***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The aim was to examine the effects of a Mindfulness-Based Stress Reduction ( MBSR ) intervention on cardiovascular and cortisol activity during acute stress . METHOD Eighty-eight healthy community-dwelling individuals reporting elevated stress levels were r and omly assigned to the MBSR protocol or a waitlist control group . Before and after the intervention period they participated in a laboratory stress protocol consisting of mental arithmetic and speech tasks . Laboratory measurements included continuous cardiovascular parameters ( heart period , heart rate variability , and systolic and diastolic blood pressure [ SBP and DBP ] ) , and salivary cortisol . RESULTS Compared to the control group and controlling for age , sex , body mass index , and beta-blockers , the MBSR group showed larger pre- to postintervention decreases in overall SBP ( F(1 , 58 ) = 4.99 , p = .029 , partial η² = .08 ) and DBP ( F(1 , 58 ) = 11.09 , p = .002 , partial η² = .16 ) . In addition , the MBSR group exhibited smaller SBP and DBP stress-related changes from pre- to postintervention ( F(2 , 116 ) = 4.89 , p = .012 , partial η² = .08 ; F(2 , 116 ) = 6.07 , p = .007 , partial η² = .10 , respectively ) . No effects were obtained on other physiological measures . CONCLUSION MBSR may help reducing blood pressure levels and blood pressure reactivity to stress OBJECTIVE Emotional distress is common in out patients with diabetes , affecting ∼20–40 % of the patients . The aim of this study was to determine the effectiveness of group therapy with Mindfulness-Based Cognitive Therapy ( MBCT ) , relative to usual care , for patients with diabetes with regard to reducing emotional distress and improving health-related quality of life and glycemic control . RESEARCH DESIGN AND METHODS In the present r and omized controlled trial , 139 out patients with diabetes ( type 1 or type 2 ) and low levels of emotional well-being were r and omized to MBCT ( n = 70 ) or a waiting list group ( n = 69 ) . Primary outcomes were perceived stress ( Perceived Stress Scale ) , anxiety and depressive symptoms ( Hospital Anxiety and Depression Scale ) , mood ( Profiles of Mood States ) , and diabetes-specific distress ( Problem Areas In Diabetes ) . Secondary outcomes were health-related quality of life ( 12-Item Short-Form Health Survey ) , and glycemic control ( HbA1c ) . Assessment s were conducted at baseline and at 4 and 8 weeks of follow-up . RESULTS Compared with control , MBCT was more effective in reducing stress ( P < 0.001 , Cohen d = 0.70 ) , depressive symptoms ( P = 0.006 , d = 0.59 ) , and anxiety ( P = 0.019 , d = 0.44 ) . In addition , MBCT was more effective in improving quality of life ( mental : P = 0.003 , d = 0.55 ; physical : P = 0.032 , d = 0.40 ) . We found no significant effect on HbA1c or diabetes-specific distress , although patients with elevated diabetes distress in the MBCT group tended to show a decrease in diabetes distress ( P = 0.07 , d = 0.70 ) compared with the control group . CONCLUSIONS Compared with usual care , MBCT result ed in a reduction of emotional distress and an increase in health-related quality of life in diabetic patients who had lower levels of emotional well-being Objective Mindfulness-based stress reduction ( MBSR ) is an increasingly popular practice demonstrated to alleviate stress and treat certain health conditions . MBSR may reduce  elevated blood pressure ( BP ) . Treatment guidelines recommend life-style modifications for BP in the prehypertensive range ( systolic BP [ SBP ] 120–139 mm Hg or diastolic BP [ DBP ] 80–89 mm Hg ) , followed by antihypertensives if BP reaches hypertensive levels . MBSR has not been thoroughly evaluated as a treatment of prehypertension . A r and omized clinical trial of MBSR for high BP was conducted to determine whether BP reductions associated with MBSR exceed those observed for an active control condition consisting of progressive muscle relaxation ( PMR ) training . Methods Fifty-six men ( 43 % ) and women ( 57 % ) averaging ( st and ard deviation ) 50.3 ( 6.5 ) years of age ( 91 % white ) with unmedicated BP in the prehypertensive range were r and omized to 8 weeks of MBSR or PMR delivered in a group format . Treatment sessions were administered by one treatment provider and lasted approximately 2.5 hours each week . Clinic BP was the primary outcome measure . Ambulatory BP was a secondary outcome measure . Results Analyses were