Behavioral treatment of hypertensive heart disease in African Americans: Rationale and design of a randomized controlled trial

African Americans experience higher morbidity, and mortality, than Whites d o as a result of hypertension and associated cardiovascular disease. Chroni c psychosocial stress has been considered an important contributing factor to these high rates. The authors describe the rationale and design for a pl anned randomized controlled trial comparing Transcendental Meditation, a st ress-reduction technique, with lifestyle education in the treatment of hype rtension and hypertensive heart disease in urban African Americans. They pr etested 170 men and women aged 20 to 70 years over a 3-session baseline per iod, with posttests at 6 months. Outcomes included clinic and ambulatory bl ood pressure, quality, of life, left ventricular mass measured by, M-mode e chocardiography, left ventricular diastolic function measured by Doppler an d carotid atherosclerosis measured by fi-mode ultrasound. This trial was de signed to evaluate the hypothesis that a selected stress reduction techniqu e is effective in reducing hypertension and hypertensive heart disease in A frican Americans.