Reference

Zamarra, J.W., Schneider, R.H., Besseghini, I., Robinson, D., and Salerno, J. Usefulness of the Transcendental Meditation program in the treatment of patients with coronary artery disease. American Journal of Cardiology 77,pp. 867-870, 1996.

Summary

Epidemiological studies of long-term Transcendental Meditation^® (TM) practitioners have suggested lower rates of cardiovascular morbidity and mortality in this group compared to controls. Previous studies have shown that patients who exhibit mental stress induced ischemia, exercise induced ischemia or ambulatory induced ischemia are more likely to suffer adverse clinical cardiac events. However, the impact of stress reduction with the TM program on stress-induced myocardial ischemia, a precursor to CHD morbidity and mortality has not been previously evaluated. Therefore, in a controlled pilot study by Zamarra, Schneider, and colleagues, 21 patients with angiographically documented CAD were recruited from a VA Hospital (Buffalo, New York) cardiovascular clinic. After baseline symptom-limited exercise tolerance testing, 12 subjects were assigned to the TM group and 9 subjects were allocated to a wait-list control group. Single blind testing was repeated after an average 7.6 months of follow-up. At pre and posttest, subjects were exercised on a bicycle ergometer to an end point of moderately severe angina pectoris. Antianginal medications were stopped 1 week before testing. After an average of 7.6 months of intervention, the experimental group showed a significant pre-posttest increase of 14.5% in exercise duration (p=.013), 11.7% increase in maximum work load (p=.004) and an 18.1% delay of onset of ST segment depression (p=.029), whereas controls were essentially unchanged.

Posttest changes in exercise duration, workload, and onset of ST-segment depression after an average of 7.6 months of the Transcendental Meditation (TM) program or usual care. * duration to moderately-severe angina.

In conclusion, results of this prospective, single-blind, controlled pilot study suggest that practice with the Transcendental Meditation program is useful in reducing exercise-induced myocardial ischemia in patients with coronary heart disease. Since myocardial ischemia induced by either exercise or mental stress predicts subsequent CVD morbidity and mortality, the reduction in myocardial ischemia suggests a physiologically plausible mechanism for the reduction of CV events in TM program practitioners reported in epidemiological studies and in our preliminary randomized trials in African Americans and whites.

This study was supported by a grant from the Western New York Heart Association.