Abstract
Non-pharmacological therapy or lifestyle modification is recommended as a first-line approach to hypertension management. Chronic stress is a modifiable risk factor of hypertension through behavioral change. However, no prior studies have conducted a meta-analysis of stress management aimed at the primary prevention of hypertension in normotensive general population. We systematically searched PubMed, Web of Science, Scopus, and Cochrane library for eligible trials, limited to English-language articles published up to October 2025. Studies involving healthy adults without hypertension that used interventions for stress management and reported blood pressure outcomes were included. Effect sizes were calculated as between-group mean differences in systolic and diastolic blood pressures change, and were pooled using a random-effects model. Twenty-two randomized controlled trials with a maximal total sample of 3089 individuals were included in the meta-analysis. Among the different types of intervention considered, a consistent reduction in systolic blood pressure (between-group mean difference (mmHg) [95% confidence interval]) compared with the control was found for mind-body exercise (-2.17 [-3.29, -1.05]); for meditation (-1.49 [-2.67, -0.31]); and for relaxation (-4.76 [-8.48, -1.04]). Similarly, reductions in diastolic blood pressure were found with values of -1.69 [-2.81, -0.56]; -1.00 [-1.84, -0.15]; and -1.71 [-3.99, 0.56], respectively. Interventions for stress management may lower systolic and diastolic blood pressures in normotensive general population. It is possible that stress management contributes to reduce future cardiovascular risk.