The promising role of Transcendental Meditation in the prevention and treatment of cardiometabolic diseases: A systematic review.

Psychological distress has a demonstrable impact on cardiovascular diseases (CVD) and risk factors. Transcendental Meditation (TM) has been shown to reduce stress and improve health and well-being. The current review aimed to synthesize the evidence on the effects of TM on cardiometabolic outcomes and identify gaps for future research. We searched PubMed/MEDLINE, EMBASE, SCOPUS, and Web of Science databases for relevant literature. Forty-five papers that reported studies of TM on cardiometabolic risk factors and diseases were included. Evidence shows that TM is effective in reducing blood pressure (BP). We found some evidence that TM can improve insulin resistance and may play a role in improving dyslipidemia, exercise tolerance, and myocardial blood flow, and in reducing carotid intima-media thickness and left ventricular mass. Studies show that long-term TM practice can reduce the risk of myocardial infarction, stroke, and CVD mortality. This review identified that certain studies have high participant drop-out rates, and fewer studies targeted comprehensive cardiometabolic outcomes beyond BP with longer follow-up periods. We found that most studies were conducted in specific populations, which may limit generalizability. In conclusion, TM has the potential to improve cardiometabolic health; however, research gaps highlight the need for larger phase III multicenter clinical trials with long-term follow-ups.

Peace through health: traditional medicine meditation in the prevention of collective stress, violence, and war.

In the midst of global armed conflicts, notably the Israel-Hamas and Ukraine-Russia wars, there is an urgent need for innovative public health strategies in peacebuilding. The devastating impact of wars, including mortality, injury, disease, and the diversion of healthcare resources, necessitates effective and durable interventions. This perspective aligns with WHO recommendations and examines the role of evidence-based meditation from Ayurveda and Yoga in public health to mitigate collective stress and prevent collective violence and war. It highlights the Transcendental Meditation program, recognized for reducing stress, with contemporary evidence supporting its effectiveness in mental health, mind-body disorders, cardiovascular disease, and public health. Empirical studies with cross-cultural replications indicate that these Traditional Medicine meditation practices can reduce collective stress and prevent collective violence and war activity while improving quality of life. The mechanisms of group meditation in mitigating collective violence are explored through public health models, cognitive neuroscience, population neuroscience, quantum physics principles, and systems medicine. This perspective suggests that Transcendental Meditation and the advanced TM-Sidhi program, as a component of Traditional Medicine, can provide a valuable platform for enhancing societal well-being and peace by addressing brain-based factors fundamental to collective stress and violence.

Managing the Built Environment for Health Promotion and Disease Prevention With Maharishi Vastu Architecture: A Review.

Background and objectives: The evolution of healthcare from 18th-century reductionism to 21st-century postgenomic holism has been described in terms of systems medicine, and the impact of the built environment on human health is the focus of investigation and development, leading to the new specialty of evidence-based, therapeutic architecture. The traditional system of Vastu architecture-a design paradigm for buildings which is proposed to promote mental and physical health-has been applied and studied in the West in the last 20 years, and features elements absent from other approaches. This review critically evaluates the theory and research of a well-developed, standardized form of Vastu-Maharishi Vastu® architecture (MVA). MVA's principles include development of the architect's consciousness, universal recommendations for building orientation, siting, and dimensions; placement of key functions; and occupants' head direction when sleeping or performing tasks. The effects of isolated Vastu elements included in MVA are presented. However, the full value of MVA, documented as a systematic, globally applicable practice, is in the effect of its complete package, and thus this review of MVA includes evaluating the experience of living and working in MVA buildings. Methods: The published medical and health-related literature was systematically surveyed for research on factors related to isolated principles applied in MVA as well as on the complete system. Results: Published research suggests that incorporating MVA principles into buildings correlates with significant improvements in occupants' physical and mental health and quality of life: better sleep, greater happiness of children, and the experience of heightened sense of security and reduced stress. The frequency of burglaries, a social determinant of health, also correlates. Potential neurophysiological mechanisms are described. Conclusions: Findings suggest that MVA offers an actionable approach for managing a key social determinant of health by using architectural design as preventive medicine and in public health.

