Stress Reduction in the Secondary Prevention of Cardiovascular Disease

Abstract

Background-Blacks have disproportionately high rates of cardiovascular disease. Psychosocial stress may contribute to this disparity. Previous trials on stress reduction with the Transcendental Meditation (TM) program have reported improvements in cardiovascular disease risk factors, surrogate end points, and mortality in blacks and other populations. Methods and Results-This was a randomized, controlled trial of 201 black men and women with coronary heart disease who were randomized to the TM program or health education. The primary end point was the composite of all-cause mortality, myocardial infarction, or stroke. Secondary end points included the composite of cardiovascular mortality, revascularizations, and cardiovascular hospitalizations; blood pressure; psychosocial stress factors; and lifestyle behaviors.During an average follow-up of 5.4 years, there was a 48% risk reduction in the primary end point in the TM group (hazard ratio, 0.52; 95% confidence interval, 0.29-0.92; P=0.025). The TM group also showed a 24% risk reduction in the secondary end point (hazard ratio, 0.76; 95% confidence interval, 0.51-0.1.13; P=0.17). There were reductions of 4.9 mm Hg in systolic blood pressure (95% confidence interval −8.3 to -1.5 mm Hg; P=0.01) and anger expression (P<0.05 for all scales). Adherence was associated with survival. Conclusions-A selected mind-body intervention, the TM program, significantly reduced risk for mortality, myocardial infarction, and stroke in coronary heart disease patients. These changes were associated with lower blood pressure and psychosocial stress factors. Therefore, this practice may be clinically useful in the secondary prevention of cardiovascular disease. Clinical Trial ParticipantsEligible patients were black men and women with angiographic evidence of at least 1 coronary artery with >50% stenosis. Exclusion criteria were acute myocardial infarction (MI), stroke, or coronary revascularization within the previous 3 months, chronic heart failure with ejection fraction <20%, cognitive impairment, and noncardiac life-threatening illness. Subjects continued usual medical care throughout the study.

Meditation: Should a cardiologist care?

“…More recently, TM® was found to decrease a composite of all-cause mortality, myocardial infarction, or stroke in African American patients with coronary heart disease. 76 Though the results appear promising, analysis of the study and the statistics utilized raise questions making the data at best less than robust.…”

Effect of Midnight Prayer on Sympathetic Tone

“…Stress reduction with trancedental meditation program has given an advantage to condition like hypertension and psychological stress 7 , which is caused bylower blood pressure and pulse rate. The improvement of blood pressure and pulse rate is associated with regularity of trancedental meditation practice.…”

Reversal of Early Atherosclerosis in Metabolic Syndrome by Yoga – A Randomized Controlled Trial

“…Control of several risk factors like hypertension, type II DM lipids [4][5][6][7][8][9][10]. Reversal or preventive effects of both psychosocial and oxidative stress and reduction of inflammation [18][19][20][21] may be contributing factors.…”

“…Yoga is a holistic lifestyle and includes not only physical postures (asanas), breathing exercises (Pranayamas), meditation but also emphasizes on vegetarian diet, tobacco cessation and stress control. Yoga has been reported to be beneficial for control of risk factors of CHD (like hypertension, diabetes, obesity, lipids and stress) [4][5][6], regression of advanced coronary atherosclerosis [7][8][9] and secondary prevention of CHD [10]. The objective of the present study was to determine whether yoga can regress the progression of early atherosclerosis in MetS [11].…”