Transcendental Meditation: Overview of Research on Health
Dr Roger Chalmers, 16 July 2019

Transcendental Meditation (TM), as taught by Maharishi Mahesh Yogi, is a simple, effortless technique practised for 15-20 minutes twice daily.  TM is taught by qualified teachers who have completed an extensive training programme.  It requires no belief, nor any change in life-style or diet, and can be easily learned by anyone regardless of age, education, or culture.  More than six million people have learned the technique worldwide.  Since 1970, more than 600 research studies on TM have been conducted at over 250 universities and research institutions in 33 countries.  Many have been published in peer-reviewed journals.

Improved cardiovascular health: reduction of high blood pressure, reduced cardiovascular events, and decreased mortality

A multi-centre US research team has conducted a series of randomized controlled trials (RCTs) investigating effects of TM on cardiovascular health, with particular emphasis on prevention of cardiovascular disease in older African-Americans (a high-risk group for vascular disease).  This research has been supported by grants totalling over $25 million, principally from the US National Institutes of Health.  These and other RCTs have shown:

  • In a nine-year study of patients with coronary heart disease, TM led to a 48% reduction in the rate of major clinical events (all-cause mortality plus non-fatal myocardial infarction and stroke) compared to controls who received education on risk factor reduction. Regularity of TM was significantly associated with longer survival; subjects who practised the technique regularly showed a 66% risk reduction for major clinical events.1
  • TM was more effective in reducing mild hypertension than progressive muscular relaxation or health education;2-3 after one year, subjects practising TM demonstrated reduced use of antihypertensive medication relative to the other groups.4
  • TM reduced carotid artery atherosclerosis compared to controls who received health education.5-6
  • Pooled data from two RCTs on hypertensive older people showed that TM was associated with a 23% reduction in all-cause mortality and a 30% decrease in cardiovascular deaths.7-8
  • In patients with stable coronary heart disease (CHD), TM decreased both blood pressure (BP) and insulin resistance – key components of the ‘metabolic syndrome’ associated with many major disorders of modern society, including CHD, type 2 diabetes, and hypertension. TM also increased stability of the cardiac autonomic nervous system.9
  • TM improved functional capacity and quality of life in patients with chronic heart failure. TM subjects also showed reduced depression and had fewer hospitalizations.10
  • In university students, TM reduced BP, and also decreased total psychological distress, anxiety, depression, and anger/hostility; and improved coping.11
  • In pre-hypertensive adolescents, TM decreased BP at rest and during acute laboratory stress;12 and decreased ambulatory blood pressure during normal daily activity.13
  • TM decreased left ventricular mass in pre-hypertensive adolescents compared to controls receiving health education, indicating reduction of an early sign of left ventricular hypertrophy (the strongest predictor of cardiovascular mortality apart from age).14

A systematic review and meta-analysis of RCTs from 107 published studies on stress reduction and high blood pressure found that TM significantly reduced both systolic and diastolic BP, while other methods of meditation and relaxation, biofeedback, and stress management did not produce significant effects.15  Further meta-analyses of RCTs by independent teams have confirmed that TM leads to clinically important reductions in BP.16-18  Authors conclude that sustained BP changes of the magnitude produced by TM would be associated with substantially decreased risk of heart attack and stroke, the leading cause of mortality worldwide.16  These findings are corroborated by other reviews addressing the role of TM in prevention and treatment of hypertension and cardiovascular disease.19-21

Other research on TM has found: improved exercise tolerance in angina patients with documented coronary lesions;22 reduction of elevated cholesterol (independent of dietary changes);23 improvements in clinical and ECG variables in patients with cardiac syndrome X (anginal pain, positive exercise ECG, and normal angiogram);24 lower cortisol levels and reduced cardiovascular risk factors in post-menopausal women.25  An analysis of cost-effectiveness based on US cost data indicated that TM could compare favourably with pharmacological treatment for hypertension.26

American Heart Association scientific statement 2013

A scientific statement from the American Heart Association (AHA) in 2013 found evidence that Transcendental Meditation lowers blood pressure, and recommends that TM may be considered in clinical practice for prevention and treatment of hypertension.  However, the AHA report found insufficient scientific evidence to recommend other meditation or relaxation techniques.20-21

Improved quality of life and well-being for patients with breast cancer and other chronic disorders

In an 18-month randomized controlled trial in women with breast cancer (stage II to IV), subjects practising TM showed improvements in overall quality of life, emotional well-being, social well-being, and mental health compared to control patients.27  TM has also been found to improve functional quality of life and well-being for people with other chronic disorders.10, 28-29