The Future of Medicine: Frontiers in Integrative Health and Medicine.

Despite advances in modern medicine, contemporary society has experienced a series of epidemics and pandemics of noncommunicable, chronic diseases and communicable, infectious diseases [...].

Randomized controlled trial of stress reduction with meditation and health education in black men and women with high normal and normal blood pressure.

BACKGROUND: Black men and women suffer from disparities in morbidity and mortality from hypertension, cardiovascular disease, and currently, COVID-19. These conditions are associated with social determinants of health and psychosocial stress. While previous trials demonstrated that stress reduction with meditation lowered BP in the grade I range in Black adults, there is a paucity of evidence for high normal and normal BP. OBJECTIVE: This randomized controlled trial was conducted to evaluate the effect of stress reduction with the Transcendental Meditation (TM) technique in Black adults with high normal BP and normal BP using international classifications. METHODS: A total of 304 Black men and women with high normal (130-139/85-89 mm Hg) and normal BP (120-129/80-84 mm Hg) were randomized to either TM or health education (HE) groups. BP was recorded at 3, 6, 9, 12, 24, 30 and 36 months after baseline. Linear mixed model analysis was conducted to compare the BP change between TM and HE participants in the high-normal BP and normal-BP groups. Survival analysis for hypertensive events was conducted. RESULTS: After an average of 19.9 ± 11.1 months follow-up, TM participants in the high-normal BP group showed significantly lower posttest SBP (-3.33 mm Hg, p = 0.045). There was no difference in DBP (-0.785 mm Hg, p = 0.367) compared to HE participants. In the normal BP group, the SBP and DBP were not different between the TM and HE participants. The hazard ratio for hypertensive events was 0.52 (p = 0.15) in the high normal BP group (7 TM vs 13 HE) with no difference in the normal BP group. CONCLUSION: This RCT found that meditation lowered systolic BP in Black men and women with high normal BP but not in normal BP participants. These results may be relevant to reducing health disparities in CVD and related co-morbidities.

A Systematic Review and Meta-Analysis of Ayurvedic Herbal Preparations for Hypercholesterolemia.

Background and Objectives: Cardiovascular disease (CVD) is the leading cause of death globally and hypercholesterolemia is one of the major risk factors associated with CVD. Due to a growing body of research on side effects and long-term impacts of conventional CVD treatments, focus is shifting towards exploring alternative treatment approaches such as Ayurveda. However, because of a lack of strong scientific evidence, the safety and efficacy profiles of such interventions have not been well established. The current study aims to conduct a systematic review and meta-analyses to explore the strength of evidence on efficacy and safety of Ayurvedic herbs for hypercholesterolemia. Methods: Literature searches were conducted using databases including Medline, Cochrane Database, AMED, Embase, AYUSH research portal, and many others. All randomized controlled trials on individuals with hypercholesterolemia using Ayurvedic herbs (alone or in combination) with an exposure period of ≥ 3 weeks were included, with primary outcomes being total cholesterol levels, adverse events, and other cardiovascular events. The search strategy was determined with the help of the Cochrane Metabolic and Endocrine Disorders Group. Two researchers assessed the risk of each study individually and discrepancies were resolved by consensus or consultation with a third researcher. Meta-analysis was conducted using the inverse variance method and results are presented as forest plots and data summary tables using Revman v5.3. Results: A systematic review of 32 studies with 1386 participants found randomized controlled trials of three Ayurvedic herbs, Allium sativum (garlic), Commiphora mukul (guggulu), and Nigella sativa (black cumin) on hypercholesterolemia that met inclusion criteria. The average duration of intervention was 12 weeks. Meta-analysis of the trials showed that guggulu reduced total cholesterol and low-density lipoprotein levels by 16.78 mg/dL (95% C.I. 13.96 to 2.61; p-value = 0.02) and 18.78 mg/dL (95% C.I. 34.07 to 3.48; p = 0.02), respectively. Garlic reduced LDL-C by 10.37 mg/dL (95% C.I. -17.58 to -3.16; p-value = 0.005). Black cumin lowered total cholesterol by 9.28 mg/dL (95% C.I. -17.36, to -1.19, p-value = 0.02). Reported adverse side effects were minimal. Conclusion: There is moderate to high level of evidence from randomized controlled trials that the Ayurvedic herbs guggulu, garlic, and black cumin are moderately effective for reducing hypercholesterolemia. In addition, minimal evidence was found for any side effects associated with these herbs, positioning them as safe adjuvants to conventional treatments.

