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Cited by 244Cardiac Health and Mental HealthMindfulness and Compassion InterventionsBlood Pressure and Hypertension Studies

Stress Reduction in the Secondary Prevention of Cardiovascular Disease: Randomized, Controlled Trial of Transcendental Meditation and Health Education in Blacks

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Schneider, Robert H., Grim, Clarence E., Rainforth, Maxwell V., Kotchen, Theodore, Nidich, Sanford I., Gaylord-King, Carolyn, Salerno, John W., Kotchen, Jane Morley +1 more·2012·Circulation: Cardiovascular Quality and Outcomes
DOI 10.1161/circoutcomes.112.967406PMC PMC7269100
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Abstract

Background—: Blacks have disproportionately high rates of cardiovascular disease. Psychosocial stress may contribute to this disparity. Previous trials on stress reduction with the Transcendental Meditation (TM) program have reported improvements in cardiovascular disease risk factors, surrogate end points, and mortality in blacks and other populations. Methods and Results—: This was a randomized, controlled trial of 201 black men and women with coronary heart disease who were randomized to the TM program or health education. The primary end point was the composite of all-cause mortality, myocardial infarction, or stroke. Secondary end points included the composite of cardiovascular mortality, revascularizations, and cardiovascular hospitalizations; blood pressure; psychosocial stress factors; and lifestyle behaviors. During an average follow-up of 5.4 years, there was a 48% risk reduction in the primary end point in the TM group (hazard ratio, 0.52; 95% confidence interval, 0.29–0.92; P =0.025). The TM group also showed a 24% risk reduction in the secondary end point (hazard ratio, 0.76; 95% confidence interval, 0.51–0.1.13; P =0.17). There were reductions of 4.9 mmHg in systolic blood pressure (95% confidence interval −8.3 to –1.5 mmHg; P =0.01) and anger expression ( P <0.05 for all scales). Adherence was associated with survival. Conclusions—: A selected mind–body intervention, the TM program, significantly reduced risk for mortality, myocardial infarction, and stroke in coronary heart disease patients. These changes were associated with lower blood pressure and psychosocial stress factors. Therefore, this practice may be clinically useful in the secondary prevention of cardiovascular disease. Clinical Trial Registration—: URL: www.clinicaltrials.gov Unique identifier: NCT01299935.

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  • Several modest-sized studies of meditation for primary and secondary prevention have reported surprisingly robust decreases in nonfatal myocardial infarction, cardiovascular mortality, and all-cause mortality; these findings need to be reproduced in larger multicenter studies.

    “Several modest-sized studies of meditation for primary and secondary prevention have reported surprisingly robust decreases in nonfatal MI, cardiovascular mortality, and all-cause mortality; these findings need to be reproduced in larger multicenter studies. 81,220-222”

    From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [220]

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Authors
Schneider, R. H., Grim, C. E., Rainforth, M. V., Kotchen, T., Nidich, S. I., Gaylord-King, C., Salerno, J. W., Kotchen, J. M., & Alexander, C. N.
Affiliations
  • Maharishi International University (US)
  • From the Institute for Natural Medicine and Prevention, Maharishi University of Management, Fairfield, IA (R.H.S., M.V.R., S.I.N., C.G-K., J.W.S., C.N.A.); Center for Natural Medicine and Prevention, Maharishi University of Management Research Institute, Maharishi Vedic City, IA (R.H.S., M.V.R., S.I.N., C.G-K., J.W.S.); and Department of Medicine, Medical College of Wisconsin, Milwaukee, WI (C.E.G., T.K., J.M.K.).
ORCID
Venue
Circulation: Cardiovascular Quality and Outcomes
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2012-11
Volume
5
Issue
6
Pages
750-758
ISSN
  • 1941-7705 (ISSN-L)
  • 1941-7713
DOI
10.1161/circoutcomes.112.967406
PMC
PMC7269100
OpenAlex
W2111007118
Cited by
244
References
74
Citations by year
2026: 5 · 2025: 14 · 2024: 15 · 2023: 16 · 2022: 17 · 2021: 17 · 2020: 16 · 2019: 22 · 2018: 23 · 2017: 29 · 2016: 13 · 2015: 20 · 2014: 16 · 2013: 19 · 2012: 1
FWCI
11.53
Type
journal article
Language
en
Open access
Locations
  • Circulation Cardiovascular Quality and Outcomes (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • University of Texas Health Science Center at Houston
  • National Institutes of Health
  • National Heart, Lung, and Blood Institute (R01HL48107, R01HL048107)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
transcendental meditation, psychosocial stress, secondary prevention, cardiovascular disease, coronary artery disease, racial disparities, all-cause mortality, myocardial infarction, stroke, blood pressure, anger expression, mind-body interventions, health education, adherence
MeSH terms
Aged, Black or African American, Coronary Disease, Female, Hospitalization, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Myocardial Infarction, Patient Education as Topic, Risk Factors, Stress, Psychological, Time Factors, Wisconsin, Multivariate Analysis, Proportional Hazards Models, Treatment Outcome, Risk Assessment, Meditation, Stroke, Kaplan-Meier Estimate, Secondary Prevention

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