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Effects of a Randomized Controlled Trial
of Transcendental Meditation on Components
of the Metabolic Syndrome in Subjects
With Coronary Heart Disease
Maura Paul-Labrador, MPH; Donna Polk, MD, MPH; James H. Dwyer, PhD†; Ivan Velasquez, MD;
Sanford Nidich, PhD; Maxwell Rainforth, PhD; Robert Schneider, MD; C. Noel Bairey Merz, MD

Background: The metabolic syndrome is thought to be
a contributor to coronary heart disease (CHD), and components
of the syndrome have been identified as possible
therapeutic targets. Previous data implicate neurohumoral
activation related to psychosocial stress as a
contributor to the metabolic syndrome. The aim of this
study was to evaluate the efficacy of transcendental meditation
(TM) on components of the metabolic syndrome
and CHD.

Methods: We conducted a randomized, placebocontrolled
clinical trial of 16 weeks of TM or active control
treatment (health education), matched for frequency
and time, at an academic medical center in a total
of 103 subjects with stable CHD. Main outcome measures
included blood pressure, lipoprotein profile, and
insulin resistance determined by homeostasis model assessment
(calculated as follows: [(fasting plasma glucose
level [in milligrams per deciliter]
fasting plasma
insulin level [in microunits per milliliter])
0.0552]/
22.5); endothelial function measured by brachial artery
reactivity testing; and cardiac autonomic system activity
measured by heart rate variability.

Results: TheTMgroup had beneficial changes (measured
asmean±SD)in adjusted systolicbloodpressure (−3.4±2.0
vs 2.8±2.1mmHg;P=.04), insulin resistance (−0.75±2.04
vs 0.52±2.84;P=.01),andheart rate variability (0.10±0.17
vs −0.50±0.17 high-frequency power; P=.07) compared
with the health education group, respectively. There was
no effect of brachial artery reactivity testing.
Conclusions: Use of TM for 16 weeks in CHD patients
improved blood pressure and insulin resistance components
of the metabolic syndrome as well as cardiac autonomic
nervous system tone compared with a control
group receiving health education. These results suggest
thatTMmay modulate the physiological response to stress
and improve CHD risk factors, which may be a novel
therapeutic target for the treatment of CHD.
Arch Intern Med. 2006;166:1218-1224