Brain education-based meditation for patients with hypertension and/or type 2 diabetes: A pilot randomized controlled trial

Abstract

Background: Hypertension and type 2 diabetes are chronic diseases, which generally require lifetime care. Meditation and yoga can be complementary to pharmacological therapies according to the scientific evidences so far. Brain education-based meditation (BEM) is a technique, which has been known to change brain structure, psychology, and physiology of healthy adult participants. This randomized, nonblinded pilot trial aimed to examine whether BEM affects the conditions of patients with hypertension and/or type 2 diabetes compared with health education classes.

Methods: We randomly allocated 48 patients with hypertension and/or type 2 diabetes to BEM (n = 24) or health education (n = 24) classes in the Ulsan Junggu Public Health Center in Korea, where the classes were run during the same period and explored the impact of 8-week practice on the serum glutamic-oxaloacetic transaminase, serum glutamic pyruvic transaminase, gamma glutamyl transpeptidase, creatinine, high-density lipoprotein cholesterol, and low-density lipoprotein (LDL) cholesterol. Total RNA was extracted to examine inflammatory gene expressions from the whole blood using PAXgene blood RNA System. In addition, self-reports on mental/physical health were evaluated. The Student's t test, chi-squared test, and analysis of covariance were used for statistical analysis.

Results: The number of people who participated until the completion of the study was 14 in the control and 21 in the BEM group. After 8 weeks, LDL cholesterol level was significantly decreased in the BEM group after the intervention (13.82 mg/dL reduction, P < .05), while it was not significantly altered in the control group. The expression of inflammatory genes was significantly reduced after 8 weeks of the BEM training (0.3-, 0.5-, and 0.2-fold change for NFKB2, RELA, and IL1B, respectively, all P < .05). In the item analysis of mental/physical health self-reports, a significant improvement was confirmed as follows: increases in focus, confidence, relaxation, and happiness; decreases in fatigue, anger, and loneliness (all P < .05). There were no important adverse events or side-effects by BEM intervention.

Conclusion: Compared to health education, BEM helps lower LDL cholesterol level and the inflammatory gene expression in the patients with hypertension and/or type 2 diabetes. Moreover, BEM induces positive effects on the self-reported mental/physical states, warranting further study.

Figure 1

Alterations in values of self-reports and blood markers between preintervention and postintervention. “BEM (Att ≥ 5)” presents brain education-based meditation (BEM) group with high attendance rate: more than 5 times of attendance. The indicated values stand for the subtraction of values at preintervention from values at postintervention. Dots at the midline (y = 0) mean no changes between the values of preintervention and postintervention. The values of following self-reports and blood markers are shown: (A) mental health; (B) physical health; (C) serum glutamic-oxaloacetic transaminase (SGOT); (D) serum glutamic pyruvic transaminase (SGPT); (E) γ-glutamyl transferase (GGT); (F) creatinine; (G) high-density lipoprotein (HDL) cholesterol; (H) low-density lipoprotein (LDL) cholesterol. ^∗P = .04, an independent samples t test between BEM (Att ≥ 5) and control; ^∗P = .01, an independent samples t test between BEM and control; ^#P = .04, a paired samples t test from the same group at preintervention and postintervention; n = 8 (BEM (Att ≥ 5)), 21 (BEM), and 14 (control). Dots and error bars indicate the mean values and standard of errors, respectively. Att = attendance, GGT = γ-Glutamyl transferase, HDL = high-density lipoprotein, LDL = low-density lipoprotein, SGOT = serum glutamic-oxaloacetic transaminase, SGPT = serum glutamic pyruvic transaminase.

Figure 2

Relative inflammatory gene expressions of the meditation group at preintervention and postintervention. Expression of inflammatory genes was all initially normalized by ACTB expression and the normalized values were used for further analysis. Second normalizations for values of brain education-based meditation (BEM) group at preintervention and postintervention were done by using values of control group of the same time point; this was performed due to the gene expression changes by the temperature at preintervention and postintervention. Dots indicate the mean values of the following relative gene expressions of BEM group, which are normalized by the value of the control group: (A) Nuclear Factor kappa B subunit 2 (NF-κB2), ^∗P = .01; (B) RELA, ^∗P = .03; (C) RELB, P = .34; (D) interleukin 1 beta (IL1B), ^∗∗P < .01, a paired samples t test (n = 6 and 8 for control and BEM, respectively). Error bars indicate standard of errors.