Abstract

Introduction: Epidemiological research has documented that psychosocial stress is a major risk factor for atherosclerotic cardiovascular disease (CVD). In providing effective health education to patients with CVD, nurses and other health professionals require evidence-based information on behavioral methods to reduce stress for primary and secondary prevention of CVD. Previously published trials suggest that selected stress reduction methods, including meditation may modify CVD risk factors, quality of life, morbidity and mortality. Hypothesis: Stress reduction with meditation may contribute to the management of psychosocial stress, hypertension, metabolic syndrome, chronic CVD, nonfatal/fatal CVD clinical events and associated health care costs. Methods: We performed a meta-synthesis (qualitative review) of published biomedical literature for randomized controlled trials, meta-analyses and professional guidelines on the effects of meditation on CVD and its risk factors. Results: The two most widely studied stress reduction - meditation approaches in CVD were the Transcendental Meditation (TM) technique and mindfulness meditation There were 11 RCTs, two meta-analyses and one American Heart Association scientific statement on TM and blood pressure that suggest TM is clinically useful in lowering high BP, short and long-term, in diverse populations. Other risk factors showing beneficial responses to TM were anxiety, insulin resistance, smoking and surrogate markers for CVD. RCTs and meta-analyses report significant risk reductions for myocardial infarction, stroke and mortality over 5-8 years. In patients with CVD, mindfulness meditation was associated with beneficial psychological effects; however, in meta-analyses of physical parameters of CVD, effects were not yet well-established. Conclusion: Available evidence suggests that meditation may be useful in the behavioral interventions for cardiovascular health and quality of life. Both Transcendental Meditation and mindfulness meditation practices show beneficial effects on psychosocial stress factors. Substantial evidence indicates that TM practice is associated with reductions in hypertension, other CVD risk factors, and rates of CVD morbidity and mortality.

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