Cardiovascular Implications of TM
Cardiovascular Implications of TM
June 2001; Volume 4; 63
Hypertension is not just a number, but an essential component of a broader cardiovascular risk, i.e., atherosclerosis. As the Dean Ornish program shows,1 decreasing the impact of coronary artery disease morbidity and mortality is multifactorial (including a very low-fat diet, weight reduction, exercise, social support, and meditation/prayer) and unlikely is achieved solely by decreasing blood pressure (BP). The most important individual lifestyle modification technique is unknown.
Zamarra et al compared transcendental meditation (TM) in 10 patients with angiographically documented coronary artery disease for an average of 7.6 months to six controls with coronary artery disease at the Buffalo, NY, Veterans Administration Hospital.2 Utilizing a single-blind, upright-bicycle exercise test, TM increased exercise duration (P = 0.013) and maximum workload (P = 0.004), as well as time to onset of ST depression (P = 0.03). No baseline BPs were provided. Although TM was not among the stress reduction techniques used by Blumenthal et al, 102 patients with coronary artery disease were treated for 37 months and showed improvement, i.e., less ischemia, in the absence of a BP effect.3
Castillo-Richmond et al studied 138 male and female African-Americans from Los Angeles with high-normal to Stage II hypertension (160-179/100-109 mm Hg) for an average of 6.8 months; they compared TM to risk factor reduction education.4 Sixty subjects completed pre/post beta-mode carotid ultrasound for intimal-medial thickness (IMT). Average baseline BPs ranged from 145/83 mm Hg (TM, n = 31) to 150/88 mm Hg (education, n = 29). Adjusted mean change in IMT was -0.098 mm Hg for TM vs. 0.05 mm Hg for education (P = 0.038). Decreases in systolic BP and diastolic BP were similar in both groups, i.e., -7.8/-3.5 mm Hg for TM vs. -6.7/-5.9 mm Hg for education.
The NIH National Center for Complementary and Alternative Medicine (NCCAM) recently awarded an $8 million grant to Schneider and the College of Maharishi Vedic Medicine in Fairfield, Iowa, for the establishment of a Center for Natural Medicine and Prevention. According to R. Schneider (written communication, April 2001), this center, one of nine NCCAM-supported centers, will focus on treatment and prevention of cardiovascular disease in African-Americans and other high-risk groups. Four institutions will collaborate with the center: the University of Iowa, Morehouse School of Medicine, Charles R. Drew University, and Cedars-Sinai Medical Center.
References
1. Ornish D, et al. Intensive lifestyle changes for reversal of coronary artery disease. JAMA 1998;280:2001-2007.
2. Zamarra JW, et al. Usefulness of the transcendental meditation program in the treatment of patients with coronary artery disease. Am J Cardiol 1996;77:867-870.
3. Blumenthal JA, et al. Stress management and exercise training in cardiac patients with myocardial ischemia. Effects on prognosis and evaluation of mechanisms. Arch Intern Med 1997;157: 2213-2223.
4. Castillo-Richmond A, et al. Effects of stress reduction on carotid atherosclerosis in hypertensive African Americans. Stroke 2000;31;568-573.
June 2001; Volume 4; 63
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