 95 % CI 1.06, 2.04), and high physical activity (PR = 1.56, 95 % CI 1.04, 2.35), but not blood pressure, total cholesterol, or fruit/vegetable consumption. Exploratory mediation analyses suggested that sense of control and depressive symptomatology may be mediators.


This study demonstrated preliminary cross-sectional evidence that dispositional mindfulness is positively associated with cardiovascular health, with the associations particularly driven by smoking, body mass index, fasting glucose, and physical activity. If in future research mindfulness-based practices are found to consistently improve cardiovascular disease risk factors, such interventions may have potential to strengthen effects of cardiovascular health promotion programs.


Mindfulness Cardiovascular health Epidemiology Prevention 



Funding for this study was provided by NIH/NIA grant 1RC2AG036666.

Ethical Standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all participants for being included in the study.

Conflict of Interest

Eric Loucks, Willoughby Britton, Chanelle Howe, Charles Eaton and Stephen Buka declare that they have no conflict of interest.


  1. 1.
    Mendis S, Puska P, Norrving B. Global atlas on cardiovascular disease prevention and control. Geneva: World Health Organization; 2011.Google Scholar
  2. 2.
    Ezeamama AE, Viali S, Tuitele J, McGarvey ST. The influence of socioeconomic factors on cardiovascular disease risk factors in the context of economic development in the Samoan archipelago. Soc Sci Med. 2006;63(10):2533–45. doi: 10.1016/j.socscimed.2006.06.023.CrossRefPubMedGoogle Scholar
  3. 3.
    Brewer JA, Mallik S, Babuscio TA, et al. Mindfulness training for smoking cessation: results from a randomized controlled trial. Drug Alcohol Depend. 2011;119(1–2):72–80. doi: 10.1016/j.drugalcdep.2011.05.027.PubMedCentralCrossRefPubMedGoogle Scholar
  4. 4.
    Brand M, Young KS, Laier C. Prefrontal control and internet addiction: a theoretical model and review of neuropsychological and neuroimaging findings. Front Hum Neurosci. 2014;8:375. doi: 10.3389/fnhum.2014.00375.PubMedCentralCrossRefPubMedGoogle Scholar
  5. 5.
    O’Reilly GA, Cook L, Spruijt-Metz D, Black DS. Mindfulness-based interventions for obesity-related eating behaviours: a literature review. Obes Rev. 2014;15(6):453–61. doi: 10.1111/obr.12156.PubMedCentralCrossRefPubMedGoogle Scholar
  6. 6.
    Carim-Todd L, Mitchell SH, Oken BS. Mind-body practices: an alternative, drug-free treatment for smoking cessation? A systematic review of the literature. Drug Alcohol Depend. 2013;132(3):399–410. doi: 10.1016/j.drugalcdep.2013.04.014.PubMedCentralCrossRefPubMedGoogle Scholar
  7. 7.
    Brewer JA, Sinha R, Chen JA, et al. Mindfulness training and stress reactivity in substance abuse: results from a randomized, controlled stage I pilot study. Subst Abus. 2009;30(4):306–17. doi: 10.1080/08897070903250241.PubMedCentralCrossRefPubMedGoogle Scholar
  8. 8.
    Katterman SN, Kleinman BM, Hood MM, Nackers LM, Corsica JA. Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review. Eat Behav. 2014;15(2):197–204. doi: 10.1016/j.eatbeh.2014.01.005.CrossRefPubMedGoogle Scholar
  9. 9.
    Lillis J, Hayes SC, Bunting K, Masuda A. Teaching acceptance and mindfulness to improve the lives of the obese: a preliminary test of a theoretical model. Ann Behav Med. 2009;37(1):58–69. doi: 10.1007/s12160-009-9083-x.CrossRefPubMedGoogle Scholar
  10. 10.
    Tapper K, Shaw C, Ilsley J, Hill AJ, Bond FW, Moore L. Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women. Appetite. 2009;52(2):396–404. doi: 10.1016/j.appet.2008.11.012.CrossRefPubMedGoogle Scholar
  11. 11.
