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Kondwani, Kofi Anum
Nonpharmacologic treatment of hypertensive heart disease in African Americans: a trial of the Transcendental Meditation program and a health education program.

Order No. 9836284

Hypertensive heart disease (HHD), a major public health problem in African American communities, contributes to the disproportionally high rate of cardiovascular disease (CVD) in this population. Left ventricular hypertrophy (LVH) and diastolic dysfunction are key indicators of HHD. Lifestyle modification with diet restriction, weight reduction and exercise have been found to regress left ventricular mass and reduce elevated blood pressure (BP). The Transcendental MeditationΠ(TM) technique has been reported to reduce blood pressure, sympathetic arousal and the influence of psychosocial stressors associated with CVD. In a randomized, clinical, controlled trial with a one-year follow-up, we investigated the effect of the TM technique and a diet and exercise, health education (HE) program on left ventricular mass index (LVMI) and diastolic function (E/A ratio) determined by standard M-mode and Doppler echocardiography (echo). Within group analysis were assessed by paired t-test and between groups comparison was assessed by ANCOVA. Thirty-four (15 male and 19 female) African Americans, mean (+-SD) LVMI, 102.89 (24) and E/A ratio, 0.98 (.34) were randomized to the TM (N = 19) and the HE (N = 15) groups. There was no significant difference between groups at baseline on clinical or echo measures. Both groups showed significant within group reductions in LVMI after one year, 10.3% (p <.01) in the TM group and 14.5% (p <.01) in the HE group. Diastolic function (p =.035, one tailed) was significant in the TM group when controlling for age, pre E/A ratio and systolic BP, compared to the HE group. Furthermore, the TM group showed significant improvements in quality of life measures including energy (p =.023), positive affect (p =.01), behavioral control (p =.01) and self efficacy (p =.02) compared to the HE group. Both lifestyle modification approaches were found to be efficacious in reducing left ventricular mass in African Americans. However, the TM group showed additional improvements in quality of life, diastolic function and diastolic blood pressure. Source: DAI, 59, no. 06B, (1998): 311

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