# Mechanisms of mindfulness training to prevent hypertensive disorders of pregnancy

> **NIH NIH R01** · MIRIAM HOSPITAL · 2022 · $514,011

## Abstract

ABSTRACT
Hypertensive disorders of pregnancy are the most common medical condition affecting pregnancy and a
leading cause of maternal morbidity and mortality in the Unites States. Hypertensive disorders of pregnancy
increase lifetime cardiac disease risk in women and infants exposed during pregnancy and are considered an
independent, gender-specific cardiovascular risk factor by the American Heart Association. Current
interventions to prevent hypertensive disorders of pregnancy are extremely limited and minimally effective.
Mindfulness-based interventions hold significant promise as a non-pharmacological intervention to prevent
hypertensive disorders of pregnancy; mindfulness-based interventions significantly reduce blood pressure in
adults with hypertension and prehypertension. However, prenatal clinical trials of mindfulness-based
interventions have excluded women at risk for hypertensive disorders of pregnancy from participating, and
have not examined effects of mindfulness on maternal cardiovascular parameters. Our pilot RCT of prenatal
mindfulness training for women at risk for hypertensive disorders of pregnancy demonstrated medium to large
effects on maternal cardiovascular parameters of risk for hypertensive disorders of pregnancy, including lower
ambulatory blood pressure and accelerated fetal growth velocity. However, the mechanisms explaining effects
of prenatal mindfulness training on indicators of risk for hypertensive disorders of pregnancy are unknown.
Building upon these promising preliminary findings, the proposed RCT will harness subjective and objective
ecological momentary assessment (EMA) methodologies (in vivo repeated assessments) in combination with
wearable biosensor technology to capture rich epochs of ecologically-valid psychological (Aim 1), physiological
(Aim 2), and interpersonal (Aim 3) processes through which mindfulness training may lead to improved
maternal cardiovascular parameters and reduced risk for hypertensive disorders of pregnancy. N=150
pregnant women at risk for HDP will be randomized to an 8-week phone-delivered mindfulness intervention or
usual care. For every participant, we will measure maternal cardiovascular parameters (24-hour blood
pressure and uterine artery resistance values by ultrasound Doppler) before and after the RCT. All participants
will complete EMA for 2 weeks ‘bursts’ before and after the RCT to evaluate mechanisms of mindfulness
training on maternal cardiovascular parameters. EMA will include smartphone-app based experience sampling
of psychological processes; smartphone-app based ambient audio sampling (i.e. the Electronically Activated
Recorder [EAR] method) and wearable wrist-worn biosensor monitoring (heart rate and heart rate variability) of
physiological responses to everyday experiences. Results will provide new insights into 1) effects of
mindfulness training on cardiovascular parameters in pregnancy, 2) pathophysiological mechanisms of
hypertensive disorders of pregnancy, ...

## Key facts

- **NIH application ID:** 10477199
- **Project number:** 5R01HL157288-02
- **Recipient organization:** MIRIAM HOSPITAL
- **Principal Investigator:** Margaret Bublitz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $514,011
- **Award type:** 5
- **Project period:** 2021-09-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10477199

## Citation

> US National Institutes of Health, RePORTER application 10477199, Mechanisms of mindfulness training to prevent hypertensive disorders of pregnancy (5R01HL157288-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10477199. Licensed CC0.

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