Heart Disease and Other Cardiovascular Risk Factors

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Zamarra, J.W., Schneider, R.H., Besseghini, I., Robinson, D.K., & Salerno, J.W. (1996).  Usefulness of the transcendental meditation program in the treatment of patients with coronary artery disease.  American Journal of Cardiology, 77, 867-870.  A clinical trial that tested the hypothesis that stress reduction intervention with TM could reduce exercise-induced myocardial ischemia in patients with known CAD (coronary artery disease). 21 pts. with known CAD were recruited from the Buffalo, NY VA Hospital and prospectively studied. Subjects were randomly assigned to TM (n=12) or waitlist control group (n=9).  TM group received 10 hours of basic instruction and follow-up, including personal instruction for 60 minutes initially and 30 minutes twice/week for 6-8 months. After 8 months, the TM group had a 14.7% increase in exercise duration (p=.004), and an 18.1% delay of onset of ST depression (p=0.029), whereas control subjects showed no substantial changes in these outcomes.  Furthermore, the TM group showed significantly greater reduction in rate-pressure products after 3 and 6 minutes of exercise (p=.02), compared to controls.

Leserman, J., Stuart, E.M., Mamish, M.E., & Benson, H. (1989).  The efficacy of the relaxation response in preparing for cardiac surgery.  Behavioral Medicine, Fall, 111-117.  In this study, 27 cardiac surgery patients (mean age 68) were randomly assigned to either educational information only.  On the Profile of Mood States scale, the relaxation response group experienced significantly greater reductions in tension and anger than the education only group.  More importantly, the experimental group had lower incidence of supraventricular tachycardia (SVT) (p=.04), a dangerous heart rhythm often complicating cardiac surgery. 

Sudsuang, R., Chentanez, V., & Veluvan, K. (1991).  Effect of Buddhist meditation on serum cortisol and total protein levels, blood pressure, pulse rate, lung volume and reaction time.  Physiology & Behavior, 50, 543-548.  this was a clinical trial involving  52 males ages 20-25 years practicing Dhammakaya Buddhist meditation (similar to Zen or transcendental meditation).  Control group was 30 males of the same age group not meditating.  Serum cortisol levels were significantly reduced in treatment group (combined A and B), and was different from controls (p<.05). Systolic and diastolic blood pressures both significantly different in combined treatment group (p<.01) and from controls (p<.01 at 3 weeks, p<.05 at 6 weeks).  Pulmonary function (vital capacity, tidal volume, and maximum voluntary ventilation) significantly different at 3 and 6 weeks (p<.05) before and after in treatment group.

Alexander, C.N., Robinson, P., Orme-Johnson, D.W., Schneider, R.H., & Walton, K.G. (1994).  Effects of transcendental meditation compared to other methods of relaxation and meditation in reducing risk factors, morbidity and mortality.  Homeostasis, 35, 243-264.  Review of research showing that TM is associated with reduced cardiovascular risk factors such as hypertension, smoking and cholesterol.

Goldbourt, U., Yaari, S., & Medalie, J.H. (1993).  Factors predictive of long-term coronary heart disease mortality among 10,059 male Israeli civil servants and municipal employees.  Cardiology, 82, 100-121.  This was a prospective study of 10,059 Jewish males aged 40 or over working as civil servants or municipal employees in Israel.  Subjects were first assessed in 1963 and mortality from heart disease (coronary artery disease, CAD) was assessed in 1986 (23 year follow-up).  Religious orthodoxy was measured by 3 items (religious vs. secular education; self-definition as orthodox believers, traditional believers, or secular believers; and frequency of synagogue attendance) summed to crate an orthodoxy of belief index.  The most orthodox group had lowest rate of mortality form CAD (38 vs. 61 per 10,000) and other causes (135 vs. 168 per 10,000) than did non-believers.  The risk of death from CAD among most orthodox believers during the 23-year follow-up was at least 20% less than among non-orthodox Jews or non-believers.  These results remained significant after controlling for age, blood pressure, cholesterol, smoking, diabetes, body mass index, and baseline coronary heart disease.

Koenig, H.G., George, L.K., Cohen, H.J., Hays, J.C., Blazer, D.C., Larson, D.B. (1998).  The relationship between religious activities and blood pressure in older adults.  International Journal of Psychiatry in Medicine, 28, 189-213.  (noted earlier) This was a study of 4,000 randomly selected older adults in North Carolina participating in the NIA-sponsored EPESE study.  Persons who both attended religious services regularly (reflecting belief) and who did not (p<.0001, alter controlling for age, sex, race, education, smoking, physical functioning, and body mass index).  Among black persons in the sample (54% of subjects) and younger elderly (ages 65-74), the effects on blood pressure were even greater.  In these groups, religious activities at one wave predicted blood pressure levels three years later, after controlling for baseline blood pressure and other compounding variables.

Oxman, T.E., Freeman, D.H., & Manheimer, E.D. (1995).  Lack of social participation or religious strength and comfort as risk factors for death after cardiac surgery in the elderly.  Psychosomatic Medicine, 57, 5-15.  These investigators at Dartmouth followed 232 adults for six months after open-heart surgery, examining predictors of mortality.  The mortality rate in persons with low social support network who relied heavily on religion, after other covariates were controlled.  Even when social factors were accounted for, persons who depended on religious beliefs were only about one-third as likely to die as those who did not.

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