Psychological distress significantly impacts the health of patients with cardiovascular diseases (CVDs). Research has shown that mindfulness-based interventions (MBIs) improve both physical and mental well-being. Non-face-to-face MBIs, such as app-based programs, are essential for increasing accessibility. This study assessed the effects of non-face-to-face MBIs on the psychological health and quality of life of CVD patients. A systematic review and meta-analysis of randomized controlled trials identified nine studies involving 765 participants. Results indicated that non-face-to-face MBIs significantly reduced anxiety, depression, and stress, and improved quality of life, though they did not significantly increase mindfulness. App-based MBIs were especially effective. These findings suggest that non-face-to-face MBIs may be beneficial in reducing psychological distress in CVD patients, but further research is needed to confirm their long-term efficacy.
AlsubaieMDickensCDunnBD, et al. (2020) Feasibility and acceptability of mindfulness-based cognitive therapy compared with mindfulness-based stress reduction and treatment as usual in people with depression and cardiovascular disorders: A three-arm randomised controlled trial. Mindfulness11: 30–50.
2.
BaerRGuJCavanaghK, et al. (2019) Differential sensitivity of mindfulness questionnaires to change with treatment: A systematic review and meta-analysis. Psychological Assessment31: 1247–1263.
3.
BohlmeijerETen KloosterPMFledderusM, et al. (2011) Psychometric properties of the five facet mindfulness questionnaire in depressed adults and development of a short form. Assessment18: 308–320.
CollaborationTC (2014) Review Manager (RevMan). Version 5.3. Copenhagen: The Nordic Cochrane Centre. Available at: https://revman.cochrane.org/info.
6.
CoxCEHoughCLJonesDM, et al. (2019) Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness: A pilot randomised clinical trial. Thorax74: 33–42.
7.
CreswellJDTarenAALindsayEK, et al. (2016) Alterations in resting-state functional connectivity link mindfulness meditation with reduced interleukin-6: A randomized controlled trial. Biological Psychiatry80: 53–61.
8.
FalconeGJerramM (2018) Brain activity in mindfulness depends on experience: A meta-analysis of fMRI studies. Mindfulness9: 1319–1329.
9.
GongX-GWangL-PRongG, et al. (2023) Effects of online mindfulness-based interventions on the mental health of university students: A systematic review and meta-analysis. Frontiers in Psychology14: 1073647.
10.
GotinkRAYoungeJOWeryMF, et al. (2017) Online mindfulness as a promising method to improve exercise capacity in heart disease: 12-month follow-up of a randomized controlled trial. PLoS One12: e0175923.
11.
GuendelmanSBayerMPrehnK, et al. (2022) Towards a mechanistic understanding of mindfulness-based stress reduction (MBSR) using an RCT neuroimaging approach: Effects on regulating own stress in social and non-social situations. NeuroImage254: 119059.
12.
HeYTangZSunG, et al. (2023) Effectiveness of a mindfulness meditation app based on an electroencephalography-based brain-computer interface in radiofrequency catheter ablation for patients with atrial fibrillation: Pilot randomized controlled trial. JMIR Mhealth Uhealth11: e44855.
13.
HigginsJPThompsonSGDeeksJJ, et al. (2003) Measuring inconsistency in meta-analyses. British Medical Journal327: 557–560.
14.
HouYZhaoXLuM, et al. (2019) Brief, one-on-one, telephone-adapted mindfulness-based stress reduction for patients undergoing percutaneous coronary intervention: A randomized controlled trial. Translational Behavioral Medicine9: 1216–1223.
15.
JanssenMHeerkensYKuijerW, et al. (2018) Effects of mindfulness-based stress reduction on employees’ mental health: A systematic review. PLoS One13: e0191332.
16.
JayewardeneWPLohrmannDKErbeRG, et al. (2017) Effects of preventive online mindfulness interventions on stress and mindfulness: A meta-analysis of randomized controlled trials. Preventive Medicine Reports5: 150–159.
17.
KangQLuoA (2022) The efficacy of mindfulness-based intervention for heart diseases: A meta-analysis of randomized controlled trials. Medicine101: e29649.
18.
KeirnsNGOuaddiSDunsigerS, et al. (2023) Mind Your Heart-ii: Protocol for a behavioral randomized controlled trial of mindfulness training to promote self-care in patients with comorbid heart failure and cognitive impairment. Contemporary Clinical Trials126: 107094.
19.
LeeSYGathrightECWuWC, et al. (2023) Mindfulness-based interventions for patients with cardiovascular disease: A focused review for practicing clinicians. Current Cardiology Reports25: 185–191.
20.
LevineGNCohenBECommodore-MensahY, et al. (2021) Psychological health, well-being, and the mind-heart-body connection: A scientific statement from the American Heart Association. Circulation143: e763–e783.
