Stress reduction in the secondary prevention of cardiovascular disease: randomized, controlled trial of transcendental meditation and health education in Blacks.
Stress reduction in the secondary prevention of cardiovascular disease: randomized, controlled trial of transcendental meditation and health education in Blacks.
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DOI：
10.1161/circoutcomes.112.967406
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发表时间：
2012-11
期刊：
影响因子：
--
通讯作者：
Alexander CN
中科院分区：
文献类型：
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作者：
Schneider RH;Grim CE;Rainforth MV;Kotchen T;Nidich SI;Gaylord-King C;Salerno JW;Kotchen JM;Alexander CN
非裔美国人心血管疾病 (CVD) 的发病率不成比例。社会心理压力可能会导致这种差异。之前通过先验冥想 (TM) 计划减轻压力的试验报告称，非裔美国人和其他人群的 CVD 危险因素、替代终点和死亡率有所改善。这是一项随机对照试验，受试者为 201 名患有冠心病 (CHD) 的非裔美国男性和女性，他们被随机分配接受 TM 计划或健康教育。主要终点是全因死亡率、心肌梗死或中风的复合终点。次要终点包括心血管死亡率、血运重建和心血管住院的综合终点；血压（BP）；社会心理压力因素；和生活方式行为。在平均 5.4 年的随访中，TM 组的主要终点风险降低了 48%（风险比 [HR]，0.52；95% 置信区间 [CI]，0.29-0.92）（P =.025）。 TM 组的次要终点风险也降低了 24%（HR，0.76；95% CI，0.51-0.1.13）（P =.17）。收缩压（95% CI -8.3 至 –1.5 mm Hg）（P = .01）和愤怒表达（所有量表 P < .05）降低了 4.9 mm Hg。依从性与生存相关。选定的身心干预措施，即先验冥想计划，显着降低了先心病患者的死亡、心肌梗塞和中风风险。这些变化与较低的血压和社会心理压力因素有关。因此，这种做法在临床上可能有助于CVD的二级预防。 www.clinicaltrials.gov；
African Americans have disproportionate rates of cardiovascular disease (CVD). Psychosocial stress may contribute to this disparity. Previous trials on stress reduction with the Transcendental Meditation (TM) program have reported improvements in CVD risk factors, surrogate endpoints and mortality in African Americans and other populations. This was a randomized controlled trial of 201 African American men and women with coronary heart disease (CHD) 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 endpoints included the composite of cardiovascular mortality, revascularizations, and cardiovascular hospitalizations; blood pressure (BP); psychosocial stress factors; and lifestyle behaviors. Over 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 [HR], 0.52; 95% confidence interval[CI], 0.29-0.92)(P =.025). The TM group also showed a 24% risk reduction in the secondary end point (HR, 0.76; 95% CI, 0.51-0.1.13) (P =.17). There were reductions of 4.9 mm Hg in systolic BP (95% CI −8.3 to –1.5 mm Hg) (P =.01) and anger expression (P < .05 for all scales). Adherence was associated with survival. A selected mind-body intervention, the Transcendental Meditation program, significantly reduced risk for mortality, myocardial infarction and stroke in CHD patients. These changes were associated with lower BP and psychosocial stress factors. Therefore, this practice may be clinically useful in the secondary prevention of CVD. www.clinicaltrials.gov;