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Calderon, Raul, Jr.
Effects of nonpharmacological approaches on cholesterol levels in mild hypertensive African Americans: A pilot study of the Transcendental Meditation program and a health education program.

Order No.9965261

Psychosocial stress may directly contribute to the disproportionately high rates of coronary heart disease morbidity and mortality and its etiologic risk factors in African Americans. Specifically, acute and chronic stress have been shown to raise serum lipids and are associated with clinical coronary events.

In a randomized, clinical trial with a 6 month follow-up, the effects of the Transcendental Meditation® (TM) program and a health education (HE) program on change in lipid and lipoprotein levels were investigated. Sixty-six mildly hypertensive African Americans, ages 25–72, were randomized, at baseline, to either the TM (N = 33) or HE (N = 33) groups. Primary and secondary outcome measures (i.e., lipid and lipoproteins, blood pressure, diet, exercise, and psychological variables) were assessed using analysis of covariance (ANCOVA).

Baseline analyses indicated no significant between-group differences in lipid levels, demographic, physiological, psychological, dietary or exercise variables. Post-test analyses indicated no significant reductions in total cholesterol (TC), triglycerides (TG), or low density lipoproteins (LDL), and no significant increase in high density lipoproteins (HDL) between-groups. However, both groups showed significant positive changes in secondary outcome variables, such as blood pressure, pulse, diet, and psychological variables. Additional within-group analyses showed positive correlations between change in TC and LDL with change in Anger-Out and DBP, respectively, in the TM group. Similar correlations were also found in the HE group. Furthermore, a TM subgroup analysis by education revealed that subjects with high school education significantly differed in magnitude of reduction in TC and LDL compared to those with college education.

This study did not support the hypothesis of reduction in lipids with behavioral intervention in the overall sample over six months. On the other hand, this study did support the use of the TM technique and a HE program for reduction of blood pressure and pulse rate, and improvement in psychological and dietary measures. Furthermore, subgroup analyses suggest the hypothesis that education/SES may interact with lipid response to the practice of the TM technique.

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