A randomized controlled trial of stress reduction in African Americans treated for hypertension for over one year.
BACKGROUND
Psychosocial stress has been implicated in the disproportionately higher rates of hypertension among African Americans. This randomized controlled trial compared the effects of two stress reduction techniques and a health education control program on hypertension during a period of 1 year in African-American men and women (N = 150, mean age 49 +/- 10 years, mean blood pressure (BP) = 142/95 mm Hg) at an urban community health center.


METHODS
Interventions included 20 min twice a day of Transcendental Meditation (TM) or progressive muscle relaxation (PMR), or participation in conventional health education (HE) classes. All subjects continued usual medical care. Outcomes assessed were systolic BP and diastolic BP at 3, 6, 9, and 12 months after treatment, analyzed by repeated measures ANCOVA.


RESULTS
The TM group showed decreases in systolic BP/diastolic BP of -3.1/-5.7 mm Hg compared to -0.5/-2.9 mm Hg for PMR or HE, (P = .12 to .17 for systolic BP, P = .01 for diastolic BP). In addition the TM group demonstrated reduced use of antihypertensive medication relative to increases for PMR (P = .001) and HE (P = .09) groups. Group analysis by gender showed that women practicing TM had decreased BP (-7.3/-6.9 mm Hg) significantly more than women practicing PMR (0.7/-2.7 mm Hg) or HE (-.07/-3.0 mm Hg) (P .01 to .03). The change in men praticing TM (0.2 /-4.7 mm Hg) was greater than men practicing HE (-0.9/-2.0 mm Hg) for diastolic BP only (P = .09,) and not different from PMR men (-2.0/-3.1).


CONCLUSIONS
A selected stress reduction approach, the Transcendental Meditation program, may be useful as an adjunct in the long-term treatment of hypertension in African Americans.
Schneider
Robert H
RH
Institute for Natural Medicine and Prevention, Maharishi University of Management, Fairfield, Iowa, USA. rschneider@mum.edu
Alexander
Charles N
CN
Staggers
Frank
F
Orme-Johnson
David W
DW
Rainforth
Maxwell
M
Salerno
John W
JW
Sheppard
William
W
Castillo-Richmond
Amparo
A
Barnes
Vernon A
VA
Nidich
Sanford I
SI
D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D002140:California / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000523:psychology* / Q000628:therapy*; D008019:Life Style; D008297:Male; D019122:Meditation; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D012737:Sex Factors; D013315:Stress, Psychological / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome
D000959:Antihypertensive Agents