meditation and heart disease

Hilary E. MacGregor, LA Times: Inside a church community room, beginning meditators close their eyes, straighten their spines in their folding metal chairs and try to rein in, for just 10 minutes, the thoughts that race like wild horses through their minds.

A woman in the back row yawns. The woman next to her fidgets. Another student sneaks a peek.

“My mind still wanders,” Jeremy Morelock, 33, says of the Buddhist meditation class he has attended for three months in search of stress relief and spiritual growth. “I have these imaginary conversations with people, and then I think, ‘Whoa, whoa, whoa … concentrate!’ “

Regular meditation practice is supposed to quiet the mind and allow the body to tap into its own innate healing mechanisms. Yogis and monks have preached the powers of meditation for thousands of years, and the counterculture generation of the ’60s embraced transcendental meditation — a still-thriving form of internal mantra-chanting — as a method to alter consciousness.

But many people today are taking up meditation for reasons that have little or nothing to do with spiritual enlightenment and a lot to do with improving their health. Scientists are using MRI and other advanced technologies to study the physiological changes that occur in meditating Buddhist monks. These researchers are starting to demonstrate, with the type of laboratory science that can influence even skeptical physicians, what those who engage in this ancient practice have believed for many centuries: Meditation works.

A growing body of research has shown that meditation has clear benefits. Now, doctors and other health-care professionals are recommending meditation as a way to treat a variety of ills, from depression to high blood pressure and hyperactivity. In some cases, meditation — or as it’s sometimes called, “relaxation techniques” — is prescribed when other treatments, such as prescription drugs, haven’t worked, or as a complement to drug therapy. Recent research has shown that meditation can help reduce the risk of heart disease and stroke, as well as reduce pain and enhance the body’s immune system.

Meditation is free, accessible and portable. It has no negative side effects — a fact that makes doctors feel comfortable recommending it. Meditation requires only that you be able to sit quietly for 10 minutes or more, while focusing on your breath or a word or phrase. Anyone can do it. And while millions of Americans already are meditating in some fashion, many more would likely benefit.

“I believe that meditation is the most important thing a person can do for their health,” said Dr. David Simon, medical director and chief executive of the Chopra Center at La Costa Resort and Spa in Carlsbad, Calif., the wellness clinic founded by New Age author and physician, Dr. Deepak Chopra. “The most powerful pharmacy on Earth is not Savon or Rite Aid, but the human body,” Simon said.

With so much evidence, why aren’t more people doing it?

As with many lifestyle changes, most notably diet and exercise, getting started and sticking with meditation can be difficult. Meditation takes time and discipline. Desperately seeking health or sanity, many stressed-out people yearn for some quiet time amid the chaotic frenzy of their daily lives. Finding 10 uninterrupted minutes and a quiet place to sit down and shut your eyes can be a stumbling block. It’s problematic to zone out in a cubicle at work, or at a restaurant during lunch. And home life can be hectic in these wired and wireless times.

No one knows for sure how many of those who begin meditating continue the practice. Gen Kelsang Lekma, a Buddhist nun who has taught meditation for a decade in Los Angeles, said the dropout rate is fairly high: Only about half the students who begin a typical 13-class series will complete it, she estimates, and perhaps two out of 10 students who begin meditating will still be doing so after a couple of years.

Students abandon the practice for a variety of reasons, Lekma said. Some don’t like it or can’t get the hang of it, and others lack the discipline to practice it regularly, usually daily. Some students are attracted to meditation out of a desire to learn something about Buddhist philosophy, but eventually lose interest.

How a person comes to meditation may also have an impact on his or her willingness to stick with it. For example, an increasing number of physicians are recommending meditation as a form of therapy to patients with heart disease, high blood pressure and even infertility. Dr. Herbert Benson, a Harvard University professor and president of the Mind/Body Medical Institute in Chestnut Hill, Mass., said that in his clinical experience, about 60% to 70% of those who begin a meditation-type practice primarily for medical reasons (sometimes at the recommendation of their doctor) adopt the teachings.

