The Effect of Zikr Meditation on Anxiety, Stress Levels and Blood Pressure in Hypertensive Patients

Erna Yovi Kurniawati; Dian Nirmala Sari

doi:10.58545/jrcnp.v2i2.396

Authors

Erna Yovi Kurniawati Alma Ata University, Indonesia https://orcid.org/0000-0002-4023-099X
Dian Nirmala Sari Banjar Negara Polytechnic, Indonesia

DOI:

https://doi.org/10.58545/jrcnp.v2i2.396

Abstract

Background: Hypertension, a prevalent chronic condition, poses significant health risks when left untreated. Psychological factors like stress and anxiety are known contributors to high blood pressure. Effective management of hypertension may benefit from non-pharmacological interventions that address these psychological elements. Purpose: This study aims to evaluate the impact of Zikr meditation, a spiritual mindfulness practice, on reducing anxiety, stress, and blood pressure in individuals with hypertension. Methods: A double-blind randomized controlled trial was conducted with 60 hypertensive patients, randomized into intervention and control groups. The intervention group participated in 20-minute Zikr meditation sessions for four weeks daily, while the control group engaged in a placebo activity. Anxiety and stress levels were measured using the Hamilton Anxiety Rating Scale (HAM-A) and the Perceived Stress Scale (PSS), respectively. Blood pressure readings were taken before and after the intervention. Results: Participants in the Zikr meditation group showed a significant reduction in anxiety and stress levels compared to the control group. Additionally, there was a notable decrease in systolic and diastolic blood pressure among those practicing Zikr meditation. Conclusions: Zikr meditation effectively reduces anxiety and stress, leading to lower blood pressure in hypertensive patients. These findings suggest that incorporating Zikr meditation into standard hypertension management could offer a valuable, non-pharmacological approach to improving cardiovascular health. Further research is recommended to examine Zikr meditation's long-term effects and broader applicability in hypertension care.

Keywords:

Anxiety, Blood pressure, Hypertention, Meditation, Stress, Zikr

Downloads

Download data is not yet available.

References

Al-Makki, A., DiPette, D., Whelton, P. K., Murad, M. H., Mustafa, R. A., Acharya, S., Beheiry, H. M., Champagne, B., Connell, K., Cooney, M. T., Ezeigwe, N., Gaziano, T. A., Gidio, A., Lopez-Jaramillo, P., Khan, U. I., Kumarapeli, V., Moran, A. E., Silwimba, M. M., Rayner, B., Khan, T. (2022). Hypertension pharmacological treatment in adults: A world health organization guideline executive summary. Hypertension, 79(1), 293–301. https://doi.org/10.1161/HYPERTENSIONAHA.121.18192/ASSET/76F8706D-CF9C- 4F8A-9403- FE8008609866/ASSETS/GRAPHIC/HYPERTENSIONAHA.121.18192.FIG04.JPG DOI: https://doi.org/10.1161/HYPERTENSIONAHA.121.18192

Carey, R. M., Moran, A. E. & Whelton, P. K. (2022). Treatment of Hypertension: A Review. JAMA, 328(18), 1849–1861. https://doi.org/10.1001/JAMA.2022.19590 DOI: https://doi.org/10.1001/jama.2022.19590

Di Giacomo, D., Ranieri, J., Guerra, F., Cilli, E., Sciarra, L. & Romano, S. (2024). Cardiovascular risk and biopsychosocial interplay: Association among hypertension, anxiety, and emotional dysregulation-observational study in primary care setting for efficient self-care. Clinical Cardiology, 47(1), e24152. https://doi.org/10.1002/CLC.24152 DOI: https://doi.org/10.1002/clc.24152

Duman, H., Duman, H., Puşuroǧlu, M. & Yilmaz, A. S. (2024). Anxiety disorders and depression are associated with resistant hypertension. Advances in Clinical and Experimental Medicine, 33(2), 111–118. https://doi.org/10.17219/ACEM/166304 DOI: https://doi.org/10.17219/acem/166304

Duque, A., Cano-López, I. & Puig-Pérez, S. (2022). Effects of psychological stress and cortisol on decision making and modulating factors: A systematic review. European Journal of Neuroscience, 56(2), 3889–3920. https://doi.org/10.1111/EJN.15721 DOI: https://doi.org/10.1111/ejn.15721

Fontes, M. A. P., Marins, F. R., Patel, T. A., de Paula, C. A., dos Santos Machado, L. R., de Sousa Lima, É. B., Ventris-Godoy, A. C., Viana, A. C. R., Linhares, I. C. S., Xavier, C. H., Filosa, J. A. & Patel, K. P. (2023). Neurogenic Background for Emotional Stress-Associated Hypertension. Current Hypertension Reports, 25(7), 107–116. https://doi.org/10.1007/S11906-023-01235-7/FIGURES/5 DOI: https://doi.org/10.1007/s11906-023-01235-7

Hamam, M. S., Kunjummen, E., Hussain, M. S., Nasereldin, M., Bennett, S. & Miller, J. (2020). Anxiety, Depression, and Pain: Considerations in the Treatment of Patients with Uncontrolled Hypertension. Current Hypertension Reports, 22(12), 1–7. https://doi.org/10.1007/S11906-020-01117-2/METRICS DOI: https://doi.org/10.1007/s11906-020-01117-2

Han, X., Liu, X., Zhong, F., Wang, Y. & Zhang, Q. (2021). Comparison of efficacy and safety of complementary and alternative therapies for essential hypertension with anxiety or depression disorder. PLOS ONE, 16(7), e0254699. https://doi.org/10.1371/JOURNAL.PONE.0254699 DOI: https://doi.org/10.1371/journal.pone.0254699

