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A randomized controlled trial of stress reduction in African Americans treated for hypertension for over one year
Robert H Schneider1, Charles N Alexander, Frank Staggers
1Institute for Natural Medicine and Prevention, Maharishi University of Management, Fairfield, Iowa, USA. rschneider@mum.edu
Insights
Transcendental Meditation (TM) significantly lowered diastolic blood pressure and reduced antihypertensive medication use in African Americans compared to progressive muscle relaxation (PMR) or health education (HE). TM may be a beneficial adjunct therapy for hypertension in this population.
Area of Science:
- Cardiology
- Public Health
- Behavioral Medicine
Background:
- Psychosocial stress is linked to higher hypertension rates in African Americans.
- This study investigated stress reduction techniques for hypertension management in this demographic.
Purpose of the Study:
- To compare the efficacy of Transcendental Meditation (TM) and progressive muscle relaxation (PMR) against a health education (HE) control group for hypertension treatment.
- To assess the long-term (1-year) effects of these interventions on blood pressure and medication use.
Main Methods:
- A randomized controlled trial involving 150 African American adults with hypertension.
- Interventions included daily TM, PMR, or HE classes, alongside usual medical care.
- Blood pressure was measured at 3, 6, 9, and 12 months, analyzed using repeated measures ANCOVA.
Main Results:
- The TM group showed a significant decrease in diastolic blood pressure (BP) (-5.7 mm Hg) compared to PMR and HE (P = .01).
- TM participants had reduced antihypertensive medication use (P = .001 for PMR comparison).
- Women in the TM group experienced significantly greater BP reduction than women in PMR or HE groups (P .01 to .03).
Conclusions:
- Transcendental Meditation (TM) may serve as an effective complementary therapy for managing hypertension in African Americans.
- Stress reduction through TM demonstrates potential for improving cardiovascular health outcomes in at-risk populations.
Background:
Psychosocial stress has been implicated in the disproportionately higher rates of hypertension among African Americans. This randomized controlled trial compared the effects of two stress reduction techniques and a health education control program on hypertension during a period of 1 year in African-American men and women (N = 150, mean age 49 +/- 10 years, mean blood pressure (BP) = 142/95 mm Hg) at an urban community health center.
Methods:
Interventions included 20 min twice a day of Transcendental Meditation (TM) or progressive muscle relaxation (PMR), or participation in conventional health education (HE) classes. All subjects continued usual medical care. Outcomes assessed were systolic BP and diastolic BP at 3, 6, 9, and 12 months after treatment, analyzed by repeated measures ANCOVA.
Results:
The TM group showed decreases in systolic BP/diastolic BP of -3.1/-5.7 mm Hg compared to -0.5/-2.9 mm Hg for PMR or HE, (P = .12 to .17 for systolic BP, P = .01 for diastolic BP). In addition the TM group demonstrated reduced use of antihypertensive medication relative to increases for PMR (P = .001) and HE (P = .09) groups. Group analysis by gender showed that women practicing TM had decreased BP (-7.3/-6.9 mm Hg) significantly more than women practicing PMR (0.7/-2.7 mm Hg) or HE (-.07/-3.0 mm Hg) (P .01 to .03). The change in men praticing TM (0.2 /-4.7 mm Hg) was greater than men practicing HE (-0.9/-2.0 mm Hg) for diastolic BP only (P = .09,) and not different from PMR men (-2.0/-3.1).
Conclusions:
A selected stress reduction approach, the Transcendental Meditation program, may be useful as an adjunct in the long-term treatment of hypertension in African Americans.
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