Proponents of the practice — from Buddhists to cardiologists — are trying to help more people work meditation into their daily lives. So what are the most effective approaches for starting meditation and ensuring you’ll stick with it?

The first step is to make the commitment, experts said. Learn about why it works physiologically and how it might benefit your health.

Published more than 25 years ago, Benson’s pioneering book, “The Relaxation Response,” showed how 10 minutes of meditative technique a day could increase concentration and counteract the harmful effects of stress, such as high blood pressure and strokes.

Considered by many to be the father of meditation in this country, Benson uses the phrase “relaxation response” to refer broadly to various meditation-type techniques — including prayer, qi gong, yoga and tai chi — that quiet the brain. The practices also counter the “fight-or-flight” response, which is triggered in stressful situations, and the accompanying secretion of norepinephrine, a hormone produced by the adrenal gland that, along with epinephrine, increases metabolism, blood pressure, mental activity and heart rate.

Newcomers need to stick with meditation long enough to make it a habit. Taking a meditation class or attending a meditation retreat can be a shortcut to feeling the positive effects of meditation faster and establishing a routine, experts said.

“Most people find it very difficult to begin a meditation practice on their own,” said Lekma, 37, resident teacher at the Echo Park Buddhist temple. “When you meditate with others, you get some kind of group dynamic going. When you get some people who are experienced, you kind of feed off it.”

Experts caution, however, that meditation won’t produce the immediate “hit,” such as reduced stress or increased energy, that a workout in the gym or other brisk exercise will do. Meditation takes time to learn, and even people who have been doing it for years still have times when their minds wander.

“The first few times you feel like an idiot doing it,” said Dr. Lee Lipsenthal, medical director of the Dr. Dean Ornish Program for Reversing Heart Disease and Lifestyle Advantage in Sausalito, Calif., who has meditated for 20 years and recommends meditation, along with diet and exercise changes, to patients with heart disease. “You are feeling anxious, your head is spinning, you are thinking you could be doing X, Y and Z, until you get the hang of it. That takes nearly six weeks of daily practice.”

Experts also stress the importance of new students choosing a meditation technique that conforms to their own belief system. This should make it easier to stick to the discipline over the long run. For a Catholic, it could be saying Hail Marys. For a Jew, it could be davening. For others, it could mean simply repeating a mantra-type phrase like “peace, love.” Finally, it is important to be patient and start slowly. Lekma, the Buddhist nun, suggests starting with tiny steps, such as a single weekly session with others, followed by a small personal commitment that you could stick to — for example, five to 10 minutes a day.

“People come in with a lot of enthusiasm, but have unrealistic expectations,” Lekma said. “Instead of taking very small steps they say, ‘I want to run a marathon.’ First you have to run half a block.”

A study recently conducted at Cedars-Sinai Medical Center in Los Angeles showed how quickly those small steps can make a difference. The study, sponsored by the National Institutes of Health and presented at the American Heart Assn. scientific sessions in Orlando, Fla., in November, found that patients with coronary heart disease who practiced transcendental meditation for the first time showed a significant improvement in their blood pressure and insulin resistance (pre-diabetes).

The 16-week study, conducted by Dr. Bairey Merz, of Cedars-Sinai, with Dr. Robert Schneider, director of the Institute for Natural Medicine and Prevention at the Maharishi University of Management in Fairfield, Iowa, is the first to demonstrate this blood pressure effect in heart patients. Meditation was able to produce a benefit roughly equivalent to the use of one type of blood pressure medication, the researchers found.

Mario Farnier, 53, a biomedical researcher, was recovering from a 1999 heart attack when he was admitted to the hospital last August with chest pains and underwent an angioplasty procedure. He enrolled in the meditation study and, by the study’s end, had improved enough that his doctors were able to cut one of his medications by half.