Diagnostic Validity of Ayurvedic Pulse Assessment: Maharishi Nadi-Vigyan in Cardiovascular Health.

This study is the first of its kind to systematically investigate the relationship between the clinical practice of Maharishi á¾¹yurVeda pulse assessment and cardiovascular health. Given that cardiovascular disease is a major threat to the health of people in many countries, the question of diagnostic validity of a traditional, non-invasive method of health assessment is an important one for prevention and therapeutics. For this reason, we investigated the diagnostic validity of examining the pulse of patients using the technique of Maharishi Nadi-Vigyan compared to an objective measure of blood pressure and to self-reports of other cardiovascular risk factors. The study sample consisted of 160 participants at a Maharishi á¾¹yurVeda clinic in the United States and assessed consistency of diagnoses between Maharishi Nadi-Vigyan and hypertension as measured by blood pressure using a standard sphygmomanometer, and patient self-reports of elevated cholesterol, insomnia, and psychological stress (operationalised in this study as 'state of mind'). Our findings showed diagnostic validity of 95% for hypertension by Maharishi Nadi-Vigyan compared to objectively measured hypertension. For elevated cholesterol, insomnia, and psychological stress, the agreement was 76%. Previous studies assessed the reliability of conventional forms of pulse examination in á¾¹yurVeda and found relatively low levels of both inter-rater and within-rater reliability, whereas the present study of Maharishi Nadi-Vigyan found generally higher levels. These findings have implications for the use of Maharishi Nadi-Vigyan as a diagnostic approach in the context of holistic, integrated, and preventive healthcare offered by Maharishi á¾¹yurVeda. We conclude the study with a discussion of key theoretical domains which underpin the findings, namely the traditional forms of á¾¹yurVeda and Nadi-Vigyan, and the introduction of next generation Maharishi á¾¹yurVeda and Maharishi Nadi-Vigyan. Finally, we consider the influence pulse assessment might have on the future of cardiovascular healthcare.

Effects of cardiac rehabilitation with and without meditation on myocardial blood flow using quantitative positron emission tomography: A pilot study.

BACKGROUND: Psychosocial stress is recognized as a risk factor for coronary heart disease (CHD). High rates of CHD in African-Americans may be related to psychosocial stress. However, standard cardiac rehabilitation (CR) usually does not include a systematic stress-reduction technique. Previous studies suggest that the Transcendental Meditation (TM) technique may reduce CHD risk factors and clinical events. This pilot study explored the effects of standard CR with and without TM on a measure of CHD in African-American patients. METHODS: Fifty-six CHD patients were assigned to CR, CR + TM, TM alone, or usual care. Testing was done at baseline and after 12 weeks. The primary outcome was myocardial flow reserve (MFR) assessed by 13N-ammonia positron emission tomography (PET). Secondary outcomes were CHD risk factors. Based on guidelines for analysis of small pilot studies, data were analyzed for effect size (ES). RESULTS: For 37 patients who completed posttesting, there were MFR improvements in the CR + TM group (+20.7%; ES = 0.64) and the TM group alone (+12.8%; ES = 0.36). By comparison, the CR-alone and usual care groups showed modest changes (+ 5.8%; ES = 0.17 and - 10.3%; ES = - 0.31), respectively. For the combined TM group, MFR increased (+ 14%, ES = 0.56) compared to the combined non-TM group (- 2.0%, ES = - 0.08). CONCLUSIONS: These pilot data suggest that adding the TM technique to standard cardiac rehabilitation or using TM alone may improve the myocardial flow reserve in African-American CHD patients. These results may be applied to the design of controlled clinical trials to definitively test these effects. TRIAL REGISTRATION: ClinicalTrials.gov registration # NCT01810029.