    Mantzios M, Giannou K. Group vs. single mindfulness meditation: exploring avoidance, impulsivity, and weight management in two separate mindfulness meditation settings. Appl Psychol Health Well-Being. 2014. doi: 10.1111/aphw.12023.PubMedGoogle Scholar
  12. 12.
    Daubenmier J, Kristeller J, Hecht FM, et al. Mindfulness intervention for stress eating to reduce cortisol and abdominal fat among overweight and obese women: an exploratory randomized controlled study. J Obes. 2011;2011:651936. doi: 10.1155/2011/651936.PubMedCentralCrossRefPubMedGoogle Scholar
  13. 13.
    Hebert JR, Ebbeling CB, Olendzki BC, et al. Change in women’s diet and body mass following intensive intervention for early-stage breast cancer. J Am Diet Assoc. 2001;101(4):421–31. doi: 10.1016/S0002-8223(01)00109-2.CrossRefPubMedGoogle Scholar
  14. 14.
    Gregg JA, Callaghan GM, Hayes SC, Glenn-Lawson JL. Improving diabetes self-management through acceptance, mindfulness, and values: a randomized controlled trial. J Consult Clin Psychol. 2007;75(2):336–43. doi: 10.1037/0022-006X.75.2.336.CrossRefPubMedGoogle Scholar
  15. 15.
    Hartmann M, Kopf S, Kircher C, et al. Sustained effects of a mindfulness-based stress-reduction intervention in type 2 diabetic patients: design and first results of a randomized controlled trial (the Heidelberger Diabetes and Stress-study). Diabetes Care. 2012;35(5):945–7. doi: 10.2337/dc11-1343.PubMedCentralCrossRefPubMedGoogle Scholar
  16. 16.
    Patel C, Marmot MG, Terry DJ, Carruthers M, Hunt B, Patel M. Trial of relaxation in reducing coronary risk: four year follow up. Br Med J (Clin Res Ed). 1985;290(6475):1103–6.CrossRefGoogle Scholar
  17. 17.
    Hughes JW, Fresco DM, Myerscough R, van Dulmen M, Carlson LE, Josephson R. Randomized controlled trial of mindfulness-based stress reduction for prehypertension. Psychosom Med. 2013;75:721–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Blom K, Baker B, How M, et al. Hypertension analysis of stress reduction using mindfulness meditation and yoga: results from the harmony randomized controlled trial. Am J Hypertens. 2013. doi: 10.1093/ajh/hpt134.PubMedGoogle Scholar
  19. 19.
    Abbott RA, Whear R, Rodgers LR, et al. Effectiveness of mindfulness-based stress reduction and mindfulness based cognitive therapy in vascular disease: a systematic review and meta-analysis of randomised controlled trials. J Psychosom Res. 2014;76(5):341–51. doi: 10.1016/j.jpsychores.2014.02.012.CrossRefPubMedGoogle Scholar
  20. 20.
    Epstein RM. Mindful practice. JAMA. 1999;282(9):833–9.CrossRefPubMedGoogle Scholar
  21. 21.
    Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. J Pers Soc Psychol. 2003;84(4):822–48. doi: 10.1037/0022-3514.84.4.822.CrossRefPubMedGoogle Scholar
  22. 22.
    Park T, Reilly-Spong M, Gross CR. Mindfulness: a systematic review of instruments to measure an emergent patient-reported outcome (PRO). Qual Life Res. 2013;22(10):2639–59. doi: 10.1007/s11136-013-0395-8.CrossRefPubMedGoogle Scholar
  23. 23.
    Bowen S, Witkiewitz K, Clifasefi SL, et al. Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders: a randomized clinical trial. JAMA Psychiatry. 2014. doi: 10.1001/jamapsychiatry.2013.4546.PubMedCentralPubMedGoogle Scholar
  24. 24.
    Holzel BK, Lazar SW, Gard T, Schuman-Olivier Z, Vago DR, Ott U. How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspect Psychol Sci. 2011;6(6):537–59.CrossRefPubMedGoogle Scholar
  25. 25.
    Sedlmeier P, Eberth J, Schwarz M, et al. The psychological effects of meditation: a meta-analysis. Psychol Bull. 2012;138(6):1139–71. doi: 10.1037/a0028168.CrossRefPubMedGoogle Scholar
  26. 26.