Improved health and well-being for elderly people

A well-controlled randomized study from Harvard found that elderly people who learned TM showed greater improvement on measures of mental health, cognitive flexibility, blood pressure, and well-being, and lower mortality than three comparison groups from the same residential institutions (who learned either a relaxation technique, ‘mindfulness’ training, or received no treatment).30

Improved psychological health and reduced substance abuse

Many studies have documented benefits from TM for mental health and reduced substance abuse.1, 10-11, 27-28, 30-50, 83-86, 94-111   In meta-analyses, TM was more effective than other meditation and relaxation procedures in reducing anxiety and improving overall psychological health.31-32  Results remained robust after controlling for strength of design and exclusion of studies by experimenters with a known interest in TM.31

These findings are supported by a more recent meta-analysis of randomized controlled trials which found that TM was effective in reducing trait anxiety, with greater effects seen in subjects with high anxiety levels before starting the technique.  TM had a stronger effect in decreasing anxiety than was observed with mindfulness in a previous meta-analysis.33

Another series of meta-analyses found that TM was significantly more effective in reducing smoking, alcohol consumption, and illicit drug use than conventional programmes, whether or not these were combined with relaxation techniques.34

Improvements in post-traumatic stress disorder (PTSD)

In a three-month randomized controlled trial in 203 military veterans with post-traumatic stress disorder (PTSD) funded by the US Department of Defense, TM reduced PTSD severity and depression, and improved overall mood disturbance and quality of life.  Reductions in PTSD and depression with TM were significantly non-inferior to the effects of Prolonged Exposure therapy (PE)—a gold standard, Veterans Administration-approved, psychological treatment for PTSD involving repeated exposure to trauma-related experiences.  Both TM and PE groups showed significantly greater improvements than a health education control group.  Overall, 61 percent of the TM group showed clinically-meaningful improvement in PTSD symptoms, compared to 42 percent for PE and 32 percent for health education.35-36

Other studies have also found marked, rapid, and sustained improvements in PTSD, depression, and overall mental health in military veterans, active service members and civilians with PTSD, including US veterans of Vietnam, Iraq, and Afghanistan wars, Congolese war refugees, and South African university students.37-44

Compared to controls, TM also: decreased mental and physical stress symptoms in residents directly affected by the 2011 Japan earthquake and tsunami disaster;45 reduced stress, increased self-efficacy, and improved mental and physical well-being in vulnerable women living in poverty in Uganda;46 and reduced trauma symptoms and improved mental health in both male and female prisoners.106-107

Decreased health care needs and costs

A 14-year retrospective study of 2836 people enrolled in the Quebec provincial health insurance scheme found that, after beginning TM, subjects showed a progressive decline in payments to physicians compared to controls.  The average annual difference was 13%, leading to a cumulative cost reduction of 55% after six years.51-52

These findings are supported by further analyses of two important subgroups whose costs contribute strongly to overall health care expenditure: for the highest-cost 10% of subjects, the TM group’s payments decreased by 11% over one year, with a cumulative reduction of 28% after five years; and for subjects over 65 years, the TM group showed a five-year cumulative cost reduction of 70%.53-54

Earlier research using data from Blue Cross/Blue Shield, a major US health insurer, found that both hospital admissions and outpatient consultations were over 50% fewer for subjects practising TM compared to norms and controls.  In the over-40 age group, the reduction was over 70%.  Hospital admissions were markedly reduced in all 17 disease categories studied.55-56

Deep rest and increased integration of brain functioning

The physiological basis of TM’s effects has been extensively investigated, revealing a unique state of restful alertness during the technique characterized by increased integration of brain functioning and by metabolic, electrophysiological and biochemical markers of deep rest.  Regular practice is associated with sustained increases in brain integration and reductions in psychophysiological correlates of stress and ageing.57-82, 30

Improvements in education, occupational health, and rehabilitation

Educational research (including randomized controlled trials) has shown that TM develops intelligence and creativity; increases academic achievement in school, university, and postgraduate students; promotes cognitive and self development; improves social-emotional learning; increases brain integration; improves perception and mind-body co-ordination; decreases negative school behaviour in adolescents; and improves brain integration, cognitive functioning, behaviour and symptoms in children with ADHD.70-71, 83-95

In research on schoolteachers, educational administrators, and support staff, TM reduced stress and burnout, improved psychological health, and increased emotional intelligence and brain integration.61, 96-97  Other workplace studies in varied settings have found improved job performance and occupational health.98-104  TM also promotes effective rehabilitation of offenders, including reduced recidivism.105-110

Improved collective health for society

More than 50 controlled studies (including prospective projects) have found that collective practice of TM (and its advanced techniques, including Yogic Flying) by a small fraction of the total population can improve the collective health of society as a whole, as measured by reductions in crime, violence, accidents, unemployment, and both civil and international conflict; and by positive economic, social and political developments throughout the community, nation, and world.111-129

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