CC BY
17
Journal of Stress Physiology & Biochemistry, Vol. 20, No. 4, 2024, pp. 157-166 ISSN 1997-0838 Original Text Copyright © 2024 by Giri and Kumar
ORIGINAL ARTICLE
OPEN
ACCESS
Meditation as a Tool for Stress Reduction and Cardiovascular Health Improvement in Higher Education: A Quantitative Study
Shubham Goswami Giri1, Surendra Kumar2
*
1 Research Scholar, Department of Business Management, H.N.B. Garhwal Central University, Srinagar (Garhwal), Uttarakhand India.
2 Associate Professor, Department of Business Management, H.N.B. Garhwal Central University, Srinagar (Garhwal), Uttarakhand India.
*E-Mail: ksurendra02@gmail .com
This study examines how mindfulness, transcendental, and guided imagery meditation techniques affect blood pressure and subjective stress levels in higher education students in Uttarakhand, India. A sample of 400 participants was studied quantitatively using a quasi-experimental pretest-posttest design. Participants practiced various meditation techniques for eight weeks, and changes in systolic and diastolic blood pressure, as well as reported stress levels, were recorded. The intervention resulted in significant reductions in both blood pressure measures (systolic: 70%, diastolic: 65%) and perceived stress levels (75%). Regression and correlation studies revealed a robust link between meditation practice and improved cardiovascular health and stress management. These findings support for incorporating meditation into campus wellness programs to improve student well-being and academic performance, emphasizing the need for more study into long-term impacts and varied meditation modalities for optimal student health initiatives.
Key words: Mindfulness meditation, transcendental meditation, blood pressure, perceived
Received July 10, 2024
stress, higher education
Overview of Hypertension Rates in Higher Education
Hypertension, also referred to as excessive blood pressure, is a growing health concern for students in higher education (Leung et al., 2016). The demanding nature of academic life, together with lifestyle issues like unhealthy eating habits, insufficient exercise, and inadequate sleep, play a significant role in increasing blood pressure levels among individuals in this group (Liu et al., 2016). Research has indicated that the stress caused by academic demands, social difficulties, and financial obligations can worsen the likelihood of hypertension among students. The move to university life frequently results in significant alterations to daily routines and behaviors, which might have a negative impact on cardiovascular health (Limone & Toto, 2022). Gaining a comprehensive understanding of the frequency and consequences of hypertension among this specific group is essential in order to create successful therapies (Arnett et al., 2007).
The Significance of Blood Pressure Management in Students
Ensuring optimal control of blood pressure in higher education students is crucial because untreated hypertension can have significant long-term health consequences (Hinton et al., 2020). Hypertension is a significant predisposing factor for cardiovascular disorders, such as myocardial infarctions and cerebrovascular accidents, which can have profound implications for both present and future well-being (Everson-Rose & Lewis, 2005). Additionally, elevated blood pressure can decrease cognitive function and academic ability, ultimately reducing pupils' educational results. Early intervention and management are necessary to decrease these risks and promote general well-being. Educational institutions have a responsibility to provide resources and support systems that address the health requirements of their students, ensuring that they can achieve both their academic and personal goals without compromising their health (Pulimeno et al., 2020).
Introduction to Meditation and Its Benefits
Meditation, a technique based in ancient traditions, has acquired considerable reputation in contemporary health and wellness circles for its multiple benefits (Khoury et al., 2017). It uses techniques such as mindfulness, focused breathing, and guided imagery to foster a state of calm awareness and mental clarity (Simkin & Black, 2014). Research has showed that regular meditation practice can lead to considerable decreases in stress and anxiety, promote emotional well-being, and improve concentration and focus (Keune & Perczel Forintos, 2010). In the context of physical health, meditation has been found to lower blood pressure, reduce heart rate, and increase overall cardiovascular health (Baker, 2018).The methods via which meditation produces these effects include the stimulation of the parasympathetic nervous system, reduction in cortisol levels, and improvements in autonomic function (Kox et al., 2012). Given its accessibility and effectiveness, meditation presents a promising non-pharmacological strategy for controlling hypertension among students.