    Goyal M, Singh S, Sibinga EM, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014;174(3):357–68. doi: 10.1001/jamainternmed.2013.13018.PubMedCentralCrossRefPubMedGoogle Scholar
  27. 27.
    Kenford SL, Smith SS, Wetter DW, Jorenby DE, Fiore MC, Baker TB. Predicting relapse back to smoking: contrasting affective and physical models of dependence. J Consult Clin Psychol. 2002;70(1):216–27.CrossRefPubMedGoogle Scholar
  28. 28.
    Evans DL, Charney DS, Lewis L, et al. Mood disorders in the medically ill: scientific review and recommendations. Biol Psychiatry. 2005;58(3):175–89. doi: 10.1016/j.biopsych.2005.05.001.CrossRefPubMedGoogle Scholar
  29. 29.
    Pan A, Sun Q, Okereke OI, Rexrode KM, Hu FB. Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review. JAMA. 2011;306(11):1241–9. doi: 10.1001/jama.2011.1282.PubMedCentralCrossRefPubMedGoogle Scholar
  30. 30.
    Lloyd-Jones DM, Hong Y, Labarthe D, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic impact goal through 2020 and beyond. Circulation. 2010;121(4):586–613. doi: 10.1161/CIRCULATIONAHA.109.192703.CrossRefPubMedGoogle Scholar
  31. 31.
    Niswander K, Gordon M. The women and their pregnancies: the Collaborative Perinatal Study of the National Institute of Neurological Diseases and Stroke. Washington DC: National Institutes of Health; 1972.Google Scholar
  32. 32.
    Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006;13(1):27–45. doi: 10.1177/1073191105283504.CrossRefPubMedGoogle Scholar
  33. 33.
    Christopher MS, Christopher V, Charoensuk S. Assessing “Western” mindfulness among Thai Theravada Buddhist monks. Ment Health Relig Cult. 2009;12(3):303–14.CrossRefGoogle Scholar
  34. 34.
    Visted E, Jollestad J, Nielsen MB, Nielsen GH. The impact of group-based mindfulness training on self-reported mindfulness: a systematic review and meta-analysis. Mindfulness. 2014. doi: 10.1007/s12671-014-0283-5.Google Scholar
  35. 35.
    Rapgay L, Bystrisky A. Classical mindfulness: an introduction to its theory and practice for clinical application. Ann N Y Acad Sci. 2009;1172:148–62. doi: 10.1111/j.1749-6632.2009.04405.x.CrossRefPubMedGoogle Scholar
  36. 36.
    Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics–2012 update: a report from the American Heart Association. Circulation. 2012;125(1):e2–220. doi: 10.1161/CIR.0b013e31823ac046.PubMedCentralCrossRefPubMedGoogle Scholar
  37. 37.
    Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation. 2013;127(1):e6–245. doi: 10.1161/CIR.0b013e31828124ad.CrossRefPubMedGoogle Scholar
  38. 38.
    Allain CC, Poon LS, Chan CS, Richmond W, Fu PC. Enzymatic determination of total serum cholesterol. Clin Chem. 1974;20(4):470–5.PubMedGoogle Scholar
  39. 39.
    Sacks D. Carbohydrates. In: Burtis C, Ashwood E, editors. Tietz textbook of clinical chemsitry. Philadelphia: Saunders; 1999. p. 750–808.Google Scholar
  40. 40.
    Pickering TG, Hall JE, Appel LJ, et al. Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Circulation. 2005;111(5):697–716. doi: 10.1161/01.CIR.0000154900.76284.F6.CrossRefPubMedGoogle Scholar
  41. 41.
    World Health Organization. Fruit and vegetables for health: Report of a joint FAO-WHO workshop. Kobe, Japan, 2004.Google Scholar
  42. 42.
    Craig CL, Marshall AL, Sjostrom M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95. doi: 10.1249/01.MSS.0000078924.61453.FB.CrossRefPubMedGoogle Scholar
  43. 43.
    Lee PH, Macfarlane DJ, Lam TH, Stewart SM. Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act. 2011;8:115. doi: 10.1186/1479-5868-8-115.PubMedCentralCrossRefPubMedGoogle Scholar
  44. 44.
    Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10(2):77–84.PubMedGoogle Scholar
  45. 45.
    Pearlin LI, Schooler C. The structure of coping. J Health Soc Behav. 1978;19(1):2–21.CrossRefPubMedGoogle Scholar
