Transcendental Meditation and Hypertension

Transcendental Meditation and Hypertension

Is Transcendental Meditation (TM) a scam? An analysis of Clinical study of the effect of TM and exercise on High blood pressure.

What is High Blood Pressure

Blood pressure is the pressure of blood pushing against the walls of the arteries that carry blood from heart to other parts of the body. Everybody has blood pressure and without blood pressure people cannot survive because then blood will not flow to the remote part of the body from heart. Blood pressure normally rises and falls throughout the day. Blood pressure has a normal range and if that exceeds the range it can damage heart and cause health problems if it stays high for a long time. High blood pressure is also called hypertension.

High Blood Pressure Statistics

According to “center for disease control and prevention” the hypertension statistics says

  • About 75 million American adults (32%) have high blood pressure—that’s 1 in every 3 adults.
  • About 1 in 3 American adults has prehypertension—blood pressure numbers that are higher than normal—but not yet in the high blood pressure range.3
  • Only about half (54%) of people with high blood pressure have their condition under control.2
  • High blood pressure was a primary or contributing cause of death for more than 410,000 Americans in 2014—that’s more than 1,100 deaths each day.1
  • High blood pressure costs the nation $48.6 billion each year. This total includes the cost of health care services, medications to treat high blood pressure, and missed days of work.
High blood statistics
Hypertension Statistics

High Blood Pressure and Medication

Blood pressure is often controlled by medication but it is widely spoken out that exercise and meditation can improve the blood pressure.  As those improves stress and anxiety of human life since those are related to blood pressure. There are many clinical studies were presented in favour of those claims. But is it so? Let us analyse few clinical study which were published in famous medical journal.

People now a days started believing and depending strongly on meditation to reduce all sorts of physical and mental illness. This was supported by lots of meditation gurus and one of them is Deepak Chopra. He mentioned that pharmaceuticals are only 20% effective on any chronic illness [1].

People tend to forget that all drugs have side effects and all drugs lose their efficacy when taken over a long enough period [2].

 TM Clinical Trial 

This article will be comparative study of  relation between exercise and hypertension and TM and hypertension. This article will discuss with three clinical trials results published in American journal of Hypertension and those are:

  1. Post-Exercise hypertension after aquatic exercise in older women with hypertension: A randomized cross over clinical trials [3].
  2. A Randomized Controlled Trial on Effects of the Transcendental Meditation Program on Blood Pressure, Psychological Distress, and Coping in Young Adults [ 4].
  3. Blood Pressure Response to Transcendental Meditation: A Meta-analysis [5].

This analysis will discuss the findings of those three trials and try to find whether the transcendental meditation has any remarkable or statistically significant impact on healing blood pressure.

First Method:

Twenty-four women 70.0±3.9 years with a resting systolic / diastolic BP (SBP/DBP) of 124.0/72.3 mmHg and body mass index (BMI) of 29.8±4.1 kg/m 2 were randomly assigned to participate in a 45 min session of moderate intensity, water-based exercise (WATER) and a 45 min land control session (CONTROL). All experimental sessions started at 9 am sharply with 7 days between them. Subjects left the experiments wearing an ambulatory BP monitor for the next 21 hr.

First Results:

Systolic BP was lower by 5.1±1.0 mmHg after WATER than CONTROL over 21 hours (p<0.001), over awake hours by 5.7±1.1 mmHg (p<0.001) and sleep hours by 4.5±0.4 mmHg (p=0.004). Diastolic BP was lower following WATER compared to CONTROL: 1.2±0.3 mmHg over 21 hours (p=0.043); 0.9±0.6 mmHg over awake hours (p=0.101); and 1.4±0.9 mmHg over sleep hours (p=0.039).

Second Method:

The second clinical trial was a randomized control trial (RCT) of 298 university students randomly allocated to either transcendental meditation program or wait-lists control. At baseline and after three months, BP, psychological distress and coping ability were assed. A subgroup of 159 at risk for hypertension was analyzed similarly.