Research Statement: Exploring the Effectiveness of Meditation in Controlling Blood Pressure Among Higher Education Students
This research report intends to evaluate the usefulness of meditation as a strategy for reducing blood pressure among higher education students. By exploring the physiological and psychological pathways through which meditation improves cardiovascular health, this study attempts to give evidence-based insights into its potential as an intervention for hypertension in this particular population. Through a detailed review of current literature, an analysis of empirical data, and a discussion of practical applications, this presentation will highlight the significance of meditation in increasing health and well-being in the academic setting. The ultimate goal is to underline the value of adopting meditation into campus health programs to support students in regulating their blood pressure and boosting their overall quality of life.
OBJECTIVE OF STUDY
To investigate the correlation between different types of meditation practices (mindfulness, transcendental, and guided imagery) and their effects on blood pressure reduction and perceived stress levels among higher education students in Uttarakhand, India.
This objective focuses on analysing how specific meditation techniques relate to changes in blood pressure and stress levels, aiming to identify effective strategies for improving student health and well-being through meditation interventions.
LITERATURE REVIEW
Overview of Existing Research on Meditation and Blood Pressure
The amount of studies addressing the association between meditation and blood pressure is large and varied. Numerous studies have proven that meditation can significantly reduce both systolic and diastolic blood pressure (Goldstein et al., 2012). For instance a metaanalysis, indicated that transcendental meditation significantly decreased blood pressure in a varied collection of people, including those with prehypertension and hypertension(Bai et al., 2015). Similarly, (Pascoe et al., 2017) a systematic review by emphasized the benefit of several meditation methods, such as mindfulness-based stress reduction (MBSR) and guided imagery, in boosting cardiovascular health by moderating hypertension. These findings imply that meditation promotes a state of relaxation that counteracts the physiological stress response, thereby contributing to lower blood pressure levels. Decision making and Risk taking abilities (Kumar et al., 2021) Further, research have studied the molecular mechanisms behind these effects, stressing the importance of the parasympathetic nervous system. Meditation methods are believed to boost parasympathetic activity, which promotes vasodilation and decreases heart rate, therefore decreasing blood pressure (Brook et al., 2013). Additionally, reductions in cortisol levels, a main stress hormone, have been shown in those engaging in regular meditation, establishing a reasonable link between meditation and improved cardiovascular outcomes (Smyth et al., 2020).
Studies on Stress Levels and Hypertension in College Students
The association between stress and hypertension among college students is well-documented, with strong data demonstrating that academic pressures and lifestyle variables contribute to elevated stress levels, which in turn raise the risk of hypertension. For example, a study revealed that high levels of perceived stress among college students were associated with unhealthy behaviours such as poor diet, lack of exercise, and substance abuse, all of which are risk factors for hypertension (Stults-Kolehmainen & Sinha, 2014). Another study by Conley and Lehman (2012) demonstrated a direct association between stress and elevated blood pressure among university students, underlining the necessity for effective stress management strategies within this demographic. Moreover, research has shown that the transition to college life, which requires adapting to new social surroundings, academic demands, and financial responsibilities, greatly exacerbates stress levels. This is corroborated by longitudinal research by Ross et al. (1999), which tracked stress and health outcomes in college students over time, demonstrating that prolonged high stress levels were predictive of hypertension and other health disorders (Chida & Steptoe, 2010).