Stress Reduction in the Prevention of Left Ventricular Hypertrophy: A Randomized Controlled Trial of Transcendental Meditation and Health Education in Hypertensive African Americans.

Background: African Americans have disproportionately high rates of cardiovascular disease (CVD). Left ventricular hypertrophy (LVH) is an independent risk factor for CVD and may contribute to this disparity. Psychological stress contributes to LVH in African Americans and other populations. Objective: This study evaluated the effects of stress reduction with the Transcendental Meditation (TM) technique on preventing LVH in African American adults with hypertension. Setting: Martin Luther King Hospital - Charles R. Drew University of Medicine and Science, Los Angeles, CA. Method: In this trial, 85 African American adults (average 52.8 years) were randomly assigned to either TM program or health education (HE) control group and completed posttesting. Participants were tested at baseline and after six months for left ventricular mass index (LVMI) by M-mode echocardiography, blood pressure, psychosocial stress and behavioral factors. Change in outcomes was analyzed between groups by ANCOVA and within groups by paired t-test. Results: The TM group had significantly lower LVMI compared with the HE group (-7.55gm/m2, 95% CI -14.78 to -.34 gm/m2, P=.040). Both interventions showed significant within group reductions in BP, (SBP/DBP changes for TM: -5/ -3 mm Hg, and for HE: -7/-6 mm Hg, P=.028 to <.001) although between group changes were not significant. In addition, both groups showed significant reductions in anger (P=.002 to .001). There were no other changes in lifestyle factors. Conclusions: These findings indicate that stress reduction with TM was effective in preventing LVMI progression and thus may prevent LVH and associated CVD in high-risk African American patients.

Non-trauma-focused meditation versus exposure therapy in veterans with post-traumatic stress disorder: a randomised controlled trial.

BACKGROUND: Post-traumatic stress disorder (PTSD) is a complex and difficult-to-treat disorder, affecting 10-20% of military veterans. Previous research has raised the question of whether a non-trauma-focused treatment can be as effective as trauma exposure therapy in reducing PTSD symptoms. This study aimed to compare the non-trauma-focused practice of Transcendental Meditation (TM) with prolonged exposure therapy (PE) in a non-inferiority clinical trial, and to compare both therapies with a control of PTSD health education (HE). METHODS: We did a randomised controlled trial at the Department of Veterans Affairs San Diego Healthcare System in CA, USA. We included 203 veterans with a current diagnosis of PTSD resulting from active military service randomly assigned to a TM or PE group, or an active control group of HE, using stratified block randomisation. Each treatment provided 12 sessions over 12 weeks, with daily home practice. TM and HE were mainly given in a group setting and PE was given individually. The primary outcome was change in PTSD symptom severity over 3 months, assessed by the Clinician-Administered PTSD Scale (CAPS). Analysis was by intention to treat. We hypothesised that TM would show non-inferiority to PE in improvement of CAPS score (Δ=10), with TM and PE superior to PTSD HE. This study is registered with ClinicalTrials.gov, number NCT01865123. FINDINGS: Between June 10, 2013, and Oct 7, 2016, 203 veterans were randomly assigned to an intervention group (68 to the TM group, 68 to the PE group, and 67 to the PTSD HE group). TM was significantly non-inferior to PE on change in CAPS score from baseline to 3-month post-test (difference between groups in mean change -5·9, 95% CI -14·3 to 2·4, p=0·0002). In standard superiority comparisons, significant reductions in CAPS scores were found for TM versus PTSD HE (-14·6 95% CI, -23·3 to -5·9, p=0·0009), and PE versus PTSD HE (-8·7 95% CI, -17·0 to -0·32, p=0·041). 61% of those receiving TM, 42% of those receiving PE, and 32% of those receiving HE showed clinically significant improvements on the CAPS score. INTERPRETATION: A non-trauma-focused-therapy, TM, might be a viable option for decreasing the severity of PTSD symptoms in veterans and represents an efficacious alternative for veterans who prefer not to receive or who do not respond to traditional exposure-based treatments of PTSD. FUNDING: Department of Defense, US Army Medical Research.

