title: Effectiveness of mindfulness-based stress reduction and mindfulness based cognitive therapy in vascular disease: A systematic review and meta-analysis of randomised controlled trials.
abstract: OBJECTIVE
  To determine the effectiveness of mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) on psychological and physical outcomes for people with vascular disease.
  
  
  METHODS
  Systematic review and meta-analysis of randomised controlled trials.
  
  
  METHODS
  AMED, CINAHL, EMBASE, British Nursing Index, Medline, Web of Science, PsycINFO, Cochrane Database of Systematic Reviews, Central, Social Sciences Citation Index, Social Policy and Practice, and HMIC from inception to January 2013.
  
  
  METHODS
  Articles were screened for inclusion independently by two reviewers. Data extraction and quality appraisal were performed by one reviewer and checked by a second with discrepancies resolved by discussion with a third if necessary. Random-effects meta-analyses were performed.
  
  
  RESULTS
  Nine articles (from eight original randomised controlled trials) met eligibility criteria and were included in the final review. In total, 578 participants were enrolled across the trials, with participants presenting with prehypertension/hypertension (n=3 trials), type 1 or 2 diabetes (n=2), heart disease (n=2) and stroke (n=1). Meta-analyses, using standardised mean differences, showed evidence of reductions in stress (-0.36; 95% CI -0.67 to -0.09; p=0.01), depression (-0.35; 95% CI -0.53 to -0.16; p=0.003) and anxiety (-0.50; 95% CI -0.70 to -0.29; p<0.001). Effects on physical outcomes (blood pressure, albuminuria, stress hormones) were mixed.
  
  
  CONCLUSIONS
  Whilst populations with vascular disease appear to derive a range of psychological benefits from MBSR/MBCT intervention, the effects on physical parameters of disease are not yet established. More robust studies, with longer term follow-up, are required to ascertain full effectiveness of such intervention.
authors.affiliation: PenCLAHRC, University of Exeter Medical School, Exeter EX2 4SG, United Kingdom. Electronic address: r.a.abbott@exeter.ac.uk.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Abbott
authors.affiliation: PenCLAHRC, University of Exeter Medical School, Exeter EX2 4SG, United Kingdom.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Whear
authors.affiliation: PenCLAHRC, University of Exeter Medical School, Exeter EX2 4SG, United Kingdom.
authors.forename: Lauren R
authors.initials: LR
authors.lastname: Rodgers
authors.affiliation: PenCLAHRC, University of Exeter Medical School, Exeter EX2 4SG, United Kingdom.
authors.forename: Alison
authors.initials: A
authors.lastname: Bethel
authors.affiliation: PenCLAHRC, University of Exeter Medical School, Exeter EX2 4SG, United Kingdom.
authors.forename: Jo
authors.initials: J
authors.lastname: Thompson Coon
authors.affiliation: Mood Disorders Centre, College of Life and Environmental Sciences, University of Exeter, EX4 4QG, United Kingdom.
authors.forename: Willem
authors.initials: W
authors.lastname: Kuyken
authors.affiliation: PenCLAHRC, University of Exeter Medical School, Exeter EX2 4SG, United Kingdom.
authors.forename: Ken
authors.initials: K
authors.lastname: Stein
authors.affiliation: Psychology, University of Exeter Medical School, Exeter EX2 4SG, United Kingdom.
authors.forename: Chris
authors.initials: C
authors.lastname: Dickens
mesh_terms: D001007:Anxiety / Q000209:etiology / Q000517:prevention & control; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D064866:Mindfulness; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000523:psychology* / Q000628:therapy*; D013315:Stress, Psychological
keywords: MBCT; MBSR; Meta-analysis; Mindfulness; Systematic review; Vascular disease