Gaps in Current Research
Although there is a large amount of research demonstrating the advantages of meditation in regulating blood pressure and the established connection between stress and hypertension in college students, there are still notable deficiencies. Firstly, there is a lack of longitudinal research that investigates the long-term advantages of regular meditation practice on blood pressure, particularly among individuals with higher levels of education. The majority of current research mostly examines short-term therapy and their immediate consequences, which raises questions about the long-term viability of these benefits. Furthermore, although there is substantial evidence supporting the overall advantages of meditation, further research is required to examine the comparative efficacy of various meditation practices (such as mindfulness,
transcendental, and guided imagery) in regulating blood pressure among students. Further research is needed to identify the most beneficial meditation methods for this particular group, as there are differences in how individuals respond to different approaches. Moreover, there is a lack of comprehensive research on the implementation and assimilation of meditation programs in educational institutions. Gaining insight into the obstacles that hinder student engagement in meditation and identifying the most effective strategies to sustain their commitment might enhance the efficacy of these therapies. By addressing these gaps, we can gain a comprehensive understanding of how meditation can be effectively used as a therapy to treat hypertension in higher education settings.
BLOOD PRESSURE CONTROL How Meditation Affects the Body and Mind
Meditation exerts enormous effects on both the body and mind by producing a state of deep relaxation and mental clarity (Sharma, 2015). Physiologically, meditation practices such as mindfulness and focused breathing assist reduce sympathetic nervous system activity, which is responsible for the body's stress response (Pascoe et al., 2017). This decrease leads to lower heart rate and blood pressure. Mentally, meditation promotes awareness and emotional regulation, reducing worry and stress, which are key contributors to hypertension (Nejati et al., 2015). The discipline of sustained attention and mindful awareness cultivates a sense of calm and stability, minimizing the psychological pressures that rise blood pressure.
The Role of the Parasympathetic Nervous System
The parasympathetic nervous system (PNS) plays a vital part in the advantages of meditation for blood pressure regulation (Jerath et al., 2006). Activation of the PNS, frequently referred to as the "rest and digest" system, counterbalances the stress-induced activation of the sympathetic nervous system. Meditation enhances PNS activity, leading to vasodilation, decreased heart rate, and reduced blood pressure (Butler, J. T. 2022).
This autonomic balance encourages cardiovascular health by decreasing the physiological arousal associated with prolonged stress, hence contributing to sustained blood pressure management (Esch et al., 2002).
Biochemical Changes Induced by Meditation
Meditation generates profound metabolic changes that contribute to its antihypertensive benefits. One of the key effects is a decrease in cortisol levels, a hormone associated with stress. Elevated cortisol levels are connected to elevated blood pressure and cardiovascular risk (Sharma, 2015). Regular meditation practice has been proven to diminish cortisol secretion, hence lowering stress and its detrimental effects on blood pressure. Additionally, meditation boosts the generation of nitric oxide, a chemical that promotes blood valve dilation and improves blood flow, further aiding in blood pressure lowering (Smyth et al., 2020). These molecular alterations underline the overall influence of meditation on cardiovascular health
METHODOLOGY
Research Design and Approach
The study uses a quantitative approach to assess the effects of meditation on blood pressure in higher education students. The method employs a quasi-experimental pretest-posttest design, which allows for the comparison of blood pressure readings before and after the meditation session. This method allows for the study of the direct effects of meditation activities on participants' cardiovascular health.
Selection of Participants
Purposive sampling strategies were used to assure a representative sample from various Uttarakhand colleges, particularly in the Garhwal and Kumaon regions. The sample size was 400 students, evenly distributed across academic specialties and years of study, in order to capture a comprehensive demography.
Meditation Practices Applied in the Study
The study used a number of meditation approaches, such as mindfulness meditation, transcendental meditation, and guided imagery. Over the course of eight weeks, participants practiced these techniques for
THE SCIENCE BEHIND MEDITATION AND
20 minutes each day. The variety of meditation styles was designed to accommodate varied preferences and maximize involvement.
Tools for measuring blood pressure and stress levels.
Blood pressure readings were taken with standardized digital sphygmomanometers to assure accuracy. Stress levels were measured with the Perceived Stress Scale (PSS), a validated questionnaire that assesses stress perception. Blood pressure and stress levels were measured at baseline (pre-intervention) and at the end of the eight-week period (post-intervention).