“I must say, I felt good at the time of the study,” Farnier said. He continued meditating with others until the group study ended, but has found it more difficult to continue a regular practice on his own. He still meditates occasionally, shutting his office door for quiet, but finds it harder to make time to meditate than for the regular running workouts he has done for decades. “The more you think you need it, the less time you have to do it,” he said. “If the pressure is there I can’t do it. I say I’ll do it later, but by the end of the day I never do it.”

Most beginners say they continue to need help to carry on the practice. At a crowded Wednesday night meditation class at the Khandakapala Buddhist Center in Los Angeles, Dave Hernandez, a self-employed artist, sat cross-legged on a burgundy cushion and worked to tame his restless mind. “I tried meditating on my own,” he said. “But it’s just like a rocket ship taking off when you are meditating with other people. It’s really high. That high place is just harder to get to when you are on your own.”

Article no longer available.

Medicine for the mind (The Independent, UK)

October 27, 2003

The Independent: Ian Robinson doesn’t mince his words when it comes to admitting his past failings. “I was a bugger for road rage,” he confesses. “I’d be driving along and someone would cut me up and I could kill.” Ian laughs at the admission. Other road users no longer wind him up. Their driving hasn’t changed – Ian has. The 44-year-old factory worker has discovered meditation.

Ian Robinson doesn’t mince his words when it comes to admitting his past failings. “I was a bugger for road rage,” he confesses. “I’d be driving along and someone would cut me up and I could kill.” Ian laughs at the admission. Other road users no longer wind him up. Their driving hasn’t changed – Ian has. The 44-year-old factory worker has discovered meditation.

Ian and eight of his colleagues from Indmar Sheetmetal in Wigan, Lancashire, were taught how to meditate over a three-month period for a BBC2 documentary which will be screened on Thursday evening. The results were remarkable. According to Cary Cooper, professor of organisational psychology and health at Umist, their mental and physical wellbeing increased by more than 300 per cent. “We took pulse rate measures before they started the course,” he says. “We repeated them before and after various sessions, and then at the end to see if there was an overall improvement on pulse rate.” The researchers also used psychometric stress tests at the end of the experiment. “What was very interesting was that the workers showed a massive improvement in their overall mental and physical health scores. And they were better than normative. Eight out of nine people showed substantial changes. And their heart and pulse rates improved significantly, too.”

The factory workers, most of whom were initially sceptical, were taught breathing techniques and t’ai chi, and were then taken on guided meditations during which they imagined themselves in a tranquil place. “I loved it, I really did,” says Ian, a systems manager. “I wasn’t too keen on the t’ai chi, but the meditation – there’s something in that. I felt more focused after I did it. I could meditate for 50 minutes and it would seem like five or 10 minutes. While I was doing it, all sorts of things were happening – I was flying and seeing lights. After-wards I felt relaxed and more focused.” Ian has continued to practise. “I do the meditation once a week at least. Now I’m more chilled. Nothing fazes me.”

Ian’s colleague Elaine Walsh, 40, a press operator, says that learning to meditate has changed her life. “I was sceptical at first,” admits Elaine. “But I found it very relaxing. I had mood swings before. I don’t get them at all now. My husband noticed a change straight away; he made me carry on. It has changed my life. I feel more alive, awake. I suffered from asthma and I don’t get it as much now. I still meditate twice a day.”

Meditation has never been so popular, as more people struggle to cope with the pressures of work and home life. Celebrities such as Richard Gere, Shania Twain, Sting, Goldie Hawn and Sheryl Crow are also at it. Some forms require you to concentrate on your breathing, others on an object such as a candle, or to repeat a mantra. Some are practised while walking or dancing.

Researchers continue to find evidence of its benefits. It was recently discovered that Buddhists who meditate may be able to train their brains to feel happiness and to control aggressive instincts. According to Owen Flanagan, professor of philosophy at Duke University in North Carolina, Buddhists appear to be able to stimulate the left prefrontal lobe – the area just behind the forehead – which may be why they can generate positive emotions and a feeling of wellbeing at will.