based on intent to treat . Patients r and omized to MBSR exhibited a 4.8-mm Hg reduction in clinic SBP , which was larger than the 0.7-mm Hg reduction observed for PMR ( p = .016 ) . Those r and omized to MBSR exhibited a 1.9-mm Hg reduction in DBP compared with a 1.2-mm Hg increase for PMR ( p = .008 ) . MBSR did not result in larger decreases in ambulatory BP than in PMR . Conclusions MBSR result ed in a reduction in clinic SBP and DBP compared with PMR . Trial Registration Clinical Trials.gov identifier : NCT00440596 Hypertension affects a large proportion of urban African-American older adults . While there have been great strides in drug development , many older adults do not have access to such medicines or do not take them . Mindfulness-based stress reduction ( MBSR ) has been shown to decrease blood pressure in some population s. This has not been tested in low-income , urban African-American older adults . Therefore , the primary purpose of this pilot study was to test the feasibility and acceptability of a mindfulness-based program for low income , minority older adults provided in residence . The secondary purpose was to learn if the mindfulness-based program produced differences in blood pressure between the intervention and control groups . Participants were at least 62 years old and residents of a low-income senior residence . All participants were African-American , and one was male . Twenty participants were r and omized to the mindfulness-based intervention or a social support control group of the same duration and dose . Blood pressure was measured with the Omron automatic blood pressure machine at baseline and at the end of the 8-week intervention . A multivariate regression analysis was performed on the difference in scores between baseline and post-intervention blood pressure measurements , controlling for age , education , smoking status , and anti-hypertensive medication use . Effect sizes were calculated to quantify the magnitude of the relationship between participation in the mindfulness-based intervention and the outcome variable , blood pressure . Attendance remained > 80 % in all 8 weeks of both the intervention and the control groups . The average systolic blood pressure decreased for both groups post-intervention . Individuals in the intervention group exhibited a 21.92-mmHg lower systolic blood pressure compared to the social support control group post-intervention and this value was statistically significant ( p = 0.020 ) . The average diastolic blood pressure decreased in the intervention group post-intervention , but increased in the social support group . Individuals in the intervention group exhibited a 16.70-mmHg lower diastolic blood pressure compared to the social support group post-intervention , and this value was statistically significant ( p = 0.003 ) . Older adults are at a time in life when a reflective , stationary intervention , delivered in residence , could be an appealing mechanism to improve blood pressure . Given our preliminary results , larger trials in this hypertensive study population are warranted CONTEXT Psychological distress is linked with impaired glycemic control among diabetics . OBJECTIVE Estimate changes in glycemic control , weight , blood pressure , and stress-related psychological symptoms in patients with type 2 diabetes participating in a st and ard Mindfulness Based Stress Reduction ( MBSR ) program . DESIGN Prospect i ve , observational study . SETTING Academic health center . PATIENTS Adult patients with type 2 diabetes mellitus . INTERVENTIONS Participation in MBSR program for heterogeneous patient population . Diet and exercise regimens held constant . MAIN OUTCOME MEASURES Glycosylated hemoglobin A1c ( HA1c ) , blood pressure , body weight , and Symptom Checklist 90-Revised ( anxiety , depression , somatization , and general psychological distress scores ) . RESULTS Eleven of 14 patients completed the intervention . At 1 month follow-up , HA1c was reduced by 0.48 % ( P = .03 ) , and mean arterial pressure was reduced by 6 mmHg ( P = .009 ) . Body weight did not change . A decrease in measures of depression , anxiety , and general psychological distress was observed OBJECTIVE To determine whether a mindfulness-based stress reduction ( MBSR ) intervention is effective for reducing psychosocial distress ( i.e. , depression , psychosocial stress ) and the progression of nephropathy ( i.e. , albuminuria ) and for improving the subjective health status of