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Investigators from The Medical College of Georgia find that Transcendental Meditation lowers blood pressure in sixteen-year-old African American youth at risk for the development of hypertension.

Investigators from the Pediatric Department of The Georgia Institute for Prevention of Human Diseases and Accidents and The Medical College of Georgia looked at the impact of stress reduction, by way of Transcendental Meditation (TM), on blood pressure (BP) in African-American adolescents averaging 16 years old (aged 16.2 +/- 1.3 years) with high normal systolic BP. Subjects were randomly assigned to either a 4-month TM group (n = 50) or health education control group (n = 50). Ambulatory 24-hour blood pressure measures were recorded at pretest, 2-month and 4-month post-tests, and at a 4-month follow-up.

The study found significantly greater decreases in daytime systolic BP (P < .04) and diastolic BP (P < .06) in the TM group, as compared with the control group, across all the visits, concluding that TM has a beneficial impact on youth at risk for the development of hypertension.

Citation: Barnes VA, Treiber FA, Johnson MH. Impact of transcendental meditation on ambulatory blood pressure in African-American adolescents. American Journal of Hypertension. 2004 Apr; 17(4): pages 366-9. This email address is being protected from spambots. You need JavaScript enabled to view it.

Forty-six patients were randomized to receive drug (group 1) or hypnotic sedation (group 2) during balloon angioplasty of the left anterior descending coronary artery. Patients were continuously monitored by intracoronary and standard electrocardiograms, and heart rate spectral variability was also recorded.

Normalized units of low- and high-frequency components and the ratio of low to high frequency were measured during balloon inflations. The ST segment shifted at the first balloon inflation from 0.02 +/- 0.01 to 0.09 +/- 0.6 mm in group 1 and from 0.02 +/- 0.08 to 0.1 +/- 0.6 in group 2 mm (p <0.05).

Biofeedback is shown to improve Heart Rate Variablity in patients with coronary artery disease a good thing, being as how diminished HRV is associated with increased morbidity and mortality in these patients.

In a randomized controlled trial at The California School of Professional Psychology at Alliant International University in San Diego, researchers investigated whether biofeedback could improve heart rate variablity (HRV) in patients with coronary artery disease (CAD). Diminished HRV is associated with increases in cardiac morbidity and mortality.

Sixty-three patients with CAD were randomly assigned to either conventional therapy or to six biofeedback sessions, consisting of abdominal breath training, heart and respiratory physiologic feedback, and daily breathing practice.

Meta-analysis at Teikyo University Medical School in Tokyo reveals that biofeedback significantly reduces hypertension, but only when combined with other relaxation and imagery technique

The Department of Hygiene and Public Health (EBM Center) at the School of Medicine,Teikyo University, in Tokyo, Japan published a meta-analysis of 22 randomized, controlled studies investigating the efficacy of biofeedback for reducing hypertension. The 22 studies were published between 1966 and 2001, and involved a total of 905 hypertensive patients.

Tiller, McCraty and Atkinson of the Institute of HeartMath found that subjects who were trained to use a heart-focused stress-reduction technique that shifted their attention away from stress and toward their hearts, while focusing on feelings of love, caring and appreciation, showed evidence of increased cardiac coherence and stability. This supports the imagery methodology we''ve been using on many of our tapes.

Citation: Tiller WA, McCraty R, Atkinson M. Cardiac coherence: a new, noninvasive measure of autonomic nervous system order. Alternative Therapies in Health & Medicine. 1996 Jan;2(1):52-65.

Stress management and exercise training in cardiac patients with myocardial ischemia: effects on prognosis and evaluation of mechanisms.

A placebo controlled, randomized study by J.A. Blumenthal et al, published in the Archives of Internal Medicine, 1997; 157: 2213-2223, (called Stress Management and Exercise Training in Cardiac Patients with Myocardial Ischemia: Effects on Prognosis and Evaluation of Mechanisms) showed that teaching stress reduction techniques to cardiac patients reduced their risk of having further heart problems by a whopping 75%. Of 107 patients, 40 received standard medical care; 34 additionally engaged in vigorous exercise for 35 minutes, 3 times a week for 16 weeks; and 33 additionally were given weekly group sessions where they learned relaxation and stress reduction techniques (education, progressive muscle relaxation, biofeedback, thought-stopping, anger management). Results: 30% of the standard care group had additional heart problems; 21% in the exercise group; and only 10% in the stress management group.

