AHA: Meditation May Play a Role in Lowering CVD Risk

Mediation may benefit cardiovascular risk, but traditional care for risk factors such as high cholesterol and blood pressure remains the mainstay of preventing heart disease, according to a scientific statement from the American Heart Association (AHA).

A systematic review of approximately 400 studies found a possible, though not conclusive, benefit of meditation on cardiovascular risk reduction and suggested that it may be used as low-cost, low-risk adjunct to current guidelines, stated Glenn N. Levine, MD, of Baylor College of Medicine in Houston, and colleagues in the Journal of the American Heart Association.

However, the team stressed that this statement was intended solely to review what is currently known from the scientific evidence, not to make recommendations about whether or not meditation can lower heart disease risk. The current mainstay for primary and secondary prevention of CVD is still the American College of Cardiology/AHA guideline-directed interventions.

"Although studies of meditation suggest a possible benefit on cardiovascular risk, there hasn't been enough research to conclude it has a definite role," said Levine in a press release. "Since education on how to meditate is widely available and meditation has little if any risk associated with it, interested people may want to use these techniques, in addition to established medical and lifestyle interventions, as a possible way to lower heart disease risk."

It's important that people understand that the benefits need to be better established and it should not substitute traditional medical care, he added.

Levine's group searched PubMed for studies on meditation and cardiovascular disease (CVD) risk reduction using search terms such as meditation, stress, blood pressure, hypertension, smoking, tobacco use, insulin resistance, metabolic syndrome, endothelial function, primary prevention, and secondary prevention.

While traditional meditation refers to mental practices that are designed to improve concentration, increase awareness, and familiarize a person with their own mind, a more contemporary definition focuses on attention, mindfulness, compassion, and mantra repetition. Common forms of sitting mediation included samatha, vipassana, zen, raja yoga, and transcendental.

Studies on combination mind-body practices, such as yoga and Tai Chi, were excluded since they have been established as ways to reduce heart disease risk.

The authors found that most studies showed some improvements in levels of perceived stress, mood, anxiety, depression, quality of sleep, or overall well-being, but few focused specifically on patients with CVD.

Levine's group noted that neurophysiological and neuroanatomical studies demonstrated that meditation can have long-standing effects on the brain, which may have beneficial effects on the physiological basal state and cardiovascular risk. Additionally, some randomized data suggested that mindful meditation can improve smoking cessation rates.

Two studies on short-term interventions yielded mortality reductions, but the authors said that the findings need to be reproduced in larger, multicenter studies before deeming meditation to be effective for primary prevention of CVD.

Similarly to primary prevention of CVD, there were limited and limited-quality data available for secondary prevention of CVD -- many of which had small sample sizes and limited follow-up.

The authors called for further research on meditation and cardiovascular risk, specifically randomized studies that are adequately powered to detect clinically meaningful benefit and free of inherent bias.