Hinds, J. A. & Sanchez, E. R. (2022). The Role of the Hypothalamus–Pituitary–Adrenal (HPA) Axis in Test-Induced Anxiety: Assessments, Physiological Responses, and Molecular Details. Stresses 2022, Vol. 2, Pages 146-155, 2(1), 146–155. https://doi.org/10.3390/STRESSES2010011 DOI: https://doi.org/10.3390/stresses2010011

Insyra, A. R., Alfarizi, A. F. & Zakiyyah, N. A. (2023). The Effect of Dhikr Therapy on Stress Reduction: Literature Review. Proceeding Conference on Da’wah and Communication Studies, 2(1), 5–16. https://doi.org/10.61994/CDCS.V2I1.88 DOI: https://doi.org/10.61994/cdcs.v2i1.88

Kurniawati, E. Y., Hadisaputro, S. & Suwandono, A. (2019). The Effect of Holistic Programs on Cortisol Serum Levels in Polycistic Ovarium Syndrome. Indonesian Journal of Medicine, 4(4), 376–382. https://doi.org/10.26911/THEIJMED.2019.04.04.11 DOI: https://doi.org/10.26911/theijmed.2019.04.04.11

Kurniawati, Y., Hadisaputro, S., Suwandono, A., & Khasanah, Ummi. P, (2024). Kecemasan dan Kadar Kortisol Serum Wanita dengan Sindrom Ovarium Polikistik (SOPK). (2024). Jurnal Kesehatan Reproduksi, 10(3), 163–170. https://doi.org/10.22146/jkr.72468 DOI: https://doi.org/10.22146/jkr.72468

Lauder, L., Mahfoud, F., Azizi, M., Bhatt, D. L., Ewen, S., Kario, K., Parati, G., Rossignol, P., Schlaich, M. P., Teo, K. K., Townsend, R. R., Tsioufis, C., Weber, M. A., Weber, T. & Böhm, M. (2023). Hypertension management in patients with cardiovascular comorbidities. European Heart Journal, 44(23), 2066–2077. https://doi.org/10.1093/EURHEARTJ/EHAC395 DOI: https://doi.org/10.1093/eurheartj/ehac395

Lim, L. F., Solmi, M. & Cortese, S. (2021). Association between anxiety and hypertension in adults: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 131, 96–119. https://doi.org/10.1016/J.NEUBIOREV.2021.08.031 DOI: https://doi.org/10.1016/j.neubiorev.2021.08.031

Mills, K. T., Stefanescu, A. & He, J. (2020). The global epidemiology of hypertension. Nature Reviews Nephrology 2020 16:4, 16(4), 223–237. https://doi.org/10.1038/s41581-019-0244-2 DOI: https://doi.org/10.1038/s41581-019-0244-2

Mohammed Nawi, A., Mohammad, Z., Jetly, K., Abd Razak, M. A., Ramli, N. S., Wan Ibadullah, W. A. H., & Ahmad, N. (2021). The Prevalence and Risk Factors of Hypertension among the Urban Population in Southeast Asian Countries: A Systematic Review and Meta-Analysis. International journal of hypertension, 2021, 6657003. https://doi.org/10.1155/2021/6657003 DOI: https://doi.org/10.1155/2021/6657003

Moon, S. (2022). Psychosocial Factors Influencing Anxiety Symptoms in Patients With Hypertension. Anxiety and Mood, 18(1), 17–25. https://doi.org/10.24986/ANXMOD.2022.18.1.003

Moussouni, A., Sidi-yakhlef, A., Hamdaoui, H., Aouar, A. & Belkhatir, D. (2022). Prevalence and risk factors of prehypertension and hypertension in Algeria. BMC Public Health, 22(1), 1-17. https://doi.org/10.1186/S12889-022 13942-Y/TABLES/3 DOI: https://doi.org/10.1186/s12889-022-13942-y

Nurachmah, E. & Gayatri, D. (n.d.). Spiritual Experience of Productive Age Hypertensive Patients Conducting Therapy Programs at Aisyiyah Hospital of Kudus. Retrieved September 3, 2024, from https://orcid.org/0009-0004-6536-4988

Rios, F. J., Montezano, A. C., Camargo, L. L. & Touyz, R. M. (2023). Impact of Environmental Factors on Hypertension and Associated Cardiovascular Disease. Canadian Journal of Cardiology, 39(9), 1229–1243. https://doi.org/10.1016/J.CJCA.2023.07.002 DOI: https://doi.org/10.1016/j.cjca.2023.07.002

Tjandrarini, D. H., Kristanti, D., Wurisastuti, T., Hidayangsih, P. S., Tuminah, S., Paramita, A., Kusrini, I., Dharmayanti, I., Dany, F., Ahmadi, F. & Titaley, C. R. (2024). Pandemic Pressure: Changes in Hypertensive Management Adherence in Indonesia. Asian Nursing Research, 18(2), 134–140. https://doi.org/10.1016/J.ANR.2024.04.005 DOI: https://doi.org/10.1016/j.anr.2024.04.005

Utomo, P., Djamil, M. & Suwandono, A. (2020). Effect of Dhikr on Blood Pressure in Pregnant Women with Hypertension. Indonesian Journal of Medicine, 5(1), 87–94. https://doi.org/10.26911/THEIJMED.2020.05.01.12 DOI: https://doi.org/10.26911/theijmed.2020.05.01.12

Zhang, H., Jiang, X., Da, H., Dai, R., Zhao, N., Pan, W. & Fan, J. (2020). Effect of comprehensive psychosomatic promotion in hypertension patients with anxiety and depression based on community: A randomized parallel controlled trial. Medicine (United States), 99(33), E21451. https://doi.org/10.1097/MD.0000000000021451 DOI: https://doi.org/10.1097/MD.0000000000021451