Meditation Reduces Sympathetic Activation and Improves the Quality of Life in Elderly Patients with Optimally Treated Heart Failure: A Prospective Randomized Study

Abstract

Objective:

We tested whether meditation can reduce sympathetic activation, evaluated by norepinephrine blood levels (NE), and improve quality of life in elderly persons with congestive heart failure (CHF).

Design and Setting:

This was a prospective, randomized study conducted from April 2000 to October 2001 in an ambulatory care teaching hospital in São Paulo, Brazil.

Subjects:

We studied 19 patients with CHF, 74.8 ± 6.7 years old, receiving diuretics, optimal doses of an angiotensin-converting enzyme inhibitor or angiotensin II inhibitor, maximum tolerated carvedilol dose (23.1 ± 13.6 mg) and spironolactone 25 mg (10 patients).

Interventions:

After 2 months of optimal treatment with carvedilol, patients were randomized into two groups. The meditation group (M) was provided an audiotape, 30 minutes long, to listen to at home, twice a day, for 12 weeks, plus a weekly meeting. The control group (C) just had weekly meetings.

Main Outcome Measures:

We determined before and after 14 ± k1 weeks, NE (in pg/mL); quality of life with the Minnesota Living with Heart Failure Questionnaire (MLWHFQ); VO2 and VE/VCO2 slope by cardiopulmonary exercise testing; left ventricular ejection fraction (LVEF), and left ventricular end-diastolic volume index (LVDDi) measured by echocardiography.

Results:

Meditation reduced NE (mean ± SEM) from 677.7 ± 96.6 to 387.1 ± 39.1 pg/mL (p = 0.008) in M versus 491.4 ± 35.9 to 470.6 ± 31.2 (p = 0.34) in C; improved MLWHFQ total score (mean ± SEM) from 33.2 ± 6.6 to 21.6 ± 6.8 points (p = 0.02) in M versus 18.4 ± 8.0 to 25.1 ± 8.9 (p = 0.41) in C; and reduced the VE/VCO2 slope (mean ± SEM) from 31.2 ± 3.0 to 28.2 ± 2.6 (p = 0.04) in M versus 28.4 ± 2.7 to 28.8 ± 2.6 (p = 0.24) in C. No changes occurred in LVEF, LVDDi, and VO₂.

Conclusions:

In elderly patients with optimally treated CHF, meditation reduced NE, improved quality of life, and reduced the VE/VCO₂ slope. Our results support the possible role of meditation as a new hope in the treatment of CHF.