21.
LinardonJMesserMGoldbergSB, et al. (2024) The efficacy of mindfulness apps on symptoms of depression and anxiety: An updated meta-analysis of randomized controlled trials. Clinical Psychology Review107: 102370.
22.
LindsayEKCreswellJDSternHJ, et al. (2022) Mindfulness-based stress reduction increases stimulated IL-6 production among lonely older adults: A randomized controlled trial. Brain, Behavior, and Immunity104: 6–15.
23.
LoucksEBSchuman-OlivierZBrittonWB, et al. (2015) Mindfulness and cardiovascular disease risk: State of the evidence, plausible mechanisms, and theoretical framework. Current Cardiology Reports17: 112.
24.
MarinoFFaillaCCarrozzaC, et al. (2021) Mindfulness-based interventions for physical and psychological wellbeing in cardiovascular diseases: A systematic review and meta-analysis. Brain Sciences11: 727.
25.
MeilingXHuiY (2019) The Use of Mindfulness-Based-Stress-Reduction (MBSR) on Patients With Hypertension or Heart Disease: A Descriptive Literature Review. (Bachelor’s thesis). Mälardalen University.
26.
MhorasaniNM (2025) Redefining humanity: The interconnected evolution of body, mind, consciousness, and soul. Dialog11: 324–339.
27.
MoherDLiberatiATetzlaffJ, et al. (2009) Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Journal of Clinical Epidemiology62: 1006–1012.
28.
Proeschold-BellRJEagleDETiceLC, et al. (2025) The Selah trial: A preference-based partially randomized waitlist control study of three stress management interventions. Translational Behavioral Medicine15: ibae017.
29.
RazzeraBNAdamoliANRanheiriMF, et al. (2022) Impacts of mindfulness-based interventions in people undergoing hemodialysis: A systematic review. Brazilian Journal of Nephrology44: 84–96.
30.
RosenkranzMADavidsonRJMacCoonDG, et al. (2013) A comparison of mindfulness-based stress reduction and an active control in modulation of neurogenic inflammation. Brain, Behavior, and Immunity27: 174–184.
31.
RuizSMVegaBRPérezCB, et al. (2023) Mindfulness-based emotional regulation for patients with implantable cardioverter-defibrillators: A randomized pilot study of efficacy, applicability, and safety. Cardiology Journal30: 401–410.
32.
Salmoirago-BlotcherECrawfordSLCarmodyJ, et al. (2013) Phone-delivered mindfulness training for patients with implantable cardioverter defibrillators: Results of a pilot randomized controlled trial. Annals of Behavioral Medicine46: 243–250.
33.
Scott-SheldonLAJGathrightECDonahueML, et al. (2020) Mindfulness-based interventions for adults with cardiovascular disease: A systematic review and meta-analysis. Annals of Behavioral Medicine54: 67–73.
34.
SimSMaldonadoILCastelnauP, et al. (2024) Neural correlates of mindfulness meditation and hypnosis on magnetic resonance imaging: Similarities and differences. A scoping review. Journal of Neuroradiology51: 131–144.
35.
SpruillTMReynoldsHRDicksonVV, et al. (2018) Telephone-based mindfulness training to reduce stress in women with myocardial infarction: Rationale and design of a multicenter randomized controlled trial. American Heart Journal202: 61–67.
36.
SterneJACSavovićJPageMJ, et al. (2019) RoB 2: a revised tool for assessing risk of bias in randomised trials. British Medical Journal366: 366.
37.
VaccarinoVBremnerJD (2024) Stress and cardiovascular disease: An update. Nature Reviews Cardiology21: 603–616.
YangJMYeHLongY, et al. (2023) Effects of Web-Based mindfulness-based interventions on anxiety, depression, and stress among frontline health care workers during the COVID-19 pandemic: Systematic review and meta-analysis. Journal of Medical Internet Research25: e44000.
40.
YoungeJOWeryMFGotinkRA, et al. (2015) Web-Based mindfulness intervention in heart disease: A randomized controlled trial. PLoS One10: e0143843.
41.
ZouHCaoXChairSY (2021) A systematic review and meta-analysis of mindfulness-based interventions for patients with coronary heart disease. Journal of Advanced Nursing77: 2197–2213.
42.
ZouHChairSYFengB, et al. (2024) A social media-based mindfulness psycho-Behavioral Intervention (MCARE) for patients with acute coronary syndrome: Randomized controlled trial. Journal of Medical Internet Research26: e48557.
43.
ZouHChairSYLuoD, et al. (2023) A mindfulness-oriented psycho-behavioral intervention for patients with acute coronary syndrome: A pilot study. Heart & Lung: The Journal of Acute and Critical Care62: 240–248.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
