Meditation and Cardiovascular Risk Reduction

Levine GN, Lange RA, Bairey-Merz CN, et al.
Meditation and Cardiovascular Risk Reduction: A Scientific Statement From the American Heart Association. J Am Heart Assoc 2017;Sep 28:[Epub ahead of print].

The following are summary points to remember from this American Heart Association Scientific Statement about meditation and cardiovascular (CV) risk reduction:

  1. Meditative practices are designed to improve concentration, increase awareness of the present moment, and familiarize a person with the nature of the mind—various types of meditation include “samatha” meditation (focused attention), mindful meditation, “vipassana” meditation (insight meditation), transcendental meditation (repeated thought of word), and “relaxation response” technique. The goal is to increase concentration, insight, or awareness; promote relaxation; reduce stress; “settle” the mind; achieve a state of increased consciousness; and reduce perceived suffering and increase happiness.
  2. A meta-analysis of 21 neuroimaging studies examining approximately 300 meditation practitioners found eight brain regions altered including areas of meta-awareness, body awareness, and self- and emotion regulation. Anatomical changes have been reported in the cerebral cortex, subcortical white and grey matter, cerebellum, and brainstem. Nonrandomized studies suggest that the effects of meditative practices on the brain are beneficial in reducing CV risk.
  3. The magnitude of blood pressure reduction varies widely with meditative practices.
  4. Some randomized studies suggest that mindful meditation may promote smoking cessation.
  5. On review of studies, no firm conclusions can be drawn on the effects of meditation on endothelial function, insulin resistance, metabolic syndrome, or subclinical atherosclerosis.
  6. Limited older studies indicate that medication can improve exercise duration and reduce myocardial ischemia.
  7. Two short-term interventions for primary prevention of CV disease (CVD) report reductions in mortality, and the authors opine that larger randomized multicenter studies are required to validate these findings.
  8. Data on benefits of meditation for secondary prevention of CVD are of modest quality as suggesting but not establishing benefit.
  9. This scientific statement suggests that meditation, given the low cost and low risks, may be considered as an adjunct to well established lifestyle modifications with the understanding that the benefits of meditation remain to be established.
  10. The authors opine that after review of literature, the possible benefits of meditation in CV risk needs to be established utilizing double-blind, randomized studies of adequate power, with <20% dropout rate, >80% follow-up data, with intention-to-treat analysis, and be performed by investigators who do not have inherent bias of the outcome.

Clinical Topics: Diabetes and Cardiometabolic Disease, Prevention

Keywords: Atherosclerosis, Blood Pressure, Brain Stem, Cardiovascular Diseases, Cerebral Cortex, Consciousness, Happiness, Insulin Resistance, Life Style, Meditation, Metabolic Syndrome X, Myocardial Ischemia, Neuroimaging, Primary Prevention, Risk Factors, Risk Reduction Behavior, Secondary Prevention, Smoking Cessation

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