Sanford Nidich

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.

Stress Reduction in the Secondary Prevention of Cardiovascular Disease Randomized, Controlled Trial of Transcendental Meditation and Health Education in Blacks

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 mmHg in systolic blood pressure (95% confidence interval −8.3 to –1.5 mmHg; 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 Registration—URL: www.clinicaltrials.gov Unique identifier: NCT01299935.

Effects of Transcendental Meditation practice on brain functioning and stress reactivity in college students

This randomized controlled trial investigated effects of Transcendental Meditation (TM) practice on Brain Integration Scale scores (broadband frontal coherence, power ratios, and preparatory brain responses), electrodermal habituation to 85-dB tones, sleepiness, heart rate, respiratory sinus arrhythmia, and P300 latencies in 50 college students. After pretest, students were randomly assigned to learn TM immediately or learn after the 10-week posttest. There were no significant pretest group differences. A MANOVA of students with complete data (N=38) yielded significant group vs treatment interactions for Brain Integration Scale scores, sleepiness, and habituation rates (all p<.007). Post hoc analyses revealed significant increases in Brain Integration Scale scores for Immediate-start students but decreases in Delayed-start students; significant reductions in sleepiness in Immediate-start students with no change in Delayed-start students; and no changes in habituation rates in Immediate-start students, but significant increases in Delayed-start students. These data support the value of TM practice for college students.

A Randomized Controlled Trial on Effects of the Transcendental Meditation Program on Blood Pressure, Psychological Distress, and Coping in Young Adults

BACKGROUND Psychological distress contributes to the development of hypertension in young adults. This trial assessed the effects of a mind-body intervention on blood pressure (BP), psychological distress, and coping in college students. METHODS This was a randomized controlled trial (RCT) of 298 university students randomly allocated to either the Transcendental Meditation (TM) program or wait-list control. At baseline and after 3 months, BP, psychological distress, and coping ability were assessed. A subgroup of 159 subjects at risk for hypertension was analyzed similarly. RESULTS Changes in systolic BP (SBP)/diastolic BP (DBP) for the overall sample were -2.0/-1.2 mm Hg for the TM group compared to +0.4/+0.5 mm Hg for controls (P = 0.15, P = 0.15, respectively). Changes in SBP/DBP for the hypertension risk subgroup were -5.0/-2.8 mm Hg for the TM group compared to +1.3/+1.2 mm Hg for controls (P = 0.014, P = 0.028, respectively). Significant improvements were found in total psychological distress, anxiety, depression, anger/hostility, and coping (P values < 0.05). Changes in psychological distress and coping correlated with changes in SBP (P values < 0.05) and DBP (P values < 0.08). CONCLUSIONS This is the first RCT to demonstrate that a selected mind-body intervention, the TM program, decreased BP in association with decreased psychological distress, and increased coping in young adults at risk for hypertension. This mind-body program may reduce the risk for future development of hypertension in young adults.

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.

Review of controlled research on the transcendental meditation program and cardiovascular disease. Risk factors, morbidity, and mortality.

Because of growing evidence for stress as a major factor contributing to cardiovascular disease (CVD), techniques of meditation are being increasingly used. The Transcendental Meditation (TM) technique is distinct from other techniques of meditation not only in its origin and procedure, but also in the amount and breadth of research testing it. Evidence for its ability to reduce traditional and novel risk factors for CVD includes: 1) decreases in blood pressure, 2) reduced use of tobacco and alcohol, 3) lowering of high cholesterol and lipid oxidation, and 4) decreased psychosocial stress. Changes expected to result from reducing these risk factors, namely, reversal of atherosclerosis, reduction of myocardial ischemia and left ventricular hypertrophy, reduced health insurance claims for CVD, and reduced mortality, also have been found with TM practice. Research on mechanisms suggests that some of the CVD-related benefits as a result of this technique could arise from normalization of neuroendocrine systems whose function has been distorted by chronic stress. Further randomized clinical trials are in progress with a focus on underserved minority populations.

Psychosocial stress and cardiovascular disease Part 2: effectiveness of the Transcendental Meditation program in treatment and prevention.

