Stress Reduction in the Prevention of Left Ventricular Hypertrophy
A Randomized Controlled Trial of Transcendental Meditation and Health Education in Hypertensive African Americans
Keywords:
Left Ventricular Hypertrophy; Left Ventricular Mass Index; Stress Reduction; Transcendental Meditation; Health Disparity; Cardiovascular DiseaseAbstract
African Americans have disproportionately high rates of cardiovascular disease (CVD). Left ventricular hypertrophy (LVH) is an independent risk factor for CVD and may contribute to this disparity. Psychological stress contributes to LVH in African Americans and other populations. Objective: This study evaluated the effects of stress reduction with the Transcendental Meditation (TM) technique on preventing LVH in African American adults with hypertension. In this trial, 85 African American adults (average 52.8 years) were randomly assigned to either TM program or health education (HE) control group and completed post-testing. Participants were tested at baseline and after six months for left ventricular mass index (LVMI) by M-mode echocardiography, blood pressure, psychosocial stress and behavioral factors. Change in outcomes was analyzed between groups by ANCOVA and within groups by paired t-test. The TM group had significantly lower LVMI compared with the HE group (-7.55gm/m2, 95% CI -14.78 to -.34 gm/m2, P=.040). Both interventions showed significant within group reductions in BP, (SBP/ DBP changes for TM: -5/ -3 mm Hg, and for HE: -7/-6 mm Hg, P=.028 to <.001) although between group changes were not significant. In addition, both groups showed significant reductions in anger (P=.002 to .001). There were no other changes in lifestyle factors.