Although the etiology of the metabolic syndrome (MetS) is complex, psychological stress appears to play an important role, possibly through inflammatory response and other metabolic and hormonal abnormalities. A major consequence of MetS leading to increased cardiovascular risk is endothelial dysfunction, a condition which is also influenced by psychological stress. Previous controlled clinical studies have shown that mind-body interventions for stress reduction, particularly Transcendental Meditation (TM), are effective in reducingpsychological stress and a number of cardiovascular disease (CVD) risk factors, as well as intermediate and clinical cardiovascular endpoints in AAs and Whites. It is therefore likely that TM is also beneficial in reducing adverse consequences of MetS leading to cardiovascular risk, including endothelial dysfunction, inflammation and metabolic abnormalities. These effects, however, have never been evaluated. Project IIIB Primary Aim: To evaluate the effect of a stress reduction intervention using transcendental meditation (TM) on vascular function in a sample of community individuals with the metabolic syndrome (MetS). We will compare changes in endothelial function, assessed by means of brachial artery flow-mediated dilation (FMD), before and after intervention between two randomized intervention groups: TM plus health education (HE), and HE alone. As a secondary endpoint, we will examine arterial stiffness, measured using pulse-wave velocity methodology. Project IIIB Secondary Aim #1: To evaluate the effect of TM on metabolic and other biochemical abnormalities associated with the MetS. We will compare a number of inflammatory and oxidative stress markers, adipocytokines, and indices of glucose metabolism and insulin resistance between the two randomized groups before and after the intervention. These biomarkers have been related to the MetS and CVD risk, or are likely to be influenced by stress. Project IIIB Secondary Aim #2: To evaluate the effect of TM on improving psychological well-being, including reducing perceived stress, depressive symptoms, anger and hostility. The effect of TM on reducing urinary cortisol level as a measure of stress-induced hypothalamic-pituitary-adrenal axis activation will be studied.
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