Effects of Lifestyle Modification on Telomerase Gene Expression in Hypertensive Patients: A Pilot Trial of Stress Reduction and Health Education Programs in African Americans.

BACKGROUND: African Americans suffer from disproportionately high rates of hypertension and cardiovascular disease. Psychosocial stress, lifestyle and telomere dysfunction contribute to the pathogenesis of hypertension and cardiovascular disease. This study evaluated effects of stress reduction and lifestyle modification on blood pressure, telomerase gene expression and lifestyle factors in African Americans. METHODS: Forty-eight African American men and women with stage I hypertension who participated in a larger randomized controlled trial volunteered for this substudy. These subjects participated in either stress reduction with the Transcendental Meditation technique and a basic health education course (SR) or an extensive health education program (EHE) for 16 weeks. Primary outcomes were telomerase gene expression (hTERT and hTR) and clinic blood pressure. Secondary outcomes included lifestyle-related factors. Data were analyzed for within-group and between-group changes. RESULTS: Both groups showed increases in the two measures of telomerase gene expression, hTR mRNA levels (SR: p< 0.001; EHE: p< 0.001) and hTERT mRNA levels (SR: p = 0.055; EHE: p< 0.002). However, no statistically significant between-group changes were observed. Both groups showed reductions in systolic BP. Adjusted changes were SR = -5.7 mm Hg, p< 0.01; EHE = -9.0 mm Hg, p < 0.001 with no statistically significant difference between group difference. There was a significant reduction in diastolic BP in the EHE group (-5.3 mm Hg, p< 0.001) but not in SR (-1.2 mm Hg, p = 0.42); the between-group difference was significant (p = 0.04). The EHE group showed a greater number of changes in lifestyle behaviors. CONCLUSION: In this pilot trial, both stress reduction (Transcendental Meditation technique plus health education) and extensive health education groups demonstrated increased telomerase gene expression and reduced BP. The association between increased telomerase gene expression and reduced BP observed in this high-risk population suggest hypotheses that telomerase gene expression may either be a biomarker for reduced BP or a mechanism by which stress reduction and lifestyle modification reduces BP. TRIAL REGISTRATION: ClinicalTrials.gov NCT00681200.

Design and rationale of a comparative effectiveness trial evaluating transcendental meditation against established therapies for PTSD.

BACKGROUND: Although meditation therapies such as the Transcendental Meditation (TM) technique are commonly used to assist with stress and stress-related diseases, there remains a lack of rigorous clinical trial research establishing the relative efficacy of these treatments overall and for populations with psychiatric illness. This study uses a comparative effectiveness design to assess the relative benefits of TM to those obtained from a gold-standard cognitive behavioral therapy for posttraumatic stress disorder (PTSD) in a Veteran population. METHODS AND DESIGN: This paper describes the rationale and design of an in progress randomized controlled trial comparing TM to an established cognitive behavioral treatment - Prolonged Exposure (PE) - and an active control condition (health education [HE]) for PTSD. This trial will recruit 210 Veterans meeting DSM-IV criteria for PTSD, with testing conducted at 0 and 3 months for PTSD symptoms, depression, mood disturbance, quality of life, behavioral factors, and physiological/biochemical and gene expression mechanisms using validated measures. The study hypothesis is that TM will be noninferior to PE and superior to HE on changes in PTSD symptoms, using the Clinician Administered PTSD Scale (CAPS). DISCUSSION: The described study represents a methodologically rigorous protocol evaluating the benefits of TM for PTSD. The projected results will help to establish the overall efficacy of TM for PTSD among Veterans, identify bio-behavioral mechanisms through which TM and PE may improve PTSD symptoms, and will permit conclusions regarding the relative value of TM against currently established therapies for PTSD.

