Effects of Lifestyle Modification on Telomerase Gene Expression in Hypertensive Patients: A Pilot Trial of Stress Reduction and Health Education Programs in African Americans

Abstract

BackgroundAfrican Americans suffer from disproportionately high rates of hypertension and cardiovascular disease. Psychosocial stress, lifestyle and telomere dysfunction contribute to the pathogenesis of hypertension and cardiovascular disease. This study evaluated effects of stress reduction and lifestyle modification on blood pressure, telomerase gene expression and lifestyle factors in African Americans.MethodsForty-eight African American men and women with stage I hypertension who participated in a larger randomized controlled trial volunteered for this substudy. These subjects participated in either stress reduction with the Transcendental Meditation technique and a basic health education course (SR) or an extensive health education program (EHE) for 16 weeks. Primary outcomes were telomerase gene expression (hTERT and hTR) and clinic blood pressure. Secondary outcomes included lifestyle-related factors. Data were analyzed for within-group and between-group changes.ResultsBoth groups showed increases in the two measures of telomerase gene expression, hTR mRNA levels (SR: p< 0.001; EHE: p< 0.001) and hTERT mRNA levels (SR: p = 0.055; EHE: p< 0.002). However, no statistically significant between-group changes were observed. Both groups showed reductions in systolic BP. Adjusted changes were SR = -5.7 mm Hg, p< 0.01; EHE = -9.0 mm Hg, p < 0.001 with no statistically significant difference between group difference. There was a significant reduction in diastolic BP in the EHE group (-5.3 mm Hg, p< 0.001) but not in SR (-1.2 mm Hg, p = 0.42); the between-group difference was significant (p = 0.04). The EHE group showed a greater number of changes in lifestyle behaviors.ConclusionIn this pilot trial, both stress reduction (Transcendental Meditation technique plus health education) and extensive health education groups demonstrated increased telomerase gene expression and reduced BP. The association between increased telomerase gene expression and reduced BP observed in this high-risk population suggest hypotheses that telomerase gene expression may either be a biomarker for reduced BP or a mechanism by which stress reduction and lifestyle modification reduces BP.Trial RegistrationClinicalTrials.gov NCT00681200

The effectiveness of the nursing intervention on cholesterol level and quality of life among hypertensive patients with dyslipidemia

“…This may be due to the improvement of their knowledge following the instruction regarding diet and stress management. This result was also showed by Duraiman et al [28] who reported that relaxation increases the secretion of endorphin hormone and decreases the secretion of adrenalin hormone. It improves blood circulation and decreases anxiety and stress by creating a positive attitude and improving brain function.…”

“…The symptoms of depression and lifestyle also improved among participants after the implementation of the nursing intervention. A similar result was supported by Duraimani et al, [28] who observed reduced sodium and protein consumption among all subjects; while a large number of the health education group revealed reduced intake of calories, carbohydrates, and fats than the stress reduction group.…”

Stress Reduction in the Prevention of Left Ventricular Hypertrophy: A Randomized Controlled Trial of Transcendental Meditation and Health Education in Hypertensive African Americans

“…These results are consistent with previous studies of TM indicating that this practice may produce physiological changes associated with stress in the absence of changes in self-reported psychological variables. 36,37 Fifth, no record of compliance for home TM practice was collected. However, the record of meeting attendance was significantly higher in the TM (80.6%) as compared with HE (50.2%) group (P=.001).…”

Friend or foe? Telomerase as a pharmacological target in cancer and cardiovascular disease

“…Of note, the Atherosclerosis Risk in Communities (ARIC) study has shown that TERT polymorphisms are associated with increased risk of incident coronary heart disease, incident ischemic stroke, and mortality in African-Americans participants (79). Stress reduction and lifestyle modification in this same high risk population increase telomerase gene expression and produce an associated reduction in blood pressure (BP), suggesting that enhanced telomerase gene expression may either be a biomarker for reduced BP or a mechanism by which stress reduction and lifestyle modification reduces BP (80). Moreover, telomerase deletion increases endothelin ET-1 levels in the plasma suggesting that loss of telomerase may contribute to increased vasoconstriction and hypertension (81).…”