in Albania - Instituti i Shendetit Publik

INTERNATIONAL PUBLIC HEALTH CONFERENCE IN TIRANA, ALBANIAStress Reduction in the Secondary Prevention ofCardiovascular Disease Randomized, ControlledTrial of Transcendental Meditation and HealthEducation in Black individualsRobert H. Schneider 11Institute for Natural Medicine and Prevention, Maharishi University of Management, Fairfield, USA.Context: Blacks have disproportionately high ratesof cardiovascular disease. Psychosocial stress maycontribute to this disparity. Previous trials on stressreduction with the Transcendental Meditation (TM)program have reported improvements in cardiovasculardisease risk factors, surrogate end points,and mortality in blacks and other populations.Methods: This was a randomized, controlled trialof 201 black men and women with coronary heartdisease who were randomized to the TM programor health education. The primary end point was thecomposite of all-cause mortality, myocardialinfarction, or stroke. Secondary end points includedthe composite of cardiovascular mortality, revascularizations,and cardiovascular hospitalizations; bloodpressure; psychosocial stress factors; and lifestylebehaviors.Results: During an average follow-up of 5.4 years,there was a 48% risk reduction in the primary endpoint in the TM group (hazard ratio, 0.52; 95%confidence interval, 0.29 0.92; P=0.025). The TMgroup also showed a 24% risk reduction in thesecondary end point (hazard ratio, 0.76; 95%confidence interval, 0.51 0.1.13; P=0.17). Therewere reductions of 4.9 mm Hg in systolic bloodpressure (95% confidence interval -8.3 to 1.5 mmHg; P=0.01) and anger expression (P