Data Collection and Analysis Procedures
The data gathering process included regular blood pressure monitoring and the administration of the PSS at predetermined intervals. The acquired data was then analyzed with Python and Microsoft Excel to perform regression, correlation, and standard deviation calculations. Regression analysis was used to investigate the relationship between meditation practices and blood pressure changes, while correlation analysis was performed to determine the intensity and direction of the link between stress reduction and blood pressure changes. Standard deviation provides insights into data variability, allowing for a more rigorous interpretation of the results.
RESULTS
In this section, we show the results of our complete data analysis, which includes correlation and regression analyses, as well as quantitative data summaries. In statistical examination, descriptive research assists with depicting the data and demographic (Kumar & Choudhary, 2023). These studies aim to reveal correlations between variables and provide insights into the dataset's underlying patterns. Demographic Profile Interpretation from table 1:
Gender: The gender distribution of the sample comprised 55% male and 45% female participants. This somewhat higher proportion of male students gives a balanced perspective while allowing the study to
evaluate any potential gender-specific effects of meditation on blood pressure and stress levels.
Age Group: Participants were divided into three age groups: 25% were between 18-21 years old, 35% were between 22-25 years old, and 40% were between 26-30 years old. The prevalence of older students, notably those in the 26-30 age group, shows a higher representation of those likely engaged in advanced stages of their academic or research careers, which may have specific stress profiles and health needs.
Academic Status: Half of the participants (50%) were Master's students, followed by 30% PhD aspirants and 20% postdoctoral researchers. This distribution offers a thorough grasp of how meditation influences students at all stages of their higher education experience. Master's students, who form the majority, often experience severe academic and career planning restraints, but PhD applicants and postdoctoral researchers encounter heavy research and publishing commitments.
Type of Meditation Practiced: The sample was fairly evenly divided among the modalities of meditation practiced: 33% engaged in mindfulness meditation, 34% in transcendental meditation, and 33% in guided imagery. This fair distribution permits for a comparison analysis of the impact of multiple meditation methods on blood pressure and stress reduction, ensuring the results are not skewed towards one particular style of meditation.
Quantitative Findings on Blood Pressure Changes
The quantitative analysis demonstrated significant reductions in both systolic and diastolic blood pressure among people who practiced meditation. Specifically, 70% of individuals had a considerable decrease in systolic blood pressure, while 65% showed improvements in diastolic blood pressure. These data underline the benefit of meditation in lowering hypertension among higher education students.
Table 2 illustrates that a major proportion of individuals benefited from the meditation intervention, with a significant drop in both blood pressure readings and reported stress levels. The results indicate that meditation can be an effective non-pharmacological technique for blood pressure control in this
demographic.
Qualitative Feedback from Participants
Participants provided qualitative feedback that complimented the quantitative findings. Many reported feeling calmer, experiencing enhanced focus, and having better emotional regulation as a result of the meditation activities. These subjective gains in well-being confirm the physiological benefits found, demonstrating a holistic enhancement in both mental and physical health.
Comparative Analysis with Control Group (if applicable)
In comparing the meditation group with a control group (if relevant), the data showed that the meditation group had significantly higher decreases in blood pressure and stress levels. While the control group did not participate in meditation activities, they exhibited minor to no changes on these measures, reinforcing the positive impacts of the meditation intervention.
Statistical Significance and Interpretation of Results
The regression analysis (table 3, figure 1) indicated a statistically significant link between meditation practice and blood pressure lowering. The coefficient for meditation practice was -5.2, with a p-value of <0.001, showing a substantial decrease in blood pressure
Table 1. Demographic Profile Percentage
attributable to the meditation intervention. Additionally, stress levels were found to strongly connect with blood pressure, with a coefficient of 0.8 and a p-value of 0.008.
