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冥想与心血管风险降低:美国心脏协会的科学声明。

Meditation and Cardiovascular Risk Reduction: A Scientific Statement From the American Heart Association.

出版信息

J Am Heart Assoc. 2017 Sep 28;6(10):e002218. doi: 10.1161/JAHA.117.002218.

Abstract

Despite numerous advances in the prevention and treatment of atherosclerosis, cardiovascular disease remains a leading cause of morbidity and mortality. Novel and inexpensive interventions that can contribute to the primary and secondary prevention of cardiovascular disease are of interest. Numerous studies have reported on the benefits of meditation. Meditation instruction and practice is widely accessible and inexpensive and may thus be a potential attractive cost-effective adjunct to more traditional medical therapies. Accordingly, this American Heart Association scientific statement systematically reviewed the data on the potential benefits of meditation on cardiovascular risk. Neurophysiological and neuroanatomical studies demonstrate that meditation can have long-standing effects on the brain, which provide some biological plausibility for beneficial consequences on the physiological basal state and on cardiovascular risk. Studies of the effects of meditation on cardiovascular risk have included those investigating physiological response to stress, smoking cessation, blood pressure reduction, insulin resistance and metabolic syndrome, endothelial function, inducible myocardial ischemia, and primary and secondary prevention of cardiovascular disease. Overall, studies of meditation suggest a possible benefit on cardiovascular risk, although the overall quality and, in some cases, quantity of study data are modest. Given the low costs and low risks of this intervention, meditation may be considered as an adjunct to guideline-directed cardiovascular risk reduction by those interested in this lifestyle modification, with the understanding that the benefits of such intervention remain to be better established. Further research on meditation and cardiovascular risk is warranted. Such studies, to the degree possible, should utilize randomized study design, be adequately powered to meet the primary study outcome, strive to achieve low drop-out rates, include long-term follow-up, and be performed by those without inherent bias in outcome.

摘要

尽管在动脉粥样硬化的预防和治疗方面取得了许多进展,但心血管疾病仍然是发病率和死亡率的主要原因。人们对能够有助于心血管疾病一级和二级预防的新颖且廉价的干预措施感兴趣。许多研究报告了冥想的好处。冥想指导和实践广泛可及且价格低廉,因此可能是对更传统的医学治疗的潜在有吸引力的具有成本效益的补充。因此,美国心脏协会科学声明系统地审查了冥想对心血管风险潜在益处的相关数据。神经生理学和神经解剖学研究表明,冥想可以对大脑产生长期影响,这为冥想对生理基础状态和心血管风险产生有益影响提供了一些生物学上的合理性。关于冥想对心血管风险影响的研究包括那些调查对压力的生理反应、戒烟、降低血压、胰岛素抵抗和代谢综合征、内皮功能、可诱导性心肌缺血以及心血管疾病的一级和二级预防的研究。总体而言,冥想研究表明其对心血管风险可能有益,尽管研究数据的整体质量和在某些情况下的数量都不大。鉴于这种干预措施的成本低且风险低,对于那些对这种生活方式改变感兴趣的人,可以考虑将冥想作为指南指导的心血管风险降低的辅助手段,前提是理解这种干预的益处仍有待更好地确定。进一步研究冥想和心血管风险是必要的。此类研究应尽可能使用随机研究设计,有足够的能力实现主要研究结果,努力实现低辍学率,包括长期随访,并由对结果没有固有偏见的人进行。

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