"The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease."
- Thomas Edison
"There are roughly 750,000 symptomatic strokes that occur each year. These are strokes that result in obvious neurological damage...It is now estimated that there are now over 22,000,000 silent strokes a year in the U.S...most go unreported..." - Dr. David Williams
The effect of silent or "mini" strokes may seem to last a few hours or less, but they may be a precursor to a major stroke.
If the blood supply to areas of the brain is being cut off so frequently, what is happening in the rest of the body?
A New Front in War on Silent Killers
Health: Researchers test meditation's effect on high blood pressure among blacks.
By JOCELYN Y. STEWART TIMES STAFF WRITER
July 27 2001
The qualifications these researchers bring to a new study at Charles R. Drew University cannot be measured solely by their degrees and awards. Consider too all they have lost.
Each man lost his mother to hypertension.
"I knew she went to the doctor," Dr. Keith Norris said of his mother, who died at 52. "I knew she was on some medicine. I didn't know how severe it was. So when she ended up dying from a stroke, it hit me: Here I am a physician and I don't really have the relationship and understanding of this health issue." Now, Norris is one of three key players in a Drew study examining and comparing the effect of transcendental meditation with that of health education on African Americans suffering from heart disease and diabetes. In short, researchers want to see whether meditation can improve health as well as, or better than, classes on diet and exercise.
As researchers, they are guided by the protocols of science. But their relationship with these ailments is also personal.
African Americans are at greater risk for high blood pressure than any other race or ethnic group in the nation and tend to develop hypertension at an earlier age. The greater severity and early onset lead to an 80% higher stroke mortality rate than among the general U.S. population, a 50% higher heart disease mortality rate and a 320% greater rate of hypertension-related end-stage kidney disease, according to a National Institutes of Health report published in 1997.
Norris and his colleagues believe that such disparities do not have to exist, and a key to improved health may lie in the patients' own hands.
The idea is simple: Stress is believed to be a major culprit in such ailments as hypertension and heart disease. Meditation lessens stress and could allow the body to better heal itself. If the hypothesis is correct, the study could one day have implications for all who suffer from such maladies as heart disease, diabetes and hypertension.
"Being able to deal with stress and also being able to affect one's perspective on society in general should help improve high blood pressure and really all medical conditions," said Norris, the study's co-investigator. "Our body has a very powerful ability to heal itself."
Seeking Better Health for African Americans
Norris and his colleagues--Hector F. Myers and Chinelo Haney--are motivated not only by scientific inquiry, but by the possibility that they can dramatically improve the health of African Americans.
"I come to it from the standpoint of trying to understand what is it as a people we struggle with and as a psychologist how do I help us," said Myers, UCLA professor of psychiatry and director of the Biobehavioral Research Center at Drew, and principal investigator of the study. "How do I contribute to possible interventions to address those needs?"
The factors that contribute to stress among African Americans range from unemployment and poverty to racism. Stress is among several factors that contribute to heart disease and hypertension, along with obesity, lack of exercise and smoking.
For all its danger, hypertension has become known as the silent killer because it often produces no symptoms.
"The African American community in this society has, in general, pressing, acute issues to deal with, and so [dealing with] a disease that's asymptomatic is easy to put off," Norris said.
Although hypertension can be treated, the medication often produces side effects, said Norris, which discourages some patients from taking their prescription drugs.
When he entered Howard University Medical School at the age of 19, Norris was not sure what his specialty would be. He was drawn to the study of kidney disorders.
Then, while he was still in training, his middle-aged parents died a year and a half apart. His mother was a schoolteacher. His father, a veterinarian, died of an aneurysm, probably brought on by hypertension.
Now a kidney specialist, Norris sees patient after patient with hypertension. For many years high blood pressure was the leading cause of kidney failure among African Americans. Although diabetes is now the leading cause, Norris said, the vast majority of people with diabetes also have hypertension.
As he advises patients and their families about the illness, Norris draws upon his personal experience.
Since the 1970s, Myers has been involved in hypertension research aimed at demonstrating the relationship between blood pressure and stress.
"Being upset and being angry and frustrated is hard on the cardiovascular system," Myers said.
This is the kind of work that he has wanted to do since he was a student. Born in Panama, Myers had seen in his family the destructive results of hypertension and heart disease.
"Both my maternal grandmother and my mom died of heart disease," he said. "My mom died relatively young. She was in her 30s."
Lessons From Classroom and Community
Myers came to the United States as a student in the 1960s, during the civil rights movement. He identified with the struggle of African Americans and said he was struck by the huge inequities between their health and that of the general population.
Early in his career he decided to merge his medical education with a concern for social justice. So he chose to undergo his training at the Central City Community Mental Health Center, at 42nd Street and Avalon Boulevard, in an African American neighborhood.
Myers said the lessons he learned on the front line of medicine in the community were as important to his education as his formal UCLA experience.
Like Norris and Haney, Myers possesses a "loaded pedigree," a greater likelihood of developing hypertension and other ailments because someone in his family has had it. That personal history has been an added impetus to his research.
"We can't change our genetic inheritance, but we can exercise control over lifestyle and other contributing factors," Myers said. "Stress becomes a target of attention."
Norris, Haney and Myers all have personal experience with meditation.
Although Myers does not meditate regularly, in the 1970s he learned transcendental meditation, also known as TM.
"It's only recently that after many years of doing research on stress and talking about different approaches to stress reduction that I began to think professionally about TM," he said.
More than 18 years ago, Haney--whose background is in health-care administration--began meditating, following a vegetarian diet and trying to convince some in his family to see the benefits. More often he was teased about it. Haney's mother and aunt eventually died three months apart, each from a stroke and an aneurysm.
In his work as project director at Drew, Haney now shares the kind of information he believes could have saved his relatives.
"If they hear one thing that they might not have heard any place else, it might be the one thing that causes them to search or that makes them more disciplined," said Haney, the study's project director. "That one thing can literally make a huge difference in their lives."
Studies examining the effect of transcendental meditation date back to the early 1970s. Maharishi University of Management, founded by practitioners of TM in Fairfield, Iowa, has played a major role in the studies and in the promotion of TM.
For the current Drew study, researchers are recruiting about 180 patients, ages 18 and over, with a history of heart disease or diabetes.
The participants will be randomly placed for a year in one of two settings: a meditation group or a health education class.
Those practicing TM are encouraged to meditate 20 minutes twice a day and are taught a mantra.
"Anyone who can think a thought can do this," Haney said. "It's really that simple."
Outside of the meetings, participants are asked to maintain a program of meditation or to incorporate dietary changes and exercise into their lifestyles.
Participants will also undergo before and after ultrasound tests to measure the amount of plaque in the carotid artery. The buildup of plaque is often a prelude to a stroke or heart attack. The results of the two groups will then be compared.
A similar Drew study focused on people with hypertension and showed that participants who studied TM experienced a decrease in blood pressure similar to that brought about by certain medications and lifestyle changes.
The current study brings together a list of experts in numerous fields, Myers said, including a cardiologist from Cedars-Sinai.
The benefits of the study may extend beyond the participants, researchers said. Stress reduction in one person can affect an entire family.
Those interested in the study may call (323) 563-4999.
Copyright 2001, Los Angeles Times