Charles N. Alexander

A Randomized Controlled Trial of Stress Reduction for Hypertension in Older African Americans

We tested the short-term efficacy and feasibility of two stress education approaches toe the treatment of mild hypertension in older African Americans. This was a randomized, controlled, single-blind trial with 3 months of follow-up in primary care, inner-city health center. Of 213 African American men and women screened, 127 individuals (aged 55 to 85 years with initial diastolic pressure of 90 to 109 mm Hg, systolic pressure of < or = 189 mm Hg, and final baseline blood pressure of < or = 179/104 mm Hg) were selected. Of these, 16 did not complete follow-up blood pressure measurements. Mental and physical stress reduction approaches (Transcendental Meditation and progressive muscle relaxation) were compared with a lifestyle modification education control program and with each other. The primary outcome measures were changes in clinic diastolic and systolic pressures from baseline to final follow-up, measured by blinded observers. The secondary measures were linear blood pressure trends, changes in home blood pressure, and intervention compliance. Adjusted for significant baseline differences and compared with control, Transcendental Meditation reduced systolic pressure by 10.7 mm Hg (P < .0003) and diastolic pressure by 6.4 mm Hg (P <.00005). Progressive muscle relaxation lowered systolic pressure by 4.7 mm Hg (P = 0054) and diastolic pressure by 3.3 mm Hg (P <.02). The reductions in the Transcendental Meditation group were significantly greater than in the progressive muscle relaxation group for both systolic blood pressure (P = .02) and diastolic blood pressure (P = .03). Linear trend analysis confirmed these patterns.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of Stress Reduction on Carotid Atherosclerosis in Hypertensive African Americans

BACKGROUND AND PURPOSE African Americans suffer disproportionately higher cardiovascular disease mortality rates than do whites. Psychosocial stress influences the development and progression of atherosclerosis. Carotid intima-media thickness (IMT) is a valid surrogate measure for coronary atherosclerosis, is a predictor of coronary outcomes and stroke, and is associated with psychosocial stress factors. Stress reduction with the Transcendental Meditation (TM) program decreases coronary heart disease risk factors and cardiovascular mortality in African Americans. B-mode ultrasound is useful for the noninvasive evaluation of carotid atherosclerosis. METHODS This randomized controlled clinical trial evaluated the effects of the TM program on carotid IMT in hypertensive African American men and women, aged >20 years, over a 6- to 9-month period. From the initially enrolled 138 volunteers, 60 subjects completed pretest and posttest carotid IMT data. The assigned interventions were either the TM program or a health education group. By use of B-mode ultrasound, mean maximum IMT from 6 carotid segments was used to determine pretest and posttest IMT values. Regression analysis and ANCOVA were performed. RESULTS Age and pretest IMT were found to be predictors of posttest IMT values and were used as covariates. The TM group showed a significant decrease of -0.098 mm (95% CI -0. 198 to 0.003 mm) compared with an increase of 0.054 mm (95% CI -0.05 to 0.158 mm) in the control group (P=0.038, 2-tailed). CONCLUSIONS Stress reduction with the TM program is associated with reduced carotid atherosclerosis compared with health education in hypertensive African Americans. Further research with this stress-reduction technique is warranted to confirm these preliminary findings.

Trial of Stress Reduction for Hypertension in Older African Americans II. Sex and Risk Subgroup Analysis