Second Results:

Changes in systolic BP /diastolic BP for the overall sample were −2.0/−1.2 mm Hg for the TM group compared to +0.4/+0.5 mm Hg for controls (P = 0.15, P = 0.15, respectively). Changes in Systolic / Diastolic BP for the hypertension risk subgroup were −5.0/−2.8 mm Hg for the TM group compared to +1.3/+1.2 mm Hg for controls (P = 0.014, P = 0.028, respectively). Significant improvements were found in total psychological distress, anxiety, depression, anger/hostility, and coping (P values < 0.05). Changes in psychological distress and coping correlated with changes in SBP (P values < 0.05) and DBP (P values < 0.08).

Third Method:

PubMed and Cochrane databases through December 2006 and collected publications on Transcendental Meditation (TM) were searched. Randomized, controlled trials comparing blood pressure responses to the Transcendental Meditation technique with a control group were evaluated. Primary outcome measures were changes in systolic and diastolic blood pressure after practicing Transcendental Meditation or following control procedures. A specific subjects rating system (0-20 points) was used to evaluate studies and random-effects models were used for meta-analyses.

Third Results:

Nine randomized, controlled trials met eligibility criteria. Study-quality scores ranged from low (score, 7) to high (16) with three studies of high quality (15 or 16) and three of acceptable quality (11 or 12). The random-effects meta-analysis model for systolic and diastolic blood pressure, respectively, indicated that Transcendental Meditation, compared to control, was associated with the following changes: -4.7 mm Hg (95% confidence interval (CI), -7.4 to -1.9 mm Hg) and -3.2 mm Hg (95% CI, -5.4 to -1.3 mm Hg). Subgroup analyses of hypertensive groups and high-quality studies showed similar reductions.

Analysis of Clinical Trials

This analysis is based on the results of three study shown above. For the first study we found that the test was done on 24 women with average age of 70.0±3.9. There BP was 124.0/72.3, which is within the normal range (Systolic 120-130 and Diastolic 70-80). The BP was not statistically averaged like the age, which is not normal especially for BP.

Here in all three cases such as aerobic exercise in water than control and in awake and in sleep; the blood pressure of both systolic and diastolic has reduced significantly. P value in all cases shows less than 0.05, which is an indication of very minimum chance of results being false.

In the second clinical test, they demanded that changes in SBP/DBP for the hypertension risk subgroup were −5.0/−2.8 mm Hg for the TM group compared to +1.3/+1.2 mm Hg for controls (P = 0.014, P = 0.028, respectively). Significant improvements were found in total psychological distress, anxiety, depression, anger/hostility, and coping (P values < 0.05).

Other Clinical test review of TM effectiveness: Controversies

There are TM controversies. The small number of studies included in this review do not permit any conclusions to be drawn on the effectiveness of meditation therapy for anxiety disorders. Another study found out that scientific research on meditation practices does not appear to have a common theoretical perspective and is characterized by poor methodological quality. Firm conclusions on the effects of meditation practices in healthcare cannot be drawn based on the available evidence [7]. Is TM a scam?

2004 American journal of hypertension published an article concluding that “All the randomized clinical trials of TM for the control of blood pressure published to date have important methodological weaknesses and are potentially biased by the affiliation of authors to the TM organization” [8].

A study from PMID found [9] [10], A few studies of overall poor methodological quality were available for each comparison in the meta-analyses, most of which reported non-significant results. TM had no advantage over health education to improve measures of systolic blood pressure and diastolic blood pressure, body weight, heart rate, stress, anger, self-efficacy, cholesterol, dietary intake, and level of physical activity in hypertensive patients.

A 2014 Cochrane review found that it was impossible to draw any conclusions about whether TM is effective in preventing cardiovascular disease, as the scientific literature on TM was limited and at “serious risk of bias” [11].