In August, the journal Psychosomatic Medicine reported that researchers from the University of Wisconsin had found that meditation could boost the body’s immune system and change brain activity in areas associated with positive emotion. Twenty-four employees took an eight-week meditation course, and found that the positive biological effects lasted for up to four months.

Meditation appears to be helpful for a wide range of health problems. Dr Jon Kabat-Zinn, the founder of the stress reduction programme at the University of Massachusetts Medical School, has been using a type of meditation called mindfulness (which involves paying attention to the experience of the moment) to help people cope with cancer, Aids, heart disease, chronic pain, chronic fatigue syndrome, irritable bowel syndrome, high blood pressure, anxiety and panic. In two trials by Dr Kabat-Zinn, psoriasis patients who listened to meditation tapes while receiving ultraviolet light treatments healed four times faster than those on light treatment alone.

In addition, two studies by Dr John Teasdale, a psychologist at the Medical Research Council’s cognition and brain sciences unit in Cambridge, have found that, teamed with cognitive therapy, mindfulness meditation halved the risk of relapse for people who have suffered three or more episodes of clinical depression. The treatment is currently being used clinically within the NHS in a small number of places around the country.

The greatest claims, however, come from supporters of Transcendental Meditation (TM), a specific technique popularised by Maharishi Mahesh Yogi. It was first taught here in 1960 and more than 160,000 Britons have subsequently learnt it – at a cost (currently £1,280 for the course). It is practised for 15 to 20 minutes twice daily, repeating a specific mantra while sitting comfortably with the eyes closed.

Research into the technique has been conducted at more than 200 universities, hospitals and research institutions in 27 countries, its supporters say. They claim the studies show that practising TM reduces a variety of important risk factors for diseases such as coronary heart disease and cancer, including high blood pressure and cholesterol levels, cigarette smoking, alcohol consumption, drug abuse, obesity, stress levels, anxiety and depression.

One US study on volunteers with high blood pressure, which was reported in The Lancet, found that TM could significantly reduce clogging of the arteries and cut related health risks, particularly of heart disease. Studies published in The American Journal of Cardiology and Stroke have shown that TM helps to relieve angina and reduce hardening of the arteries.

More research conducted in America found that a group of 2,000 people who practised TM had fewer than half the number of visits to the doctor and days in hospital compared with a control group over a five-year period. Jonathan Hinde, a TM teacher and spokesman for the organisation in Britain, says over the last five or so years, The National Institutes of Health, the main government funding body for medical research in the US, has put about $20m into research specifically on the connection between TM and various aspects of cardiovascular health. “What has been found is that if you practise TM for about three months, blood pressure tends to be reduced by about the same amount as taking any drug for hypertension. Hypertension is implicated in both strokes and heart attacks, two of the three biggest killers in the Western world.”

There are, of course, sceptics. In an editorial in the BMJ last May, Peter H Canter, a research fellow in complementary medicine, concluded that “overall, current evidence for the therapeutic effectiveness of any type of meditation is weak, and evidence for any specific effect above that of credible control interventions even more so.” He added that most of the researchers for these studies were directly involved in the organisation offering TM, and “seem keen to demonstrate its unique value”.

Yet Larry Culliford, a consultant psychiatrist at a community mental health centre in Brighton, who was trained in meditation by Buddhist monks more than 20 years ago, is convinced that it works. He practises it once a day, paying attention to the rise and fall of his chest and abdomen while he breathes. “Sogyal Rinpoche, who wrote The Tibetan Book of Living and Dying, says that giving yourself the gift of learning to meditate is the best gift you can give yourself in this life. You could say without too much exaggeration that it has transformed me and my life.

“The evidence is that it is very good for people with a range of physical as well as mental health problems. Meditation gets the mind and body back into harmony and this allows the natural healing processes the best chance to work. Benefits are possible in every organ system of the body and every part of health disorder, including mental health disorder.”