Our objective was to test the short-term efficacy and feasibility of two stress-reduction approaches for the treatment of hypertension in older African Americans, focusing on subgroup analysis by sex and by high and low risk on six measures of hypertension risk: psychosocial stress, obesity, alcohol use, physical inactivity, dietary sodium-potassium ratio, and a composite measure. The study involved a follow-up subgroup analysis of a 3-month randomized, controlled, single-blind trial conducted in a primary care, inner-city health center. Subjects were 127 African American men and women, aged 55 to 85 years, with diastolic pressure of 90 to 104 mm Hg and systolic pressure less than or equal to 179 mm Hg. Of these, 16 did not complete follow-up blood pressure measurements. Mental and physical stress-reduction approaches-the Transcendental Meditation technique and progressive muscle relaxation, respectively-were compared with a life-style modification education control and with each other. Both systolic and diastolic pressures changed from baseline to follow-up for both sexes and for high and low risk level (defined by median split) on the six measures of hypertension risk. Compared with education control subjects, women practicing the Transcendental Meditation technique showed adjusted declines in systolic (10.4 mm Hg, P < .01) and diastolic (5.9 mm Hg, P < .01) pressures. Men in this treatment group also declined in both systolic (12.7 mm Hg, P < .01) and diastolic (8.1 mm Hg, P < .001) pressures compared with control subjects. Women practicing muscle relaxation did not show a significant decrease compared with control subjects, and men declined significantly in diastolic pressure only (6.2 mm Hg, P < .01). For the measure of psychosocial stress, both the high and low risk subgroups using the Transcendental Meditation technique declined in systolic (high risk, P = .0003; low, P = .06) and diastolic (high risk, P = .001; low, P = .008) pressures compared with control subjects, whereas for muscle relaxation, blood pressure dropped significantly only in the high risk subgroup and only for systolic pressure (P = .03) compared with control subjects. For each of the other five risk measures, Transcendental Meditation subjects in both the high and low risk groups declined significantly in systolic and diastolic pressures compared with control subjects. Effects of stress reduction on blood pressure were found to generalize to both sexes and diverse risk factor subgroups and were significantly greater in the Transcendental Meditation treatment group. These effects (along with high compliance) even in individuals with multiple risk factors for hypertension clearly warrant longer-term investigation in this and other populations.

Effects of the transcendental meditation program on stress reduction, health, and employee development: A prospective study in two occupational settings

Abstract Despite the high cost of occupational stress, few studies have empirically documented effective methods for alleviating stress and promoting employee development. This three-month prospective study evaluated the effects of the Transcendental meditation (TM) technique on stress reduction, health and employee development in two settings in the automotive industry: a large manufacturing plant of a Fortune 100 corporation, and a small distribution sales company. Employees who learned TM were compared to controls similar in worksite, job position, demographic, and pretest characteristics. Regular meditators improved significantly more than controls (with irregular meditators scoring in between) on multiple measures of stress and employee development, including: reduced physiological arousal (measured by skin conductance levels) during and outside TM practice; decreased trait anxiety, job tension, insomnia and fatigue, cigarette and hard liquor use; improved general health (and fewer health complaints)...

Lower Lipid Peroxide Levels in Practitioners of the Transcendental Meditation® Program

Objective Oxidative stress or free radical activity may contribute to the pathophysiology of atherosclerosis and other chronic diseases associated with aging. Because psychosocial stress has been shown to increase oxidative stress, we conducted an exploratory study to investigate the effects of stress reduction with the Transcendental Meditation (TM) program on serum lipid peroxide levels in elderly subjects. Method Forty-one normally healthy subjects (aged 56 to 74 years, average 67 years) were recruited from the same Midwest city. Eighteen were long-term practitioners of the TM program (average 16.5 years.). Twenty-three controls were not practicing a formal stress management technique. Venous blood samples were analyzed for lipid peroxides by the TBARS assay. A dietary questionnaire was used to assess fat intake, red meat consumption, antioxidant vitamin supplementation, and smoking. Differences between groups and subgroups were analyzed by t test, and correlations. Results Significantly lower serum levels of lipid peroxides were found in the TM practitioners compared with controls (-15%, p = .026). No significant differences were found between groups on smoking, fat intake, or vitamin supplementation. TM practitioners also had lower red meat consumption but matched subgroup analysis and partial correlations did not confirm a relationship between red meat intake and lipid peroxide levels. Conclusions These preliminary findings suggest that lower serum lipid peroxide levels may be associated with stress reduction using the Transcendental Meditation technique. Prospective controlled trials are needed to confirm that this effect is because of TM practice rather than other lifestyle factors, such as diet.

Transcendental meditation and improved performance on intelligence-related measures: A longitudinal study

This two-year longitudinal study investigated the effect of participation in a special university curriculum, whose principal innovative feature is twice-daily practice of the Transcendental Meditation (TM) and TM-Sidhi program, on performance on Cattells Culture Fair Intelligence Test (CFIT) and Hicks reaction time. These measures are known to be correlated with general intelligence. One hundred college men and women were the subjects—45 from Maharishi International University (MIU) and 55 from the University of Northern Iowa (UNI). The experimental group (MIU) improved significantly on the CFIT (t=2.79, P<0.005); choice reaction time (t=9.10, P<0.0001); SD of choice reaction time (t=11.39, P<0.0001), and simple reaction time (t=2.11, P<0.025) over two years compared to the control group, which showed no improvement. Possible confounds of subjects age, education level, level of interest in meditation, fathers education level, and fathers annual income were controlled for using analysis of covariance and stepwise regression. The results replicate the findings of previous longitudinal studies on intelligence test scores at MIU, and indicate that participation in the MIU curriculum results in improvements in measures related to general intelligence.

