Q: How does the Transcendental Meditation technique work to lower blood pressure?
Dr Barnes: Stress has been implicated in the development of hypertension. This has been documented through epidemiological blood pressure studies; naturalistic studies of the relationship among blood pressure, psychology, and everyday life events; and experimental studies of cardiovascular and neuroendocrine responses to behavioral stimuli. The mind and body are very intimately connected. The subjective experience of the Transcendental Meditation technique is one of mental relaxation and peacefulness combined with inner wakefulness. The meditation response is very rapid, and the most clear-cut effects have been seen after 15-30 minutes of practice. The mental relaxation elicits physiological relaxation; that is, when the mind settles down, the body gains deep rest.
Q: What are the possible mechanics responsible for the reduction of blood pressure with Transcendental Meditation practice?
Dr Barnes: Chronic environmental and psychosocial stress contribute to an increase in acute stress-induced sympathetic nervous system arousal, resulting in imbalance in the nervous system biochemistry. Such changes result in an exaggerated response to stress, as evidenced by constriction of the blood vessels and increased blood pressure levels. Moderating factors such as stress reduction via practice of the Transcendental Meditation technique impact on the sympathetic nervous system, resulting in reduced blood pressure reactivity to acute stress. Over time, due to decreased cardiovascular reactivity to acute events, there is reduced load upon the heart, resulting in decreased blood pressure levels, thereby helping to prevent early onset of hypertension. For more information about how the TM technique can reduce stress and make the individual more resistant to stress, see why is TM so effective against stress?.
Q: How long is it necessary to meditate before you can see the benefits on blood pressure?
Dr Barnes: The benefits can be immediate, but since every person is different it is not possible to predict exactly how soon blood pressure will drop. In most cases, the research has shown that within 1-2 months there is a significant drop in blood pressure if it has been too high.
Q: Is there evidence that the Transcendental Meditation program alone can lower high blood pressure?
Dr Kaplan: Several studies on both teenagers (American Journal of Hypertension, 2004) and elderly adults (Hypertension, 1999) have demonstrated that high blood pressure is reduced even after a few months of twice-daily practice of the Transcendental Meditation technique. The need for antihypertensive medication is reduced and sometimes eliminated. Anyone on medication who starts practicing the TM technique should follow up regularly with their physician to monitor this positive effect on blood pressure and the need for continued medication.
Q: Since the result of high blood pressure over many years is usually hardening of the arteries (atherosclerosis), leading to complications of stroke and heart attack, is there evidence that the Transcendental Meditation technique can reduce atherosclerosis?
Dr Kaplan: A groundbreaking study published in the journal Stroke showed that the thickness of the wall of the carotid artery, a warning sign for hardening of the arteries, is reduced with regular practice of the Transcendental Meditation technique.
Q: Why is the problem of hypertension such a serious health risk?
Dr Barnes: In studying the world’s population, 26.4% of the adult population are projected to have hypertension by 2025, which is a predicted increase of about 60% to a total of 1.56 billion. Therefore, hypertension is an important public-health challenge worldwide, and prevention, detection, treatment, and control of this condition is of high priority. It’s an enticing concept that a blood pressure-reducing intervention such as the Transcendental Meditation technique, if used widely by the general population, could potentially have an enormous impact on public health. Although long-term studies will be needed to demonstrate the concept, the expectation is that even a small downward shift (i.e. a few mm Hg, or points) in the distribution of blood pressure, if maintained throughout adulthood, could substantially reduce the risk of hypertension and related cardiovascular disease.
Q: What are the possible causes of hypertension and heart disease?
Dr Barnes: Factors such as advancing age, genetic predisposition, being overweight, and living a sedentary lifestyle—along with dietary factors such as too much salt and sodium—are commonly attributed as the cause of high blood pressure. Exaggerated cardiovascular reactivity to stress, due to exposure to both chronic and acute psychosocial and environmental stressors, has also been hypothesized as playing a particularly significant role in the development of hypertension. This is where regular practice of a stress reduction technique, such as Transcendental Meditation, could be very helpful. Recurrent and/or sustained exaggerated increases in blood pressure responses to stress are associated with naturally accompanying increases in heart and blood vessel wall tension. It is hypothesized that over time the Transcendental Meditation practice leads to secondary cardiovascular structural adaptation; that is, blood vessel and heart muscle wall remodeling to help normalize heart muscle and blood vessel wall tension. These results concern the Transcendental Meditation technique specifically and may not apply to other techniques of meditation as not all the techniques work in the same way.
Q: What has research found about the effect of the Transcendental Meditation technique on the physiology?
Dr Barnes: According to a review article by Dr. Jevning and his colleagues (Neuroscience and Biobehavioral Reviews, 1992), the Transcendental Meditation experience appears to elicit a physiological state characterized by a wakeful hypometabolic integrated response. Research has reported a decreased metabolism of the peripheral muscles and red cells, as well as decreased stress hormone secretion. These qualities consistent with deep rest have also been measured using EEG. Additionally, findings of reduced respiratory rates, blood lactate levels and skin conductance levels have been reported. In other words, the Transcendental Meditation technique allows us to experience a simpler, more settled form of awareness, reducing levels of stress hormones. Effects of chronic stress on hormone levels have been well documented. Acute effects on stress hormone secretion are consistent with decreased activation during meditation. Chronic decrease of this level of activation may also occur. According to scientific research, regular practice of the Transcendental Meditation technique supports reduction in blood pressure in those who have high blood pressure.
Q: Does the Transcendental Meditation technique work for everyone?
Dr Barnes: The Transcendental Meditation program works for everyone and generally it works from the first sitting, but it may take some time before the benefits are seen. Stress is often associated with high blood pressure, and high blood pressure is also a risk factor for heart disease. Practicing the Transcendental Meditation technique twice a day could reduce blood pressure. If practicing Transcendental Meditation reduces stress and high blood pressure enough, it may be possible to avoid or reduce medications. Doctors may prescribe the Transcendental Meditation technique to patients as a first line of treatment prior to prescribing medication drugs. They also may prescribe it as an adjunct treatment.
Q: Is there a time when the patient can stop with the medication?
Dr Barnes: That should be decided by the individual patient’s doctor according to certain criteria; when, for instance, the patient’s blood pressure has reached normal levels on at least three consecutive occasions. Patients should not decide for themselves when to stop medication.
Q: How do you see this treatment developing in the future?
Dr Barnes: There is a great potential for doctors to prescribe the Transcendental Meditation program to their patients, especially for those who are stressed or suffering from stress-related disorders. This technique has been viewed as having the highest potential to change clinical practice from the perspective of treatment.