Citation: Blumenthal JA, et al. Stress management and exercise training in cardiac patients with myocardial ischemia: effects on prognosis and evaluation of mechanisms. Archives of Internal Medicine. 1997(157):2213-2223.

A controlled pilot study of stress management training of elderly patients with congestive heart failure.

Researchers at the Stanford Center for Research in Disease Prevention evaluated the effects of stress management on the quality of life, functional capacity, and heart rate variability in a pilot study of 33 elderly patients with New York Heart Association class I-III congestive heart failure. Subjects were randomized to one of two treatment groups or a wait-listed control group. The 14 participants who completed the treatment attended eight training sessions during a 10-week period. The training consisted of 75-minute sessions adapted from the Freeze-Frame stress management program developed by the Institute of HeartMath. (This is a very simple and easy to use formula for stress relief, using relaxation and imagery.) Subjects were assessed at baseline and again at the completion of the training. Depression, stress management, optimism, anxiety, emotional distress, and functional capacity were evaluated, as well as heart rate variability. Significant improvements (p<0.05) were noted in perceived stress, emotional distress, 6-minute walk, and depression, and positive trends were noted in each of the other psychosocial measures. The 24-hour heart rate variability showed no significant changes in autonomic tone. The authors noted that CHF patients were willing study participants and their emotional coping and functional capacity were enhanced. They concluded that this program offered a simple and cost-effective way to augment medical management of CHF. Given the incompleteness of CHF medical management and the exploding interest in complementary medical intervention, they recommended that further work in psychosocial treatment be undertaken.

Citation: Luskin F, Reitz M, Newell K, Quinn TG, Haskell W. A controlled pilot study of stress management training of elderly patients with congestive heart failure. Preventive Cardiology 2002 Fall; Issue 5 (Volume 4): pp. 168-72.

At Columbia Presbyterian Medical Center, Ashton, Whitworth, et al found that patients who were taught self-hypnosis/relaxation techniques before undergoing first-time elective coronary artery bypass surgery were significantly more relaxed following the operation, as compared to a control group. They also used significantly less pain medication. Surgical outcomes were the same for both groups.

Citation: Ashton C Jr, Whitworth GC, et al. Self-hypnosis reduces anxiety following coronary artery bypass surgery. A prospective, randomized trial. J. Cardiovascular Surgery(Torino). 1997 Feb; 38(1): pp. 69-75.

Friday, 15 August 2003 04:05

Guided imagery in cardiac surgery.

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In 1998, a research team led by Linda Halpin at the Inova Heart Center of Inova Fairfax Hospital compared cardiac surgical outcomes between two groups of heart patients - with and without guided imagery. A questionnaire was developed to assess the benefits of the guided imagery program to those who elected to participate in it, and, in addition, data from the hospital financial cost-accounting database were collected and matched to the two groups of patients.

Analysis of the data revealed that patients who completed the guided imagery program had a shorter average length of stay, a decrease in average direct pharmacy costs, and a decrease in average direct pain medication costs while maintaining high overall patient satisfaction with the care and treatment provided.

Guided imagery is now used as a standard, complementary therapy to help reduce anxiety, pain, and length of stay among the cardiac surgery patients at Inova Fairfax.

Citation: Halpin LS, Speir AM, CapoBianco P, Barnett SD. Guided imagery in cardiac surgery. Outcomes in Management & Nursing Practice, 2002 Jul-Sep;6(3):132-7.

W J Hamel explored the effects of music therapy on the anxiety levels, heart rate and blood pressure of patients waiting for their scheduled cardiac catheterization. 101 (63 men and 38 women) patients were randomly assigned to listen to 20 minutes of pre-selected music or to a standard care control group. Measurements were taken during the waiting period and just prior to departure for the lab. The intervention group had a significant reduction in anxiety (p = 0.003) and when compared to the controls (p = 0.004). Where the heart rate and systolic blood pressure dropped in the music therapy group, it increased in the control group. This held up whether the patient was male or female, but the men as a group had higher diastolic scores than the women, and the women had higher anxiety scores than the men.

Citation: Hamel, WJ, The Effects of Music Intervention on Anxiety in the Patient Waiting for Cardiac Catheterization, Intensive Critical Care Nursing, 2001 Oct; 17 (5): pp. 279-85.

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