Stress Reduction in the Prevention of Left Ventricular Hypertrophy: A Randomized Controlled Trial of Transcendental Meditation and Health Education in Hypertensive African Americans

Abstract

Background: 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.Setting: Martin Luther King Hospital - Charles R. Drew University of Medicine and Science, Los Angeles, CA.Method: 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 posttesting. 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.Results: 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.Conclusions: These findings indicate that stress reduction with TM was effective in preventing LVMI progression and thus may prevent LVH and associated CVD in high-risk African American patients. Ethn Dis. 2019;29(4):577-586; doi:10.18865/ ed.29.4.577