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One in four adults has hypertension, a risk factor for heart attack and stroke, according to the Centers for Disease Control and Prevention. And with growing obesity and added stress in children and teens today, high blood pressure is no longer considered to be an adult disease, Vernon Barnes, PhD, a physiologist at the Medical College of Georgia, told ADVANCE.
Health officials warn that adolescents who develop higher-than-normal blood pressure are also more likely to develop the chronic disease as they enter adulthood. The threat was enough to urge Barnes and his associates to conduct a study to determine whether or not meditation could lower blood pressure in teens.
"Blood pressures are rising at an alarming rate in our youth, and this problem has become an important area of investigation. There is limited knowledge of the underlying causes of hypertension in children," Barnes said.
The study found that two 15-minute meditation sessions each day helped students lower their blood pressure over four months, an effect that continued to drop for another four months even after the meditation sessions ended. The results, Barnes concluded, point in the direction of the importance of a school- based intervention for hypertension and related health concerns.
The Study
Typically when a patient is diagnosed with high blood pressure, his doctor writes a prescription for medication which essentially becomes "a life sentence." "Hypertension is a chronic disease, and it is unlikely that you are going to get rid of it," Barnes said. "Taking the medication is going to bring your blood pressure down, but if you stop taking it, your blood pressure goes right back up."
The continuous need for medication not only becomes a costly nuisance, but Barnes also pointed out that there can be adverse side effects. Meditation, he determined, could be an effective alternative.
A total of 5,000 African American students in five different Augusta, GA, inner-city schools were screened for higher-than-normal blood pressure. "We gave African Americans priority in this study because they are at a greater risk for hypertension and heart disease," Barnes explained. "African Americans have a hypertension-related mortality rate six to 15 times greater than Caucasians prior to middle age."
Barnes explained that hypertension in youth is defined as blood pressure above the 95th percentile, and the cutoffs are determined by age, sex and height. One hundred fifty-six of the people screened fell into the category of "at risk for developing hypertension," and were randomly assigned to either a meditation or control group.
The meditation group was scheduled to attend one 10-to-15 minute supervised session in the school library or a quiet school room, followed by another session observed at home each day; those in the control group were placed in health education classes.
The study was conducted during four years (eight school semesters) with four-month interventions.
The medical community currently accepts transcendental meditation (TMT) as the only researched meditation technique to significantly reduce blood pressure. Basically, the technique involves sitting in a comfortable position, with eyes closed, and repeating a common word or sound in your mind, to stop the focused thought process and allow the brain and body to enter a pre-sleep state without losing consciousness.
Students assigned to the meditation group had a 70-percent compliance rate with their twice daily practice-meaning they attended the meditation session at school and then also meditated at home. "We asked them every day if they had meditated at home the previous day and had a very good handle on whether or not they were doing it," said Barnes. "Just as with a pill, if you don't take the medication it isn't going to help you-you need to practice meditation as a healthy habit, just as brushing your teeth, in order to get the benefit."
After two months, Barnes began seeing lowered blood pressure in the meditation group. Another four months and the readings were even lower. At the end of the semester, students left school for four months at the end of which their blood pressures were still down even though intervention had ceased.
In addition, students who meditated also had lower rates of absenteeism, school rule violations and suspensions than those in the control group.
The control group did not have any reduction in blood pressure.
Ambulatory Measurements
Barnes and his research team used state-of-the-art methodology for measuring blood pressure in the study. In typical studies subjects' blood pressure is taken in the clinic. "Their blood pressure could be high that day or low, depending on in their life that particular day," Barnes said of the readings. "Some people look at the white coat, and their blood pressure goes sky high."
In order to avoid such readings, ambulatory blood pressure monitors were used in Barnes' study-an approach that has rarely been used before with teens. "They are like little walkmans that you wear on your belt and operate using four AA batteries," he explained. "They are programmed to take your blood pressure every 20 minutes during the day no matter what you are doing-if you are in school, at home and at night while you are sleeping."
The monitor can produce a chart that shows all the peaks and dips of the subjects' blood pressure throughout the day, totaling 50 to 60 averages over all including day time averages, night time averages and 24-hour averages.
"It was important that these blood pressures be taken at a natural setting-at home, at school, when they are studying, if they are in a fight, if they are watching TV, shopping in the mall-whatever they are doing," added Barnes. "We had no control over their blood pressures when they are out there wearing the monitor."
Transcendental Meditation Program
The Transcendental Meditation(TM) program is a very simple, natural and effortless mental technique.
"There has been quite a bit of work done already with it," Barnes told ADVANCE- more than 500 studies, published in peer-reviewed journals, since the early '70s.
In addition, there have been about 12 studies conducted concerning the technique in relation to hypertension, most recently a randomized clinical trial conducted with older African Americans using a rigorous design showing a clinically significant drop of about 11 millimeters of mercury systolic blood pressure after three months of practicing TM. "On the basis of those findings, we thought it would be good to try this with teenagers," said Barnes. "We also chose TM as compared to other types of medications because the technique is easy to teach and easy to learn."
Overall, Barnes feels that benefits of stress reduction techniques such as meditation need to be examined more for youth to determine if they can feasibly be introduced in America's education system.
"Our children are in the schools every day, and it is important to be teaching them healthy lifestyle habits that will benefit them their entire lives; not something they get once in a health class but rather every grade level every year, repeatedly," he told ADVANCE. "A youngster who picks up a practice like meditation and practices it his whole life could prevent hypertension and related cardiovascular disease later on in life."
Jessica LaGrossa is ADVANCE assistant editor. She can be reached at jlagrossa@merion.com.
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