Trials of Maharishi Ayurveda for cardiovascular disease: A pooled analysis of outcome studies with carotid intima-media thickness.

Objective: To investigate a multimodality, natural medicine systems approach-Maharishi Ayurveda (MAV)-for prevention or reversal of atherosclerotic cardiovascular disease (ASCVD). Design: Pooled analysis of data from existing trials that used MAV to reduce carotid artery intima-media thickness (CIMT). Settings: Two large medical centers in the U.S. Midwest. Subjects: Thirty-four elderly patients with or at high risk for ASCVD. Interventions: Four components of MAV: Transcendental Meditation™, Ayurvedic diet, Ayurvedic exercise, and Ayurvedic herbal food supplements. Primary outcome measure: CIMT, a surrogate measure of ASCVD, was determined by B-mode ultrasonography. Results: After 9-12 months of intervention, CIMT declined in the MAV group (change in CIMT = -0.15 ± 0.22 mm; 95% CI = -0.22 to 0.01 mm) and increased in the usual care group (change in CIMT = + 0.02 ± 0.06 mm; 95% CI = -0.02 to 0.04). This difference between groups of -0.17 mm was significant [F(1,29) = 14.1, p << .01]. In the MAV group, those individuals showing the largest reductions in CIMT with treatment also had the highest risk factor levels at the start. Baseline data from this subgroup indicated the presence of hypertension, (systolic blood pressure (SBP) = 141 ± 11 mmHg, diastolic blood pressure (DBP) = 80 ± 12 mmHg, means ± SD). They also had elevated waist circumference (91 ± 8 cm), and dyslipidemia (triglyceride-to-HDL-cholesterol ratio = 4.8 ± 2.9). Each individual in this "high-CIMT-change" group, 80% of whom were women, improved notably in one or more risk factors with the MAV intervention. Conclusions: The pooled results of these two trials suggest that MAV multimodality intervention programs, including the Transcendental Meditation technique and heart-healthy Ayurvedic diet, exercise, and herbal food supplements, may be effective in the regression of ASCVD, especially in patients at high risk for cardiovascular disease.

Transcendental Meditation in the prevention and treatment of cardiovascular disease and pathophysiological mechanisms: An evidence-based review.

Objectives: Despite advances in modern medicine, cardiovascular disease (CVD) is the leading cause of death in Australia and globally. In a recently published scientific statement on alternative methods to lower blood pressure (BP), the American Heart Association (AHA) reported that the Transcendental Meditation (TM) technique may be considered in clinical practice to lower BP. The AHA statement also reported research that TM may reduce heart attack, stroke and death in CVD patients. This article reviews the background and associated evidence for these effects. Design and methods: Meta-analyses, systematic reviews and controlled clinical studies on the effects of TM technique on cardiovascular disease and its risk factors were reviewed and the outcomes synthesised. Results: Clinical trials indicate that the TM technique has a positive impact on pathophysiological mechanisms of CVD; risk factors for CVD including hypertension, psychosocial stress and smoking; surrogate markers for CVD; and CVD clinical events. Conclusions: The wide range of effects of TM practice on cardiovascular health suggests that the TM technique may be considered in clinical applications for both the prevention and treatment of cardiovascular disease.