Abstract TU246: A Meta-Analytic Review of Blood Pressure Responses to Transcendental Meditation

Abstract

Background: Hypertension is a public health burden, the most prevalent risk factor for cardiovascular disease. Transcendental meditation (TM) is a promising treatment to reduce blood pressure and improve hypertension outcomes. The objective of this review was to systematically evaluate the effects of TM on systolic (SBP) and diastolic blood pressure (DBP). Methods: A systematic review and meta-analysis was conducted to evaluate the effects of TM on systolic (SBP) and diastolic blood pressure (DBP). Four databases were searched: PubMed, APA PsycInfo, CINAHL, and Scopus. Citations in past reviews, meta analyses, and other relevant articles were searched. Two team members extracted and coded articles and all authors discussed disagreements. Coded were study characteristics, sample demographics, and outcomes; we assessed methodological study quality (risk of bias) by coding concealed allocation, group assignment (random vs. nonrandom), blinded data collector, a priori power calculation, type of comparison group, intention-to-treat analysis, comparison of participants’ characteristics at baseline, intervention fidelity, and attrition rate. Outcomes were analyzed both (1) on a repeated-measures (post vs. pre) for both controlled and uncontrolled trials and (2) a between-groups basis for controlled trials. Results: Thirty-five TM interventions were included: 24 randomized controlled trials (RCTs), 3 quasi-experimental, and 8 uncontrolled studies; five were unpublished reports. Quality was mixed, with trials overall satisfying about 50% of the items; RCTs had higher quality than non-RCTs (mainly because they were not RCTs). In total, 2,010 participants were included, predominantly overweight, middle-aged, racial and ethnic minority adults with stage 1 hypertension. TM was associated with statistically and clinically significant reductions in SBP and DBP (means = −4.72 mmHg and −3.52 mmHg, respectively) compared to baseline levels. Reductions were greatest among participants with higher baseline BP, those with cardiovascular conditions, in uncontrolled studies, and in earlier studies. Conclusions: TM was associated with modest but clinically meaningful reductions in BP and appears to be a beneficial nonpharmacologic intervention for hypertension management. Unexplained heterogeneity warrants further investigation to clarify other factors associated with trial success.