Effectiveness of the Transcendental Meditation program in preventing and treating substance misuse: a review.

This article reviews 24 studies on the benefits of Transcendental Meditation (TM) in treating and preventing misuse of chemical substances. Studies cover noninstitutionalized users, participants in treatment programs, and prisoners with histories of heavy use. All the studies showed positive effects of the TM program. Some of the survey-type studies were unable to exclude the possibility of self-selection or responder biases. However, longitudinal, random-assignment studies with objective measures also showed positive results. Taken together, these and other studies indicate the program simultaneously addresses several factors underlying chemical dependence, providing not only immediate relief from distress but also long-range improvements in well-being, self-esteem, personal empowerment, and other areas of psychophysiological health.

Developing consciousness in organizations: The transcendental meditation program in business

This paper reviews retrospective, prospective, and case research on workplace applications of Maharishis Transcendental Meditation technique for developing consciousness and human potential. The distinctive psychophysiological state of restful alertness produced by the Transcendental Meditation technique appears to improve employee health, well-being, job satisfaction, efficiency and productivity, in turn influencing organizational climate, absenteeism, and financial performance.

A unified theory of leadership

Suggests that development of consciousness is a fundamental causal variable underlying the complexity of behaviours and psychological qualities associated with leadership. This unified model is supported by evidence which indicates that world‐class leaders experience a silent, expanded, restfully alert, and non‐attached state of consciousness, which forms the basis of higher states of consciousness, more frequently than comparison groups. Discusses transcendental meditation, a mental technique which systematically cultivates development of consciousness, as a technology to lay the foundations for more widespread development of leadership.

Effects of Group Practice of the Transcendental Meditation Program on Preventing Violent Crime in Washington, D.C.: Results of the National Demonstration Project, June--July 1993

This paper reports the results of a prospective experiment in which a group of approximately 4,000 participants in the Transcendental Meditation and TM-Sidhi programs of Maharishi Mahesh Yogi assembled in Washington, D.C., from June 7 to July 30, 1993. It was hypothesized that levels of violent crime in the District of Columbia would fall substantially during the Demonstration Project, as a result of the groups effect of increasing coherence and reducing stress in the collective consciousness of the District. A 27-member Project Review Board comprising independent scientists and leading citizens approved the research protocol and monitored the research process. Weekly crime data was derived from database records provided by the District of Columbia Metropolitan Police Department (DCMPD), which are used in the FBI Uniform Crime Reports. Statistical analysis considered the effect of weather variables, daylight, historical crime trends and annual patterns in the District of Columbia, as well as trends in neighboring cities. Consistent with previous research, levels of homicides, rapes and assaults (HRA crimes) correlated with average weekly temperature. Robberies approximately followed an annually recurring cycle. Time series analysis of 1993 data, controlling for temperature, showed that HRA crimes dropped significantly during the Demonstration Project, corresponding with increases in the size of the group; the maximum decrease was 23.3% (p < 2 × 10−9) [24.6% using a longer baseline, with 1988--1993 data (p < 3 × 10−5)], coincident with the peak number of participants in the group during the final week of the assembly. When the same period in each of the five previous years was examined, no significant decreases in HRA crimes were found. Robberies did not decrease significantly. However, a model that jointly estimated the effect of the Demonstration Project on both HRA crimes and robberies showed a significant reduction in violent crimes overall of 15.6% (p = 0.0008). Further analysis showed that the effect of the coherence-creating group on reducing HRA crimes could not be accounted for by additional police staffing. The time series analysis for HRA crimes gave results that are highly robust to alternative model specifications, and showed that the effect of the group size was cumulative and persisted after the Demonstration Project ended. Also, calculation of the steady state gain based on the time series model predicted that a permanent group of 4,000 coherence-creating experts in the District would have a long-term effect of reducing HRA crimes by 48%.