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

Abstract

Background: African Americans have dis­proportionately high rates of cardiovascular disease (CVD). Left ventricular hypertrophy (LVH) is an independent risk factor for CVD and may contribute to this disparity. Psycho­logical stress contributes to LVH in African Americans and other populations.Objective: This study evaluated the effects of stress reduction with the Transcendental Meditation (TM) technique on prevent­ing LVH in African American adults with hypertension.Setting: Martin Luther King Hospital - Charles R. Drew University of Medicine and Science, Los Angeles, CA.Method: In this trial, 85 African American adults (average 52.8 years) were randomly assigned to either TM program or health education (HE) control group and completed posttesting. Participants were tested at base­line and after six months for left ventricular mass index (LVMI) by M-mode echocardiog­raphy, blood pressure, psychosocial stress and behavioral factors. Change in outcomes was analyzed between groups by ANCOVA and within groups by paired t-test.Results: The TM group had significantly lower LVMI compared with the HE group(-7.55gm/m2, 95% CI -14.78 to -.34 gm/m2, P=.040). Both interventions showed sig­nificant within group reductions in BP, (SBP/ DBP changes for TM: -5/ -3 mm Hg, and for HE: -7/-6 mm Hg, P=.028 to <.001) although between group changes were not significant. In addition, both groups showed significant reductions in anger (P=.002 to .001). There were no other changes in lifestyle factors.Conclusions: These findings indicate that stress reduction with TM was effective in preventing LVMI progression and thus may prevent LVH and associated CVD in high-risk African American patients. Ethn Dis. 2019;29(4):577-586; doi:10.18865/ ed.29.4.577

Meditation and Cardiovascular Risk Reduction

“…The effects of Transcendental Meditation on blood pressure have also been reported . A study of 298 university students randomized to Transcendental Meditation or wait‐list control found at 3‐month follow‐up no significant changes in systolic or diastolic blood pressure, although significant reductions in blood pressure (5/3 mm Hg, respectively) did occur in those at high risk of the development of hypertension .…”

“…A study of 298 university students randomized to Transcendental Meditation or wait‐list control found at 3‐month follow‐up no significant changes in systolic or diastolic blood pressure, although significant reductions in blood pressure (5/3 mm Hg, respectively) did occur in those at high risk of the development of hypertension . In a randomized study of stress reduction in 201 black men and women with angiographically documented coronary artery disease randomized to Transcendental Meditation or health education, 5.4‐year follow‐up found a 4.9 mm Hg lower systolic blood pressure, 1 of numerous secondary study end points, in those randomized to Transcendental Meditation than in those randomized to health education, primarily because of an increase in blood pressure in the health education group …”

Mind-Body-Spiritual Care for Coronary Heart Disease Patients - A Systematic Review

“…The positive psychological results reported in the studies were reducing anxiety, depression, stress (Bakara et al, 2013;Carneiro et al, 2017;Delui, Yari, Khouyinezhad, Amini & Bayazi, 2013;Ikedo, Gangahar, Quader & Smith, 2007;Lukman, Akbar & Ibrahim, 2012;Momeni, Omidi, Raygan & Akbari, 2016a;Nyklíček, Dijksman, Lenders, Fonteijn & Koolen, 2014;Parswani, Sharma & Iyegar, 2013;Stein et al, 2010;Tacón, McComb, Caldera & Randolph, 2003;, increasing psycho-spiritual comfort (Bakar, 2017), coping (Mufarokhah, Putra & Dewi, 2016), spiritual wellbeing , and anger, confusion, fatigue (Ikedo et al, 2007) and hope . The reported positive biological parameters include stress hormones (Robert McComb, Tacon, Randolph & Caldera, 2004), hemodynamic parameters (Carneiro et al, 2017;Delui et al, 2013;Momeni et al, 2016a;Parswani et al, 2013), myocardial infarction attack and cardiac revascularization (Schneider et al, 2012) and cardiovascular function (Kim et al, 2013).…”

The 2017 ACC/AHA Hypertension Guidelines: Should they have included proven nonpharmacological blood pressure‐lowering strategies such as Transcendental Meditation?

“…Furthermore, published randomized controlled trials have reported that this meditation practice, when used in conjunction with usual medical care, is associated with reductions in mortality 8 and in the composite of all-cause mortality, myocardial infarction, and stroke. 9 In light of these more recent findings, we suggest that the AHA committee update its review and recommendations on nonpharmacologic interventions for blood pressure, particularly in regard to the Transcendental Meditation technique. Patients with high blood pressure should be made aware that there is another evidence-based option for the prevention and treatment of high blood pressure that may help to mitigate the need for drug therapy.…”