Conclusions

It was demanded that after Transcendental Meditation (TM) the blood pressure has reduced. We know that blood pressure can fluctuate 10 points within couple of minutes. BP of a person at a certain point of time depends on so many factors such as his mental, psychological and physical conditions. Mental and psychological conditions includes his mood, stress level, anxiety, depression etc. and physical conditions includes his type food consumption on that day. So other than TM there are so many factors which can influence the change of BP. And there were no exact design of experiment was followed which can statistically prove the influence of each factors on the BP.

As they have mentioned the reduction of maximum SBP and DBP is between -5 and -1.2 mmHg is very subjective and could be wrong.

It can be concluded from the three studies that the first study of water based exercise with the elder women has more impact on the reduction of high blood pressure. The other two studies has greater chance of biasness due to their involvement with TM organisations as mentioned. So there is highly likely that TM has no influence to reduce blood pressure but relaxation from anxiety and stress.

References and further study

  1. [Curing disease without medicine; YouTube VDO].
  2. [Huffington post: Fatal prescription drug: Dr. Deepak Chopra]
  3. Post-Exercise Hypotension After Aquatic Exercise in Older Women With Hypertension: A Randomized Crossover Clinical Trial. American Journal of Hypertension, hpx165, https://doi.org/10.1093/ajh/hpx165, Published:07 September 2017
  4. A Randomized Controlled Trial on Effects of the Transcendental Meditation Program on Blood Pressure, Psychological Distress, and Coping in Young Adults. PDF Authors: Sanford I. Nidich, Maxwell V. Rainforth, David A.F. Haaga, John Hagelin, Published: American Journal of Hypertension, Volume 22, Issue 12, 1 December 2009, Pages 1326–1331, https://doi.org/10.1038/ajh.2009.184
  5. Blood Pressure Response to Transcendental Meditation: A Meta-analysis. Authors: Anderson, J.W.; Liu, C; Kryscio, R.J. Published: American Journal of Hypertension, 2008 Mar; vol 21(3), pp 310-6. Epub 2008 Jan 31.
  6. “Meditation therapy for anxiety disorders”. Cochrane Database of Systematic Reviews (1): CD004998. PMID16437509. doi:10.1002/14651858.CD004998.pub2 Authors: Krisanaprakornkit, T.; Krisanaprakornkit, W.; Piyavhatkul, N.; Laopaiboon, M. (2006). Krisanaprakornkit, Thawatchai, ed.
  7. “Meditation practices for health: state of the research”. Ospina MB, Bond K, Karkhaneh M, et al. (June 2007). Evid Rep Technol Assess (Full Rep) (155): 1–263. PMID17764203.
  8. Journal of Hypertension. 22 (11): 2049–54. PMID15480084. doi:10.1097/00004872-200411000-00002.Canter PH, Ernst E (November 2004). “Insufficient evidence to conclude whether or not Transcendental Meditation decreases blood pressure: results of a systematic review of randomized clinical trials”.
  9. Canter PH, Ernst E (November 2003). “The cumulative effects of Transcendental Meditation on cognitive function–a systematic review of randomised controlled trials”. Wien. Klin. Wochenschr. 115 (21–22): 758–66. PMID14743579. doi:10.1007/BF03040500.
  10. Ospina, MB.; Bond, K.; Karkhaneh, M.; Tjosvold, L.; Vandermeer, B.; Liang, Y.; Bialy, L.; Hooton, N.; et al. (June 2007). “Meditation practices for health: state of the research” (PDF). Evid Rep Technol Assess (Full Rep) (155): 1–263 [4]. PMID17764203.
  11. Hartley, L; Mavrodaris, A; Flowers, N; Ernst, E; Rees, K (1 December 2014). “Transcendental meditation for the primary prevention of cardiovascular disease.”. The Cochrane database of systematic reviews. 12: CD010359. PMID25436436. doi:10.1002/14651858.CD010359.pub2.
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