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According to University of Michigan, Meditation is a basic tenet in all major religious traditions as a way to acheive greater awareness and/or connection to self or a higher source. From a secular perspective, meditation is a dynamic mental process of focused inward attention that enourages moment to moment awareness of the mind's activity. Percieved health benefits include reduction in stress, anxiety, pain and other related physiological symptoms.
From a medical and behavioral intervention perspective, the purpose of meditation is to:
- De-condition the body and mind from habitually reacting to experiences, thoughts, emotions or images with immediate heightened arousal; and
- Teach the mind and body to respond from an inner state of physiological equilibrium and psychological calmness.
Mechanism of Action
Meditation produces responses in the physiology of the brain and body. Various studies note differences in areas of activation in the brain between long term and novice meditators, as well as between meditators who practice different forms of meditation. The effect of these neurophysiological changes on cognition and health are not well-understood.
For patients diagnosed with hypertension, such as Jim, the practice of meditation reduces sympathetic arousal and results in immediate and sustained impact on lowering blood pressure levels.
Forms of meditaion
Meditation can take many different forms, each of which may have specific and different health effects. A recent health technology report completed by the Agency for Healthcare Research Quality (AHRQ) located 813 studies of meditation with health outcomes. It concluded that the majority of the studies were of such low methodologic quality that few recommendations could be made for its use for any health condition. Subsequent publications have pointed out very vaild limitations to this report and question the conclusions, particularly for the use of meditation for hypertension.
The three meditation techniques that have been most widely researched in regard to health outcomes are:
It is important to become familiar with these techniques so that you may properly describe them to your patients. In the sections that follow, you will find information on their efficacy and safety as well as ease of community accessibility.
One popular form meditation that is not discussed in this unit is Zen meditation. While this practice has a strong presence in the Washtenaw community and nationwide, there are very few scientiifc studies that have investigated its effects on mental or physical health.
Transcendental Meditation (TM)
What is it?
TM is a practice derived from ancient religious texts in India and introduced into Western culture 40 years ago by Mahareshi Mahesh Yogi. It is a sitting meditation practice that involves inner directed attention and is facilitated by the use of a mantra that has been uniquely selected by a teacher for that individual. During TM, individuals sit quietly for a 20-minute period in the morning and evening and repeat their mantra silently to themselves. The actual practice of TM involves no religious belief or affiliation.
Research on TM and Hypertension
There have been several well designed RCTs which have examined the effect of TM on patients with hypertension in comparison to attention controls or patients using other mind-body interventions. For hypertensive patients practicing TM, significant reductions in blood pressure levels occur after three to four months of practice. There have not yet been any studies conducted that compare the effectiveness of TM across different risk populations of hypertensive patients.
In a recent meta-analysis of 17 well-designed trials comparing the effects of relaxation training, TM, biofeedback, progressive muscle relaxation and stress-management, on hypertension (N= 960 pre-hypertensive and hypertensive participants), the only statistically significant mean drop in blood pressure occured for participants practicing TM. Net BP changes of -5.0/-2.8 mm Hg, systolic and diastolic were observed. These BP reductions are similar to reported effects found from other lifestyle modifications recommended by the Joint National Committee on Prevention, Detection, Evaluation and Treatment of Hypertension (JNC 7). For example, the JNC 7 recommends average systolic blood pressure reductions for two lifestyle modifications, moderation of alcohol consumption or dietary sodium restriction, where reported average systolic blood pressure reductions range between 2 - 4 mm Hg, and 2 - 8 mm Hg respectively. To compare average systolic blood pressure reductions between TM and other lifestyle modifications.
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