1. Kayyali, Andrea MSN, RN

Article Content

According to this study:


* TM favorably affects several factors in the metabolic syndrome, an indicator of risk for coronary heart disease.


* TM may modulate the physiologic response to stress.



According to a recent study, patients with stable coronary heart disease can benefit from practicing transcendental meditation (TM), which appears to help control certain physiologic factors associated with the metabolic syndrome, which is characterized by insulin resistance, elevated blood pressure, visceral obesity, and dyslipidemia and is considered an indicator in the risk for coronary heart disease.


Researchers in the randomized, controlled clinical trial compared TM with health education to see which was more effective in altering components of the metabolic syndrome. A group of 103 patients were recruited from a monitored cardiac rehabilitation program; each was stable at the time of enrollment but had a history of coronary heart disease. During the 16-week study period, patients were randomly assigned into either the TM group (n = 52) or the health education group (n = 51). Both groups received the same "number, size, and frequency" of classes; to control for TM practice at home, the health education group was given daily home assignments. The primary end points were changes in blood pressure, lipoprotein profile, insulin resistance (as measured by a formula involving fasting plasma glucose and insulin levels), endothelial function (as measured by brachial artery reactivity testing), and cardiac autonomic nervous system activity (according to heart rate variability as assessed through ambulatory Holter monitoring).


The study population consisted primarily of older men (mean age, 67 years). Approximately 90% of the patients had previously undergone cardiac revascularization, and the majority were receiving statins. Eighty-four (82%) of the 103 patients enrolled in the trial completed it, and classes in both groups were well attended, although the TM group had better attendance (97% versus 88%).


The results of the study indicate statistically significant improvement in three of the primary end points in the TM group but not in the education group. After adjusting for confounding factors such as age, sex, body mass index, and baseline characteristics such as history of diabetes and previous myocardial infarction, systolic blood pressure decreased significantly between study entry and completion by 3.4 mmHg in the TM group, but rose by 2.8 mmHg in the education group. The level of insulin resistance also decreased significantly in the TM group yet rose in the education group. A smaller but still significant difference was noted in the TM group in regard to change in heart rate variability, but no differences in change in either endothelial function or levels of lipoproteins were observed in the two groups. Psychosocial variables and medication also remained unchanged in both groups during the study.


The authors note that over the study period, TM, in contrast to health education, had favorable effects on several physiologic components of the metabolic syndrome, suggesting that the practice modulates the physiologic response to stress by affecting neurohumoral pathways that play a role in the syndrome. They conclude that interventions for reducing cardiac risk factors that focus on those pathways should be investigated in larger, longer-term clinical trials.




Paul-Labrador M, et al. Arch Intern Med 2006;166(11):1218-24.