Thursday, May 19, 2011


According to the Australian Heart Foundation, every 10 minutes somebody in Australia dies from heart disease. The leading underlying cause of death for all Australians is reported to be ischaemic heart disease (IHD), contributing to some 18 per cent of all male deaths and some 17 per cent of all female deaths. Heart disease is also the leading cause of death for men and women in the United States of America … and many other places as well.

Joel Dimsdale's 2008 article Psychological Stress and Cardiovascular Disease’ published in the Journal of the American College of Cardiology, is a metaanalysis of the world's research literature on the unique relationship between stress and cardiovascular disease (CVD).

CVD is not a single disorder but represents over 20 different disease including stroke, various heart diseases (including coronary heart disease), and heart failure. According to the American Heart Association, if all forms of CVD were eliminated, total life expectancy in the US would increase by 7 years. The main cause of CVD is atherosclerosis – the build up of fatty plaque on the inner layer of artery walls. This can lead to blood clots. When a coronary artery or vessel is blocked, it is called coronary heart [or artery] disease, which is the major form of CVD.

Major risk factors for CVD include smoking, high blood pressure, physical inactivity, obesity and type 2 diabetes.

Now, what is clear is that stress triggers events. It is less clear if stress actually causes events. However, Dimsdale has documented overwhelming evidence confirming the ‘deleterious effects of stress on the heart and for the fact that vulnerability and resilience factors play a role in amplifying or dampening those effects’.

The heart and blood vessels are particularly sensitive to acute and chronic stress. With every beat, the heart not only pumps blood, but also transmits complex patterns of neurological, hormonal, pressure and electromagnetic information to the brain and throughout the body.

The heart is uniquely positioned as a powerful communications hub that connects the body, mind, emotions and spirit. Research suggests that there is an elaborate feedback network of hormones, chemicals and nerves that exist between the brain, the heart and centres of thoughts and emotions. The heart sends the brain messages that affect our perceptions, our mental processing and our feelings.

We all know that there is a strong connection between stress and cardiovascular health via multiple pathways including type A behaviour pattern (hostility and anger are the lethal elements), the direct effects of adrenaline on blood vessels and the heart itself (Takotsubo cardiomyopathy), acceleration of atherosclerosis leading to coronary artery disease, abnormal metabolism, insulin resistance and inflammation, and irritability of the heart muscle.

You can help prevent heart disease by quitting smoking, lowering cholesterol, controlling high blood pressure and blood sugar, maintaining a healthy weight and exercising. Oh, yes, I guess I don’t need to tell you - but I will anyway - that there is abundant evidence in the medical and scientific journals attesting to the benefits of meditation – especially mindfulness meditation – as regards personal risk management for heart disease … not to mention so many other kinds of disease as well.

A study examining the effects of mindfulness-based stress reduction found a significant improvement in breathing efficiency and frequency (Robert-McComb et al: 2004), which assists in the management of heart disease. Lowered resting level of the stress hormone cortisol was also observed (cf cortisol-induced hypertension). Higher and more prolonged levels of cortisol in the bloodstream - like those associated with chronic stress - have been shown to have numerous negative effects including hypertension, impaired cognitive performance, suppressed thyroid function, blood sugar imbalances such as hyperglycemia, decreased bone density and muscle tissue, lowered immunity, and inflammatory responses in the body.

We all know that hypertension is a major risk factor for heart attacks and cardiovascular disease. An 8-month study involving 111 teens on the verge of becoming hypertensive adults, found that meditation helps blood vessels relax (Barnes et al: 2004). Two 15-minute meditation sessions led to an average 21 per cent increase in the ability of the teens' blood vessels to dilate. In contrast, the teens who did not meditate experienced a 4 per cent decrease in blood vessel dilation over the 8-month study.

Lead investigator Dr Vernon A Barnes, stated: ‘We know that this type of change is achievable with lipid-lowering drugs, but it's remarkable that a meditation program can produce such a change. This could have important implications for inclusion of meditation programs to prevent and treat cardiovascular diseases and its clinical consequences.’

Another important study shows that mindfulness meditation is associated  with improved glycemic control in type 2 diabetes (Rosenzweig et al: 2007).

Mindfulness is not just an antidote for stress. Mindfulness actually changes things – you! The only 'thing' you can ever change. (You're powerless over everything else.) The regular practice of mindfulness meditation allows you to make the necessary ‘adjustments’ to changing circumstances and unprecedented events. You learn to refine and adjust your expectations (and invent new expectations) and to tailor your ‘responses’ [cf ‘reactions’] to emerging threats as well as general existential uncertainty.

The key elements? I have mentioned these two phrases so many times in my now more than 80 blogs since October 2010 – choiceless awareness and bare attention. Commit them to memory. Better still, commit them to daily practice.

This post sets out a simple form of mindfulness sitting meditation. Also, if you are living with heart disease you may wish to purchase this very good interactive mindfulness audio CD featuring Dr Bob Stahl.


VA, Treiber FA, Johnson MH: Impact of transcendental meditation on ambulatory blood pressure in African-American adolescents. Am J Hypertens. 2004;17, 366–369; doi: 10.1016/j.amjhyper.2003.12.008

Dimsdale JE: Psychological Stress and Cardiovascular Disease. J Am Coll Cardiol. 2008;51;1237-1246 doi:10.1016/j.jacc.2007.12.024

Robert McComb JJ, Tacon A, Randolph P, Caldera Y: A pilot study to examine the effects of a mindfulness-based stress-reduction and relaxation program on levels of stress hormones, physical functioning, and submaximal exercise responses. Journal of Alternative and Complementary Medicine. 2004;10(5):819-27.

Rosenzweig S, Reibel DK, Greeson JM, Edman JS, Jasser SA, McMearty KD, Goldstein BJ: Mindfulness-based stress reduction is associated with improved glycemic control in type 2 diabetes mellitus: A pilot study. Altern Ther Health Med. 2007;13(5):36-38.

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  1. The Barnes study cited referred to Transcendental Meditation, not mindfulness. Meditations, just like medications, have a variety of levels of effectiveness. It would be ridiculous to attribute one set of benefits of one type of hypertension medication to a different medication. Same with meditation.

    1. A new study has found that blood pressure is effectively lowered by mindfulness-based stress reduction (MBSR) for patients with borderline high blood pressure (BP) or ‘prehypertension.’ The finding is reported in the October 2013 issue of Psychosomatic Medicine: Journal of Biobehavioral Medicine, the official journal of the American Psychosomatic Society. Please see my post of today on the matter. Regards, Ian.