The effects of the Transcendental Meditation program on carotid atherosclerosis and cardiovascular disease risk factors in Native Hawaiians.

摘要

Background and objectives. Native Hawaiians have high rates of cardiovascular (CVD) morbidity and mortality compared to other ethnic groups in Hawaii. Research has shown that the Transcendental MeditationRTM (TM) program reduces CVD risk factors, markers of clinical CVD, and mortality rates in other high-risk populations. This pilot clinical trial evaluated the effects of the TM program on markers of CVD in Native Hawaiians.;Methods. This was a single-blind study conducted over 9 months. Entry criteria included: >=55 years, Hawaiian ancestry, and at least one CVD risk factor. Subjects were randomly assigned to the TM program or health education (HE). Both groups participated in a matched seven-step initial instruction program and follow up group meetings over 9 months. Primary outcome was carotid intima-media thickness (CIMT); secondary outcomes included blood pressure, cholesterol, depression, anxiety, dietary habits and exercise.;Results. Sixty-one subjects who met eligibility criteria were randomized into the study. Forty-eight subjects completed both initial instruction and had complete posttest data (TM, n=25; HE, n=23). Analysis of covariance for these completer subjects showed a non-significant reduction in CIMT in the TM program compared to the control group (-0.010+/-0.035 mm vs 0.004+/-0.062 mm; p=0.39). There was a marginally statistically significant reduction in depression in the TM group compared to HE (-1.73+/-7.46 vs 1.10+/-7.28; p=0.07). For the high cholesterol subgroup, there was a marginally significant reduction of CIMT in TM subjects (n=14, -0.019 +/-0.027 mm) compared to HE (n=17, 0.019+/-0.068 mm; p=0.07). Within group analysis showed reductions in the TM group for DBP (p<0.05), SBP (p<0.07), total cholesterol (p<0.01), LDL (p<0.01) and total cholesterol (p<0.01) and an increase in HDL (p<0.01); HE showed reductions in LDL (p<0.02) and total cholesterol (p<0.01). Ninety-two percent of the TM subjects and 79% of the HE subjects reported practicing their assigned programs on a regular basis.;Conclusion. The Transcendental Meditation program was feasible to implement and may be useful for the reduction of carotid atherosclerosis and CVD risk factors by enlivening the "body's inner intelligence." Future research should include larger sample sizes to increase statistical power to confirm and expand these pilot data.