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Randomized Controlled Trial
. 2015 Nov 16;10(11):e0142689.
doi: 10.1371/journal.pone.0142689. eCollection 2015.

Effects of Lifestyle Modification on Telomerase Gene Expression in Hypertensive Patients: A Pilot Trial of Stress Reduction and Health Education Programs in African Americans

Shanthi Duraimani  1   2   3 , Robert H Schneider  1   2 , Otelio S Randall  4 , Sanford I Nidich  1   2 , Shichen Xu  4 , Muluemebet Ketete  4 , Maxwell A Rainforth  1 , Carolyn Gaylord-King  1 , John W Salerno  1 , John Fagan  2   3
Affiliations
Randomized Controlled Trial

Effects of Lifestyle Modification on Telomerase Gene Expression in Hypertensive Patients: A Pilot Trial of Stress Reduction and Health Education Programs in African Americans

Shanthi Duraimani et al. PLoS One. .

Abstract

Background: African Americans suffer from disproportionately high rates of hypertension and cardiovascular disease. Psychosocial stress, lifestyle and telomere dysfunction contribute to the pathogenesis of hypertension and cardiovascular disease. This study evaluated effects of stress reduction and lifestyle modification on blood pressure, telomerase gene expression and lifestyle factors in African Americans.

Methods: Forty-eight African American men and women with stage I hypertension who participated in a larger randomized controlled trial volunteered for this substudy. These subjects participated in either stress reduction with the Transcendental Meditation technique and a basic health education course (SR) or an extensive health education program (EHE) for 16 weeks. Primary outcomes were telomerase gene expression (hTERT and hTR) and clinic blood pressure. Secondary outcomes included lifestyle-related factors. Data were analyzed for within-group and between-group changes.

Results: Both groups showed increases in the two measures of telomerase gene expression, hTR mRNA levels (SR: p< 0.001; EHE: p< 0.001) and hTERT mRNA levels (SR: p = 0.055; EHE: p< 0.002). However, no statistically significant between-group changes were observed. Both groups showed reductions in systolic BP. Adjusted changes were SR = -5.7 mm Hg, p< 0.01; EHE = -9.0 mm Hg, p < 0.001 with no statistically significant difference between group difference. There was a significant reduction in diastolic BP in the EHE group (-5.3 mm Hg, p< 0.001) but not in SR (-1.2 mm Hg, p = 0.42); the between-group difference was significant (p = 0.04). The EHE group showed a greater number of changes in lifestyle behaviors.

Conclusion: In this pilot trial, both stress reduction (Transcendental Meditation technique plus health education) and extensive health education groups demonstrated increased telomerase gene expression and reduced BP. The association between increased telomerase gene expression and reduced BP observed in this high-risk population suggest hypotheses that telomerase gene expression may either be a biomarker for reduced BP or a mechanism by which stress reduction and lifestyle modification reduces BP.

Trial registration: ClinicalTrials.gov NCT00681200.

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Conflict of interest statement

Competing Interests: The authors have the following interests: Dr. Fagan was Chief Scientific Officer at Global ID Group, which provides commercial GMO testing services until November 2013. Since then, Dr. Fagan has no financial, professional, or personal affiliation with Global ID Group. Global ID Group provided scholarship support to Dr. Shanthi Lakshman Duraimani for her PhD studies. There are no patents, products in development or marketed products to declare. This does not alter the authors adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

Figures

Fig 1
Fig 1. Participant Flow Diagram.
Fig 2
Fig 2. Pre-post changes in telomerase component (HTR) gene expression in the Stress Reduction (SR) and Extensive Health Education (EHE) groups.
Fig 3
Fig 3. Pre-post changes in telomerase component (HTERT) gene expression in the Stress Reduction (SR) and Extensive Health Education (EHE) groups.
See this image and copyright information in PMC

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