Effects of stress reduction on carotid atherosclerosis in hypertensive African Americans
Authors: Castillo-Richmond, A., Schneider, R.H., Alexander, C.N., Cook, R., Myers, H., Nidich, S., Haney, C., Rainforth, M., Salerno, J.
Published: Stroke. 2000 Mar; vol 31(3): pp 568-73.
Background and purpose: African Americans suffer disproportionately higher cardiovascular disease mortality rates than do whites. Psychosocial stress influences the development and progression of atherosclerosis. Carotid intima-media thickness (IMT) is a valid surrogate measure for coronary atherosclerosis, is a predictor of coronary outcomes and stroke, and is associated with psychosocial stress factors. Stress reduction with the Transcendental Meditation (TM) program decreases coronary heart disease risk factors and cardiovascular mortality in African Americans. B-mode ultrasound is useful for the noninvasive evaluation of carotid atherosclerosis. 
Methods: This randomized controlled clinical trial evaluated the effects of the Transcendental Meditation program on carotid intima-media thickness in hypertensive African American men and women, aged >20 years, over a 6- to 9-month period. From the initially enrolled 138 volunteers, 60 subjects completed pretest and posttest carotid intima-media thickness data. The assigned interventions were either the Transcendental Meditation program or a health education group. By use of B-mode ultrasound, mean maximum IMT from 6 carotid segments was used to determine pretest and posttest IMT values. Regression analysis and ANCOVA were performed.
Results: Age and pretest intima-media thickness were found to be predictors of posttest IMT values and were used as covariates. The Transcendental Meditation group showed a significant decrease of -0.098 mm (95% CI -0. 198 to 0.003 mm) compared with an increase of 0.054 mm (95% CI -0.05 to 0.158 mm) in the control group (P=0.038, 2-tailed).
Conclusions: Stress reduction with the Transcendental Meditation program is associated with reduced carotid atherosclerosis compared with health education in hypertensive African Americans. Further research with this stress-reduction technique is warranted to confirm these preliminary findings.
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