Castillo-Richmond A, Schneider R H, Alexander C N, Cook R, Myers H, Nidich S, Haney C, Rainforth M, Salerno J
Center for Natural Medicine and Prevention, Maharishi University of Management, College of Maharishi Vedic Medicine, Fairfield, Iowa 52557, USA.
Stroke. 2000 Mar;31(3):568-73. doi: 10.1161/01.str.31.3.568.
African Americans suffer disproportionately higher cardiovascular disease mortality rates than do whites. Psychosocial stress influences the development and progression of atherosclerosis. Carotid intima-media thickness (IMT) is a valid surrogate measure for coronary atherosclerosis, is a predictor of coronary outcomes and stroke, and is associated with psychosocial stress factors. Stress reduction with the Transcendental Meditation (TM) program decreases coronary heart disease risk factors and cardiovascular mortality in African Americans. B-mode ultrasound is useful for the noninvasive evaluation of carotid atherosclerosis.
This randomized controlled clinical trial evaluated the effects of the TM program on carotid IMT in hypertensive African American men and women, aged >20 years, over a 6- to 9-month period. From the initially enrolled 138 volunteers, 60 subjects completed pretest and posttest carotid IMT data. The assigned interventions were either the TM program or a health education group. By use of B-mode ultrasound, mean maximum IMT from 6 carotid segments was used to determine pretest and posttest IMT values. Regression analysis and ANCOVA were performed.
Age and pretest IMT were found to be predictors of posttest IMT values and were used as covariates. The TM group showed a significant decrease of -0.098 mm (95% CI -0. 198 to 0.003 mm) compared with an increase of 0.054 mm (95% CI -0.05 to 0.158 mm) in the control group (P=0.038, 2-tailed).
Stress reduction with the TM program is associated with reduced carotid atherosclerosis compared with health education in hypertensive African Americans. Further research with this stress-reduction technique is warranted to confirm these preliminary findings.
非裔美国人患心血管疾病的死亡率比白人高得多。心理社会压力会影响动脉粥样硬化的发生和发展。颈动脉内膜中层厚度（IMT）是冠状动脉粥样硬化的有效替代指标，是冠状动脉疾病预后和中风的预测指标，且与心理社会压力因素相关。超觉静坐（TM）计划减压可降低非裔美国人的冠心病危险因素和心血管疾病死亡率。B型超声对颈动脉粥样硬化的无创评估很有用。
这项随机对照临床试验评估了TM计划对年龄超过20岁的高血压非裔美国男性和女性在6至9个月期间颈动脉IMT的影响。从最初招募的138名志愿者中，60名受试者完成了颈动脉IMT数据的预测试和后测试。指定的干预措施要么是TM计划，要么是健康教育组。通过使用B型超声，从6个颈动脉节段的平均最大IMT来确定预测试和后测试的IMT值。进行了回归分析和协方差分析。
年龄和预测试IMT被发现是后测试IMT值的预测指标，并用作协变量。TM组显示显著下降了-0.098毫米（95%置信区间-0.198至0.003毫米），而对照组增加了0.054毫米（95%置信区间-0.05至0.158毫米）（P=0.038，双侧）。
与健康教育相比，TM计划减压与高血压非裔美国人颈动脉粥样硬化的减轻有关。有必要对这种减压技术进行进一步研究以证实这些初步发现。