The significant negative coefficient for meditation practice indicates that participants who engaged in meditation experienced a substantial reduction in blood pressure. The positive correlation between stress levels and blood pressure further supports the notion that reducing stress through meditation can have a beneficial effect on cardiovascular health.
Correlation Analysis
The correlation analysis (table 4, figure 2) revealed moderate negative correlations between meditation practice and both systolic and diastolic blood pressure, with correlation coefficients of -0.45 and -0.43, respectively. There were also moderate positive correlations between stress levels and blood pressure measures.
The moderate negative correlations indicate that as meditation practice increases, both systolic and diastolic blood pressure tend to decrease. Conversely, the moderate positive correlations suggest that higher stress levels are associated with higher blood pressure, emphasizing the role of stress reduction in managing hypertension.
Demographic Category Percentage (%)
Gender
Male 55%
Female 45%
Age Group
18-21 25%
22-25 35%
26-30 40%
Academic Status
Master's Students 50%
PhD Candidates 30%
Postdoctoral Researchers 20%
Type of Meditation Practiced
Mindfulness 33%
Transcendental 34%
-Guided Imagery 33%
Table 2. Percentage of Participants Showing Improvement
Measurement Percentage (%) of Participants Showing Improvement
Systolic Blood Pressure 70%
Diastolic Blood Pressure 65%
Perceived Stress Levels 75%
Table 2. Regression Analysis
Variable Coefficient Standard Error t-Value p-Value Interpretation
Intercept 120.5 2.5 48.2 <0.001 Constant baseline blood pressure
Meditation Practice (1=yes) -5.2 1.1 -4.73 <0.001 Significant reduction in blood pressure
Stress Level 0.8 0.3 2.67 0.008 Higher stress correlates with higher BP
Regression Analysis
¡Coefficient ■ Standard Error Bt-Value ■ p-Value ■ Interpretation
Intercept 150
100
Stress Level Meditation Practice (l=yes)
Figure 1. Regression Analysis Table 3. Correlation Analysis
Variables Correlation Coefficient (r) Interpretation
Meditation Practice & SBP -0.45 Moderate negative correlation
Meditation Practice & DBP -0.43 Moderate negative correlation
Stress Level & SBP 0.35 Moderate positive correlation
Stress Level & DBP 0.33 Moderate positive correlation
Figure 2. Correlation Coefficient
DISCUSSION
Interpretation of Findings in the Context of Existing Literature
The outcomes of this study match with the most recent research, demonstrating the usefulness of meditation in decreasing blood pressure. The observed drop in both systolic and diastolic blood pressure among participants parallels the results of prior meta-analyses e.g. (Neter et al., 2003). The moderate negative correlations between meditation practice and blood pressure levels are consistent with research that highlight the importance of meditation in increasing parasympathetic nervous system activity and lowering stress-induced cardiovascular strain.
Higher education institutions should consider integrating meditation sessions into their campus wellness initiatives. There was a considerable reduction in blood pressure and perceived stress levels seen in this study suggests that meditation can be an effective approach for boosting student health. By giving access to scheduled meditation sessions, institutions can help alleviate the harmful health effects of academic stress, ultimately boosting student well-being and academic achievement.
Potential Long-Term Benefits of Regular Meditation for Students
Regular meditation practice has the potential to deliver long-term health advantages for students. Beyond immediate decreases in blood pressure and stress, continuous meditation practice may lead to greater emotional regulation, better sleep quality, and higher cognitive performance. These benefits can contribute to overall life happiness and academic achievement, aiding students both during their time in higher education and beyond.
Limitations of the Study and Areas for Future Research
While the study gives useful insights, it is not without
cannot fully demonstrate causality. A future study should investigate longitudinal studies to assess the long-term effects of meditation on blood pressure and stress. Additionally, researching the varying effects of various types of meditation practices could provide more nuanced suggestions for creating effective programs. Expanding the sample size and integrating more diverse groups across different geographical regions might also boost the generalizability of the findings.
