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Behavioral Treatment of Hypertensive Heart Disease in African Americans: Rationale and Design of a Randomized Controlled Trial
Authors:Amparo Castillo-Richmond MD  Charles N. Alexander PhD  Hector Myers PhD  Vidya Kaushik MD  Cesar Aranguri MD
Abstract:Abstract

African Americans experience higher morbidity and mortality than Whites do as a result of hypertension and associated cardiovascular disease. Chronic psychosocial stress has been considered an important contributing factor to these high rates. The authors describe the rationale and design for a planned randomized controlled trial comparing Transcendental Meditation, a stress-reduction technique, with lifestyle education in the treatment of hypertension and hypertensive heart disease in urban African Americans. They pretested 170 men and women aged 20 to 70 years over a 3-session baseline period, with posttests at 6 months. Outcomes included clinic and ambulatory blood pressure, quality of life, left ventricular mass measured by M-mode echocardiography, left ventricular diastolic function measured by Doppler, and carotid atherosclerosis measured by β-mode ultrasound. This trial was designed to evaluate the hypothesis that a selected stress reduction technique is effective in reducing hypertension and hypertensive heart disease in African Americans.
Keywords:clinical trial  hypertension  left ventricular hypertrophy  stress reduction  Transcendental Meditation
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