A stress reduction program using Transcendental Meditation significantly reduced mortality, myocardial infarction, and stroke in African-American patients with coronary heart disease, researchers reported.
Those practicing TM had a 48% reduction in these outcomes according to Robert H. Schneider, MD, of Maharishi University of Management in Maharishi Vedic City, Iowa, and colleagues.
The TM group also had a change of −4.9 mm Hg in systolic blood pressure as reported online in Circulation: Cardiovascular Quality and Outcomes.
"Reduction in systolic BP may be a physiological mechanism for reduced clinical events in this trial since this magnitude of reduction has been associated with 15% reduction in cardiovascular clinical events," Schneider and colleagues wrote.
African Americans are disproportionately afflicted with cardiovascular disease, at least in part possibly because of environmental and psychosocial stresses.
The TM program involves daily periods during which individuals sit quietly allowing the mind to drift into a "wakeful hypometabolic state," which is characterized by physiologic changes typical of decreased stress.
Previous studies of stress reduction using TM have shown benefits for risk factors and various clinical endpoints in the general population.
Schneider and colleagues enrolled 201 black patients who had at least one coronary artery with 50% blockage.
In the study, they assigned participants to learn the meditation technique and practice it twice a day for 20 minutes, or to health education on cardiovascular health with instructions to engage in heart-healthy behaviors each day at home.
The study took place between 1998 and 2007, in two phases separated by a period of loss of funding in 2003 and 2004.
The primary endpoint was a composite of nonfatal stroke or myocardial infarction and all-cause mortality, while secondary endpoints included cardiovascular mortality, revascularization, and hospitalization for coronary heart disease or heart failure.
More than half of the patients were men, and mean age was 59. About 60% were taking lipid-lowering medications, 44% were taking ACE inhibitors, and 35% were on calcium channel blockers.
"In conclusion, this randomized controlled trial found that a selected mind-body intervention, the Transcendental Meditation program, significantly reduced risk for mortality, myocardial infarction, and stroke in African-American men and women with coronary heart disease. These changes were associated with reductions in BP and psychosocial distress," Schneider and colleagues wrote.
Limitations of the study included sample sizes that were not large enough to explore single endpoints, and varying duration for time spent in the study for some participants.
The study also did not attempt to assess the potential benefits of other types of mind-body programs, so additional research will be needed.
Primary source: Circulation: Cardiovascular Quality and OutcomesSource reference:
Schneider R, et al "Stress reduction in the secondary prevention of cardiovascular disease: a randomized controlled trial of Transcendental Meditation and health education in African Americans" Circ Cardiovasc Quality Outcomes 2012; DOI: 10.1161/CIRCOUTCOMES.112.967406.