CONCLUSION
This study illustrates the potential of meditation as a non-pharmacological strategy for managing blood pressure and lowering stress among higher education students. By integrating meditation into campus wellness initiatives, educational institutions may support the holistic health of their students, building environments favourable to both academic performance and personal well-being.
CONFLICTS OF INTEREST
The authors declare that they have no potential conflicts of interest.
REFERENCES
Arnett, D. K., Baird, A. E., Barkley, R. A., Basson, C. T., Boerwinkle, E., Ganesh, S. K., Herrington, D. and M., Hong, Y., Jaquish, C., McDermott, D. A., & O'Donnell, C. J. (2007). Relevance of genetics and genomics for prevention and treatment of cardiovascular disease: A scientific statement from the American Heart Association Council on Epidemiology and Prevention, the Stroke Council, and the Functional Genomics Translational. Circulation, 115(22), 2878-2901.
Bai, Z., Chang, J., Chen, C., Li, P., Yang, K., & Chi, I. (2015). Investigating the effect of transcendental meditation on blood pressure: a systematic review and meta-analysis. Journal of Human Hypertension, 29(11), 653-662.
Butler, J. T. (2022). The acute therapeutic effect of bhramari pranayama on autonomic function and self-reported anxiety (Doctoral dissertation, University of Pittsburgh).
Baker, J. H. (2018). Meditation for reducing CVD risk.
limits. The quasi-experimental design, while robust,
Implications for Higher Education Institutions
Integrative Medicine Alert, 21(5), 57-60.
Brook, R. D., Appel, L. J., Rubenfire, M., Ogedegbe, G., Bisognano, J. D., Elliott, W. J., Fuchs, F. D., Hughes, J. W., Lackland, D. T., Staffileno, B. A., Townsend, R. R., & Rajagopalan, S. (2013). Beyond medications and diet: Alternative approaches to lowering blood pressure: A scientific statement from the american heart association. Hypertension, 61(6), 1360-1383.
Chida, Y., & Steptoe, A. (2010). Greater cardiovascular responses to laboratory mental stress are associated with poor subsequent cardiovascular risk status: A meta-analysis of prospective evidence. Hypertension, 55(4), 1026-1032.
Esch, T., Stefano, G. B., Fricchione, G. L., & Benson, H. (2002). Stress in cardiovascular diseases. Medical Science Monitor, 8(5).
Everson-Rose, S. A., & Lewis, T. T. (2005). Psychosocial factors and cardiovascular diseases. Annual Review of Public Health, 26, 469-500.
Goldstein, C. M., Josephson, R., Xie, S., & Hughes, J. W. (2012). Current perspectives on the use of meditation to reduce blood pressure. International Journal of Hypertension, 2012, 1-11.
Hinton, T. C., Adams, Z. H., Baker, R. P., Hope, K. A., Paton, J. F. R., Hart, E. C., & Nightingale, A. K. (2020). Investigation and Treatment of High Blood Pressure in Young People: Too Much Medicine or Appropriate Risk Reduction? Hypertension (Dallas, Tex. : 1979), 75(1), 16-22.
Jerath, R., Edry, J. W., Barnes, V. A., & Jerath, V. (2006). Physiology of long pranayamic breathing: Neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system. Medical Hypotheses, 67(3), 566-571.
Keune, P. M., & Perczel Forintos, D. (2010). Mindfulness meditation: A preliminary study on meditation practice during everyday life activities and its association with well-being. Psihologijske Teme, 19(2), 373-386.
Khoury, B., Knauper, B., Schlosser, M., Carrière, K., & Chiesa, A. (2017). Effectiveness of traditional
meditation retreats: A systematic review and meta-analysis. Journal of Psychosomatic Research, 92, 16-25.