Also convinced of the benefits of meditation is Roger Chalmers, a GP working in East Anglia, who has been practising TM since 1974. “An enormous amount of what we deal with in general practice is stress-related, and TM is a really excellent method for eliminating stress.

“TM is something that anyone can do; it’s completely effortless and enhances wellbeing. Everybody benefits from being more well-rested and free from stress. We all know what it feels like when we have a good rest overnight or a good holiday. Everything in your life improves, and, in a way, you can see TM as something that just gives you a very easy technique to ensure that more of life is spent in that state and less is spent feeling tired and strained.”

[via the Independent]

Putting Meditation Under the Microscope (Hartford Courant)

October 4, 2003

Read the rest of this article…

Hartford Courant: Marietta Sabetta decided that the way to make a stand against her moderately high blood pressure was to sit still.

The 52-year-old Seymour woman asked her doctor if she could try lowering her blood pressure by taking a meditation class at Griffin Hospital.

On most Wednesday evenings since last March, she has followed instructor Lauren Liberti through a series of mindfulness exercises, beginning with simple yoga positions and leading to a meditation session that might, on a given night, involve simply focusing on the breath.

“My doctor thought it was a great idea,” Sabetta said. “It feels comfortable and peaceful, and it’s very, very strengthening emotionally.”

And her blood pressure? It’s down to normal, she says, thanks to meditation.

It’s been more than three decades since Dr. Herbert Benson of Harvard University and his colleagues found that meditation induces a calming state that is the opposite of the revved-up, heart-pounding “fight or flight” reaction to stress. Because everyone agreed that stress was bad, hard evidence that meditation fought stress established meditation as a healthful practice.

Since then, meditation has moved from the ashram to the living room. Time magazine recently reported that about 10 million Americans say they practice some form of meditation. While meditation — from guided imagery to mindfulness exercises — is widely used in health care, researchers now are looking beyond meditation’s stress-relieving virtues to see how it may help rewire the brain’s circuitry and treat or prevent a host of specific ailments.

Richard J. Davidson, a research professor of psychology and psychiatry at the University of Wisconsin and director of the university’s Keck Laboratory for Functional Brain Imaging and Behavior, is one of the leaders in this still-embryonic field. He said it is growing rapidly, thanks to recent advances in brain imaging and brain science.

“It’s an approach rooted much more [than in the past] in the neuroscience research tradition,” he said. “It is research that emphasizes the emotional benefits of meditation and corresponding changes in brain and peripheral biology that may be associated with the cultivation of certain kinds of positive emotions that meditation is said to increase.”

Davidson was the lead author of a recent, much-publicized study that measured brain activity in subjects before, immediately after and four months after they completed an eight-week training program in mindfulness meditation. A group of 25 meditators, taught to cultivate deep awareness of thoughts and feelings, showed heightened brain activity in an area associated with “positive effect,” or happiness, compared with a group of 18 non-meditators. After the study, both groups got flu shots. The meditators produced up to 25 percent more antibodies to influenza. The results suggest that the brain changes might be related to a boost in the immune system.

Davidson and his colleagues also have been using brain-imaging technology to examine the brains of some of the world’s most experienced meditators — Tibetan Buddhist monks, who are being studied with the blessing of the Dalai Lama. (Davidson helped organize a Sept. 13 meeting between leading scientists and the Dalai Lama at the Massachusetts Institute of Technology.)

The work has not yet been published, but Davidson wrote last year that one monk showed intense activity in a part of the brain associated with happiness, scoring higher than nearly 200 other individuals who had been observed.

Other studies being conducted across the country are examining how various forms of meditation might help treat or prevent a number of illnesses. These include, for example, heart disease in specific populations, binge eating and recurrent abdominal pain. Other projects are evaluating meditation as a way to improve the quality of life for patients with cancer and various stages of HIV and to reduce seniors’ susceptibility to shingles.

