Improve Cardiovascular Risk Factors and Survival in African Americans with Meditation
By John M. de Castro, Ph.D.
“Twice-a-day Transcendental Meditation helped African Americans with heart disease reduce risk of death, heart attack and stroke. Meditation helped patients lower their blood pressure, stress and anger.” – Science Daily
High Blood Pressure (Hypertension) is an insidious disease because there are no overt symptoms. The individual feels fine. But it can be deadly as more than 360,000 American deaths, roughly 1,000 deaths each day, had high blood pressure as a primary or contributing cause. In addition, hypertension markedly increases the risk heart attack, stroke, heart failure, and kidney disease. It is also a very common disorder with about 70 million American adults (29%) having high blood pressure and only about half (52%) of people with high blood pressure have their condition under control. Hypertension is more prevalent in African American populations with 40% having high blood pressure. African Americans were 20 percent more likely to die from heart disease.
High blood pressure, because it doesn’t have any primary symptoms, is usually only diagnosed by direct measurement of blood pressure usually by a health care professional. When hypertension is chronically present over three quarters of patients are treated with antihypertensive drugs. But these medications often have adverse side effects. So, patients feel lousy when taking the drugs, but fine when they’re not. So, compliance is a major issue with many patients not taking the drugs regularly or stopping entirely. Obviously, there is a need for alternative to drug treatments for hypertension.
Mindfulness practices have been shown to aid in controlling hypertension. Indeed, meditation, tai chi, and yoga, have also been shown to be helpful for heart health. These practices have also been shown to reduce the physiological and psychological responses to stress and to be helpful for producing the kinds of lifestyle changes needed to prevent heart disease such as smoking cessation, and weight reduction. They have also been shown to be effective in maintaining cardiovascular health and the treatment of cardiovascular disease. Hence it is reasonable to study the effects of meditation training on cardiovascular health in African Americans.
In today’s Research News article “Stress reduction in the secondary prevention of cardiovascular disease: randomized, controlled trial of transcendental meditation and health education in Blacks. Circulation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7269100/) Schneider and colleagues recruited African American patients with a history of coronary artery disease. They were randomly assigned to receive either health education or Transcendental Meditation. Both interventions consisted of training for 1.5 hours weekly for the first month, biweekly for the next two months, and monthly thereafter along with home practice. They were measured before and after training and every 6 months thereafter for 9 years for mortality, blood pressure, diet, alcohol and tobacco use, physical activity, depression, anger, and hostility.
They found that in comparison to the health education group, the participants who practiced meditation had significantly lower all-cause mortality rates (44% vs, 54% respectively) and lower rates of myocardial infarction and stroke over the 9-year follow-up period. They also found that the greater the amount of home practice the lower the mortality rate. In addition, at the 5-year follow-up the meditation group had significantly lower systolic blood pressure, resting heart rate, and anger.
These are excellent results that suggest that meditation practice significantly improves survival in African American patients with a history of coronary artery disease. The fact that they were followed for 9 years is remarkable and strengthens the conclusions. Similar to the current results, it has previously been found that mindfulness practices produce significant improvements in cardiovascular function and reduces anger responses. It is not known but it is reasonable to hypothesize that the reduction in blood pressure and heart rate along with anger contributed to the heightened survival.
So, improve cardiovascular risk factors and survival in African Americans with meditation.
“Meditation can serve many purposes. It can help regulate breathing, reduce stress, and aid some in getting in touch with their inner spiritual selves. When it comes to heart health, meditation can take on another role — a preventative one.” – Tri Cities Medical Center
CMCS – Center for Mindfulness and Contemplative Studies
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Schneider, R. H., Grim, C. E., Rainforth, M. V., Kotchen, T., Nidich, S. I., Gaylord-King, C., Salerno, J. W., Kotchen, J. M., & Alexander, C. N. (2012). Stress reduction in the secondary prevention of cardiovascular disease: randomized, controlled trial of transcendental meditation and health education in Blacks. Circulation. Cardiovascular quality and outcomes, 5(6), 750–758. https://doi.org/10.1161/CIRCOUTCOMES.112.967406
African Americans have disproportionate rates of cardiovascular disease (CVD). Psychosocial stress may contribute to this disparity. Previous trials on stress reduction with the Transcendental Meditation (TM) program have reported improvements in CVD risk factors, surrogate endpoints and mortality in African Americans and other populations.
Methods and Results:
This was a randomized controlled trial of 201 African American men and women with coronary heart disease (CHD) 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 endpoints included the composite of cardiovascular mortality, revascularizations, and cardiovascular hospitalizations; blood pressure (BP); psychosocial stress factors; and lifestyle behaviors. Over 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 [HR], 0.52; 95% confidence interval[CI], 0.29-0.92)(P =.025). The TM group also showed a 24% risk reduction in the secondary end point (HR, 0.76; 95% CI, 0.51-0.1.13) (P =.17). There were reductions of 4.9 mm Hg in systolic BP (95% CI −8.3 to –1.5 mm Hg) (P =.01) and anger expression (P < .05 for all scales). Adherence was associated with survival.
A selected mind-body intervention, the Transcendental Meditation program, significantly reduced risk for mortality, myocardial infarction and stroke in CHD patients. These changes were associated with lower BP and psychosocial stress factors. Therefore, this practice may be clinically useful in the secondary prevention of CVD.
What is known
Psychosocial stress is associated with the onset and progression of cardiovascular disease in African Americans and the general population
Stress reduction with the Transcendental Meditation program has previously been shown to reduce cardiovascular risk factors e.g., hypertension, psychological stress, smoking, insulin resistance and myocardial ischemia.
What this article adds
This randomized controlled trial found that adding stress-reducing Transcendental Meditation to usual care in patients with coronary heart disease resulted in a 48% reduction in the risk for cardiovascular clinical events, i.e., mortality, myocardial infarction and stroke over more than five years of follow up.
Potential mechanisms for the observed outcomes differences included lower blood pressure and anger scores. There was evidence for dose-response effect between regularity of meditation practice and longer survival.
A transcendental meditation program may be useful in the secondary prevention of cardiovascular disease.