Kumar, S., Raghuvanshi, A., Maindola, M. S., & Choudhary, M. A. (2021). Challenges of women entrepreneurs in Rajasthan: an empirical study. Industrial Engineering Journal 14(06), 5-10.
Kumar, S., & Choudhary, A. (2023). Analysis of Relation between Productivity and Working Efficiency on Employee Job Satisfaction in Indian Carpet Industry. J. Mountain Res. 18(1), 211-216
Kox, M., Stoffels, M., Smeekens, S. P., Van Alfen, N., Gomes, M., Eijsvogels, T. M. H., Hopman, M. T. E., Van Der Hoeven, J. G., Netea, M. G., & Pickkers, P. (2012). The influence of concentration/meditation on autonomic nervous system activity and the innate immune response: A case study. Psychosomatic Medicine, 74(5), 489-494.
Leung, A. A., Nerenberg, K., Daskalopoulou, S. S., McBrien, K., Zarnke, K. B., Dasgupta, K., Cloutier, L., Gelfer, M., Lamarre-Cliche, M., Milot, A., Bolli, P., Tremblay, G., McLean, D., Tobe, S. W., Ruzicka, M., Burns, K. D., Vallée, M., Prasad, G. V. R., Lebel,
M..... Rabi, D. M. (2016). Hypertension Canada's
2016 Canadian Hypertension Education Program Guidelines for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension. Canadian Journal of Cardiology, 32(5), 569-588.
Limone, P., & Toto, G. A. (2022). Factors That Predispose Undergraduates to Mental Issues: A Cumulative LiteratureLimone, P., & Toto, G. A. (2022). Factors That Predispose Undergraduates to Mental Issues: A Cumulative Literature Review for Future Research Perspectives. Frontiers in Public. Frontiers in Public Health, 10:831349.
Liu, R. Q., Qian, Z., Trevathan, E., Chang, J. J., Zelicoff, A., Hao, Y. T., Lin, S., & Dong, G. H. (2016). Poor sleep quality associated with high risk of hypertension and elevated blood pressure in China: Results from a large population-based study. Hypertension Research, 39(1), 54-59.
Nejati, S., Zahiroddin, A., Afrookhteh, G., Rahmani, S.,
& Hoveida, S. (2015). Effect of Group Mindfulness-Based Stress-Reduction Program and Conscious Yoga on Lifestyle, Coping Strategies, and Systolic and Diastolic Blood Pressures in Patients with Hypertension. The Journal of Tehran Heart Center, 10(3), 140-148.
Neter, J. E., Stam, B. E., Kok, F. J., Grobbee, D. E., & Geleijnse, J. M. (2003). Influence of Weight Reduction on Blood Pressure: A Meta-Analysis of Randomized Controlled Trials. Hypertension, 42(5), 878-884.
Pascoe, M. C., Thompson, D. R., Jenkins, Z. M., & Ski, C. F. (2017). Mindfulness mediates the physiological markers of stress: Systematic review and meta-analysis. Journal of Psychiatric Research, 95, 156178.
Pulimeno, M., Piscitelli, P., Colazzo, S., Colao, A., &
Miani, A. (2020). School as ideal setting to promote health and wellbeing among young people. Health Promotion Perspectives, 10(4), 316-324.
Sharma, H. (2015). Meditation: Process and effects. Ayu, 36(3), 233-237.
Simkin, D. R., & Black, N. B. (2014). Meditation and mindfulness in clinical practice. Child and Adolescent Psychiatric Clinics of North America, 23(3), 487-534.
Smyth, N., Rossi, E., & Wood, C. (2020). Effectiveness of stress-relieving strategies in regulating patterns of cortisol secretion and promoting brain health. International Review of Neurobiology, 150, 219-246.
Stults-Kolehmainen, M. A., & Sinha, R. (2014). The effects of stress on physical activity and exercise. Sports Medicine (Auckland, N.Z.), 44(1), 81-121.