Much of the research is being sponsored by the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health. Dr. David Katz, director of the Yale-Griffin Prevention Research Center, said the field is expanding, thanks, in part, to the role of the NIH. Katz said the NIH has determined that practices like meditation need to be backed up with credible science, “which means that you have [scientific] outcomes that can hold their head up in public,” he said. Good science, said Katz, also makes believers of health plans, which can fold proven practices into the services they will provide to members.

Doctors who now encourage patients to meditate acknowledge that it’s often trickier than prescribing drugs.

Dr. Stephen Sinatra, a Manchester cardiologist, said that he’s not that fussy about what kind of meditation his patients take up, as long as it suits them. For example, if they’re Catholic, he’ll ask if they are adverse to prayer. “If they say, `No,’ I tell them to just say `Hail Mary, full of grace’ over and over again,” he said.

One of his patients, Jilline Miceli, 64, formerly of South Windsor and now of Bonita Springs, Fla., was diagnosed with congestive heart failure three years ago and became a heart transplant candidate in 2001. She credits meditation — along with drug treatment, yoga and her family’s and friends’ prayers — with helping to get her off the transplant list.

Dr. Karen Prestwood, an associate professor of medicine at the University of Connecticut Health Center in Farmington, regularly teaches a mind-body skills group at the health center that meets for two hours a week for 10 weeks. She uses both what she calls passive forms of meditation — such as mindfully noticing thoughts that arise — and active forms, like “chaotic breathing,” which involves breathing techniques and body movement.

Lucille Meinsler of Hartford, an administrative program coordinator in the health center’s psychiatry department, took the class that began last March. Meinsler settled on using a compact disc with a narrated, guided meditation. “I found it was too hard to sit there and think,” she said of silent meditation. But her guided meditation practice — which she tries to do every other day — has helped curb sleeplessness brought on by menopause. She finds it also helps her focus in her waking life.

Prestwood observes that plenty of patients have no interest in meditation. “They would rather take a pill,” she said.

Ultimately, whether meditation is prescribed, and if so, what kind, may be dictated both by the patient’s preferences and also by the particular ailment. Davidson of the University of Wisconsin said future research may show that a particular form of meditation works best to help treat or prevent a given illness. Benson, an associate professor of medicine at Harvard who also is founding president of the Mind-Body Medical Institute, said he believes that all effective forms of meditation induce what he calls the relaxation response, characterized by lowered blood pressure, heart rate, breathing rate and metabolism.

“That is simply a doorway that clears the mind,” he said, noting that the relaxation response is the starting point for advanced meditative states that may be able to address specific health problems.

Davidson cautions that the in-depth study of meditation is new. It’s too early to make any claims about physical healing. The research underway isn’t simply about proving how healthful meditation is. Some techniques, when tried out against certain maladies or as an adjunct to other therapies, will undoubtedly fail. And there is the danger, as with any self-care practice, that patients may blame themselves for not meditating well enough if their disease gets worse.

“I think there are going to be certain kinds of diseases that are completely unresponsive to anything you do with your mind,” he said, adding that certain kinds of cancer are probably among those illnesses. “This needs to be approached extremely carefully and with the utmost responsibility.”

Meditation classes are offered in area community centers, adult education programs, yoga studios, schools and through many religiously affiliated groups and centers.

Mindfulness medication

July 5, 2003

Read the rest of this article…

ABC News: Many moons ago, a wandering Nepalese prince sat under a tree, vowing not to rise until he attained enlightenment.

After a long night of deep meditation, Siddhartha Gautama, better known as the Buddha, saw the light and declared that suffering is subjective, and can be reduced through self-awareness.

Today, 2500 years later, a growing number of American doctors and healthcare workers are teaching people who are ill how to apply Buddha’s epiphany to their lives.

In hospitals, businesses and community centers around the country, meditation is increasingly being offered as a method of stress reduction, and to help patients better cope with the physical pain and mental strain associated with many medical conditions, including heart disease and HIV infection…

The fine art of doing nothing

January 25, 2003