  46. 46.
    Spiegelman D, Hertzmark E. Easy SAS calculations for risk or prevalence ratios and differences. Am J Epidemiol. 2005;162(3):199–200.CrossRefPubMedGoogle Scholar
  47. 47.
    Valeri L, Vanderweele TJ. Mediation analysis allowing for exposure-mediator interactions and causal interpretation: theoretical assumptions and implementation with SAS and SPSS macros. Psychol Methods. 2013;18(2):137–50. doi: 10.1037/a0031034.PubMedCentralCrossRefPubMedGoogle Scholar
  48. 48.
    Westbrook C, Creswell JD, Tabibnia G, Julson E, Kober H, Tindle HA. Mindful attention reduces neural and self-reported cue-induced craving in smokers. Soc Cogn Affect Neurosci. 2013;8(1):73–84. doi: 10.1093/scan/nsr076.PubMedCentralCrossRefPubMedGoogle Scholar
  49. 49.
    Karyadi KA, VanderVeen JD, Cyders MA. A meta-analysis of the relationship between trait mindfulness and substance use behaviors. Drug Alcohol Depend. 2014. doi: 10.1016/j.drugalcdep.2014.07.014.PubMedCentralPubMedGoogle Scholar
  50. 50.
    Ulmer CS, Stetson BA, Salmon PG. Mindfulness and acceptance are associated with exercise maintenance in YMCA exercisers. Behav Res Ther. 2010;48(8):805–9. doi: 10.1016/j.brat.2010.04.009.CrossRefPubMedGoogle Scholar
  51. 51.
    Chatzisarantis NL, Hagger MS. Mindfulness and the intention-behavior relationship within the theory of planned behavior. Pers Soc Psychol Bull. 2007;33(5):663–76. doi: 10.1177/0146167206297401.CrossRefPubMedGoogle Scholar
  52. 52.
    Chambers R, Lo BCY, Allen NB. The impact of intensive mindfulness training on attentional control, cognitive style, and affect. Cogn Ther Res. 2008;32(3):303–22. doi: 10.1007/S10608-007-9119-0.CrossRefGoogle Scholar
  53. 53.
    Jha AP, Krompinger J, Baime MJ. Mindfulness training modifies subsystems of attention. Cogn Affect Behav Neurosci. 2007;7(2):109–19.CrossRefPubMedGoogle Scholar
  54. 54.
    Mrazek MD, Franklin MS, Phillips DT, Baird B, Schooler JW. Mindfulness training improves working memory capacity and GRE performance while reducing mind wandering. Psychol Sci. 2013;24(5):776–81. doi: 10.1177/0956797612459659.CrossRefPubMedGoogle Scholar
  55. 55.
    Manrique-Garcia E, Sidorchuk A, Hallqvist J, Moradi T. Socioeconomic position and incidence of acute myocardial infarction: a meta-analysis. J Epidemiol Community Health. 2011;65(4):301–9. doi: 10.1136/jech.2009.104075.CrossRefPubMedGoogle Scholar
  56. 56.
    Brown KW, Ryan RM, Loverich TM, Biegel GM, West AM. Out of the armchair and into the streets: measuring mindfulness advances knowledge and improves interventions: reply to Grossman (2011). Psychol Assess. 2011;23(4):1041–6. doi: 10.1037/A0025781.CrossRefGoogle Scholar
  57. 57.
    Grossman P. Defining mindfulness by how poorly I think I pay attention during everyday awareness and other intractable problems for psychology’s (re) invention of mindfulness: comment on Brown et al. (2011). Psychol Assess. 2011;23(4):1034–40.CrossRefPubMedGoogle Scholar

Copyright information

© International Society of Behavioral Medicine 2014

Authors and Affiliations

  • Eric B. Loucks
    • 1
    Email author
  • Willoughby B. Britton
    • 2
    • 3
  • Chanelle J. Howe
    • 1
  • Charles B. Eaton
    • 1
    • 4
  • Stephen L. Buka
    • 1
  1. 1.Department of EpidemiologyBrown University School of Public HealthProvidenceUSA
  2. 2.Department of Behavioral and Social SciencesBrown University School of Public HealthProvidenceUSA
  3. 3.Department of Psychiatry and Human BehaviorBrown University Warren Alpert Medical SchoolProvidenceUSA
  4. 4.Department of Family MedicineBrown University Warren Alpert Medical SchoolProvidenceUSA

Personalised recommendations