Abstract Psychosocial stress is a nontraditional risk factor for cardiovascular morbidity and mortality that may respond to behavioral or psychosocial interventions. To date, studies applying such interventions have reported a wide range of success rates in treatment or prevention of cardiovascular disease (CVD). The authors focus on a natural medicine approach that research indicates reduces both psychosocial and traditional risk factors for cardiovascular disease—the Transcendental Meditation (TM) program. Randomized controlled trials, meta-analyses, and other controlled studies indicate this meditation technique reduces risk factors and can slow or reverse the progression of pathophysiological changes underlying cardiovascular disease. Studies with this technique have revealed reductions in blood pressure, carotid artery intimamedia thickness, myocardial ischemia, left ventricular hypertrophy, mortality, and other relevant outcomes. The magnitudes of these effects compare favorably with those of conventional interventions for secondary prevention.

A Randomized Controlled Trial of the Effects of Transcendental Meditation on Quality of Life in Older Breast Cancer Patients

This single-blind, randomized controlled trial evaluated the impact of the Transcendental Meditation program plus standard care as compared with standard care alone on the quality of life (QOL) of older women (≥55 years) with stage II to IV breast cancer. One hundred and thirty women (mean age = 63.8) were randomly assigned to either experimental (n = 64) or control (n = 66) groups. Functional Assessment of Cancer Therapy—Breast (FACT-B), Functional Assessment of Chronic Illness Therapy— Spiritual Well-Being (FACIT-SP), and Short-Form (SF)-36 mental health and vitality scales were administered every 6 months over an average 18-month intervention period. Significant improvements were found in the Transcendental Meditation group compared with controls in overall QOL, measured by the FACT-B total score (P = .037), emotional well-being (P = .046), and social well-being (P = .003) subscales, and SF-36 mental health ( P = .017). Results indicate that the Transcendental Meditation technique improves the QOL of older breast cancer patients. It is recommended that this stress reduction program, with its ease of implementation and home practice, be adopted in public health programs.

Kohlbergian Cosmic Perspective Responses, EEG Coherence and the TM and TM-Sidhi Programme.

Abstract While considerable attention has been given to Kohlbergs stages of moral reasoning, little effort has been given to studying Kohlbergs notion of a metaphorical Stage Seven, which presupposes a cosmic rather than a universal humanistic orientation. The purpose of this study was to determine whether EEG coherence can distinguish cosmic orientation responses from non‐cosmic orientation responses to the question, ‘Why be moral?’. Thirteen cosmic orientation candidates were compared with thirteen non‐cosmic orientation subjects, matched for age, using EEG coherence measures. Results indicate that cosmic orientation candidates exhibited higher EEG bilateral frontal alpha coherence than non‐cosmic orientation subjects (p< .01). In addition, a positive correlation was found between the Principled Thinking Scale of Rests Defining Issues Test and right homolateral EEG coherence (rs = .46, p< .05). Discussion of the results, along with suggestions for further research and implications for education are i...

Effect of Transcendental Meditation on Employee Stress, Depression, and Burnout: A Randomized Controlled Study

CONTEXT Workplace stress and burnout are pervasive problems, affecting employee performance and personal health. OBJECTIVE To evaluate the effects of the Transcendental Meditation program on psychological distress and burnout among staff at a residential therapeutic school for students with severe behavioral problems. DESIGN A total of 40 secondary schoolteachers and support staff at the Bennington School in Vermont, a therapeutic school for children with behavioral problems, were randomly assigned to either practice of the Transcendental Meditation program or a wait-list control group. The Transcendental Meditation course was provided by certified instructors. MAIN OUTCOME MEASURES Outcome measures were assessed at baseline and four months, and included perceived stress, depression, and burnout. A multivariate analysis of covariance was used to determine overall effects. RESULTS Analysis of the 4-month intervention data indicated a significant improvement in the main outcomes of the study resulting from practice of the Transcendental Meditation program compared with controls (Wilks Λ [3,28] = 0.695; p = 0.019). Results of univariate F tests indicated a significant reduction of all main outcome measures: perceived stress (F[1,32] = 13.42; p = < 0.001); depression (F[1,32] = 6.92; p = 0.013); and overall teacher burnout (F[1,32] = 6.18; p = 0.018). Effect sizes ranged from 0.40 to 0.94. CONCLUSIONS The Transcendental Meditation program was effective in reducing psychological distress in teachers and support staff working in a therapeutic school for students with behavioral problems. These findings have important implications for employees’ job performance as well as their mental and physical health.