patients with type 2 diabetes . RESEARCH DESIGN AND METHODS Patients with type 2 diabetes and microalbuminuria were r and omized to a  mindfulness-based intervention ( n = 53 ) or a  treatment-as-usual control ( n = 57 ) group . The study is design ed to investigate long-term outcomes over a period of 5 years . We present data up to the first year of follow-up ( FU ) . RESULTS At FU , the MBSR group showed lower levels of depression ( d = 0.71 ) and improved health status ( d = 0.54 ) compared with the control group . No significant differences in albuminuria were found . Per- protocol analysis also showed higher stress reduction in the intervention group ( d = 0.64 ) . CONCLUSIONS MBSR intervention achieved a prolonged reduction in psychosocial distress . The effects on albuminuria will be followed up further Summary : Heart disease is the leading cause of death among Americans each year , yet the misperception still exists that cardiovascular disease is not a serious health problem for women . Evidence indicates that anxiety contributes to the development of heart disease . The primary purpose of this study was to assess the effectiveness of Kabat-Zinn 's mindfulness-based stress reduction program to reduce anxiety in women with heart disease .  Anxiety , emotional control , coping styles , and health locus of control were compared in a treatment and control group of women with heart disease . Post-intervention analyses provide initial support for beneficial effects of this program In this study effects of a brief mindfulness-based stress reduction intervention were examined in cardiac patients who had a percutaneous coronary intervention ( PCI ) . One-hundred- and -fourteen patients ( mean age 55 ± 7 years , 18 % women ) were r and omly assigned to a 4-session mindfulness group intervention or a minimal mindfulness self-help control group that received a booklet containing identical information . Compared to self-help , the group intervention showed larger increases in psychological and social quality of life ( p < .05 , partial η2 = .04 and .05 , respectively ) . For symptoms of anxiety and depression , and for perceived stress , this effect was evident only in patients younger than 60 years ( p < .01 , partial η2 = .10 and .15 , respectively ) . These effects were partially or fully mediated by increase in mindfulness . The brief group mindfulness intervention seems beneficial for cardiac PCI patients  regarding general psychosocial quality of life , although for specific psychological symptoms , this intervention can be recommended only for nonelderly patients OBJECTIVE Stress has been cited as a causal factor in heart disease . The objective of this study was to examine the effects of an 8-week mindfulness-based stress-reduction program on the resting levels of stress hormones , physical functioning , and submaximal exercise responses in women with heart disease . SUBJECTS R and om selection with the numbers 1 and 2 were used to assign 18 women ( 60 + /-6.3 years old ) with documented histories of heart disease to a treatment group ( n = 9 ) or a control group ( n = 9 ) . Speilberger 's state anxiety scores for the treatment ( M = 37.88 ; st and ard deviation ( SD ) = 10.91 ) and control group ( M = 43.22 ; SD = 12.26 ) were not significantly different prior to the start of the study . However , their scores fell in the upper percentile rank for normal adults in their age category . INTERVENTION The intervention was provided one night each week for 2 hours over a period of 8 weeks . The intervention included didactic , inductive , and experiential modes of learning regarding stress responses and mindfulness skill-development training . DESIGN Pre-post test hormonal measurements and physical function were analyzed using a 2 ( group ) by 2 ( time ) analysis of variance ( ANOVA ) with repeated measures following the 8-week program . Submaximal exercise responses were also compared between the treatment group and the control group following the 8-week program . A 2 ( group ) by 3 ( time ) ANOVA with repeated measures was used to analyze the data . SETTING S/LOCATION Weekly meetings were held on a university medical school campus . Submaximal exercise responses were recorded while participants cycled on a stationary bike in an applied physiology laboratory following the 8-week program . RESULTS There were no significant main effects 
    Output:
    
Whilst population s 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 .