Protocol
Transcendental Meditation (TM) · secondary CVD prevention
One randomized trial in 201 Black adults with coronary heart disease (Schneider 2012; PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 23149426) reported fewer deaths, heart attacks and strokes with Transcendental Meditation than with health education (HR 0.52).
Grade C: human trials exist, but they are small, mixed or not yet repeated. This is not a finding that it does not work. How to read a grade →
At a glance
Transcendental Meditation is a form of silent meditation practiced twice a day. In one study, 201 Black adults with heart disease were followed for about 5 years. Those who meditated had fewer deaths, heart attacks and strokes than those given health classes. No one has repeated it, and a careful review read the same study as showing no clear difference.
- What was measured
- Death, heart attack and stroke combined, in adults with heart disease followed for about five years.
- How big
- Over an average of 5.4 years, the full report counts 20 deaths, heart attacks or strokes among the 99 people assigned to meditation against 32 among the 102 assigned to health education, a 48% lower risk. No one has repeated the trial.Read from the full report of PMID 23149426 (PubMed Central PMC7269100).
- Who it applies to
- 201 Black men and women with coronary heart disease, in one trial from a group tied to the organization that teaches the practice.
- Safety
- This record lists no specific safety warning for the practice.
- Compared with
- Health education classes.
- Certainty
- Grade C, resting on: Randomized controlled trial People are assigned to the treatment or a comparison by chance, so the groups differ only in what they received. It is the design that can show cause and effect..
- What would change this grade
- Could rise to B with: Randomized controlled trial against an active control, run independently of the TM organization. Who: Adults with coronary heart disease, at least 500 per arm. Measured: Death, heart attack and stroke. Length: At least 5 years.
- Cost
- No price recorded yet.
- Sources
- 3 studies cited on this record, listed under Sources.
One randomized trial in 201 Black adults with coronary heart disease (Schneider 2012; PMID 23149426) reported fewer deaths, heart attacks and strokes with Transcendental Meditation than with health education (HR 0.52). Nobody has repeated it: a 2024 Cochrane review extracts the same trial as showing no clear difference, and a later trial from the same group was null on its primary endpoint The one outcome a trial names in advance as its main test. Results on other outcomes carry less weight.. Most TM research is affiliated with Maharishi University, the organization that teaches the practice.
Why this letter
Why this gradeGrade C, small or unreplicated trials. The reasoning, and what the grade does not cover.
Grade C on death, heart attack and stroke in coronary heart disease, resting on one trial: 201 Black adults followed for a mean 5.4 years, with the composite reduced against health education (hazard ratio How often an event happened in the treated group compared with the control group over the same period. A ratio of 0.80 means 20 percent fewer events. 0.52; Schneider et al., 2012; PMID 23149426). Nobody has repeated it. A Cochrane review extracts the same trial as showing no clear difference (Rees et al., 2024; PMID 38358047), and a later trial from the same group was null on its primary endpoint The outcome a trial measures to decide whether the treatment worked, such as heart attacks, blood pressure or a symptom score. (Norris et al., 2025; PMID 40177279). Most TM research is affiliated with the organization that teaches the practice.
WHAT THIS GRADE DOES NOT COVERprimary prevention in people without heart disease, other meditation practices, and blood pressure, none of which this letter grades, and populations beyond the single trial's.
A grade describes the human evidence for a named use. It is not advice, and it is not a judgment on any individual prescription. How the letters are decided →
Who responds: this record's trial reading reports no subgroup that identifies who responds.
Evidence notes: not independently replicated The same finding reproduced by a separate research group. A result seen once can be chance or bias; a replicated one is harder to explain away., randomized trial
Endpoint graded: Death, heart attack and stroke in coronary heart disease (hard)
Last reviewed: October 2026
The trial that would change this grade.
A positive trial of this shape, supported by further trials, would move this entry to B.
Why the current trials fall short
The grade rests on one trial of 201 people, which a later systematic review A review that searches for every study on a question using a method set in advance, then assesses them together. reads as showing no clear difference, and a later trial from the same group was null. An independent replication is what is missing.
Why people believe itNo human sources; two published case reports of benefit; two reports of harm.
The case for Transcendental Meditation is that 20 minutes twice a day of repeating a mantra lowers stress hormones and blood pressure, and stress drives heart disease. In one trial of Black adults with coronary disease, those taught TM had about half the rate of death, heart attack and stroke over 5 years.
No study in people has been published, so there is no human source to list. The trial described above under Evidence wanted is what would move this letter.
A case report describes what happened to one or a few patients. It cannot show the treatment caused the change, and reports of success are published more often than reports of failure.
- Three active-duty soldiers with PTSD who practiced TM for 20 minutes twice a day for 2 months reported fewer symptoms. Three patients, with no comparison. PMID 23820361
- A report of Transcendental Meditation and high blood pressure. No abstract is indexed; the title reports the topic. PMID 18832402
- A patient developed schizophrenia after excessive unguided meditation. A meditation style not specified as TM. PMID 36316997
- A 33-year-old man developed psychosis triggered by meditation, which came back when he resumed it. A meditation style not specified as TM. PMID 34426774
Searched PubMed, October 2026: 21 case report record(s) returned. Six describe psychosis linked to intensive meditation, mostly of other styles; two are listed. Ten describe improvement with TM, in blood pressure, PTSD, epilepsy, migraine and other conditions; two are listed. Five concern other meditation methods and unrelated topics.
ClinicalTrials.gov, the public registry run by the U.S. National Library of Medicine, lists studies that are recruiting volunteers. The link below searches it for Transcendental Meditation among studies recruiting now. EBL has no relationship with any listed study and receives no payment for this link.
Search recruiting studies of Transcendental Meditation on ClinicalTrials.gov
Dose, form and timing
Resting blood pressure at baseline and every 4 weeks: the AHA-reviewed evidence showed a 5 mmHg systolic reduction in hypertensive subjects. For cardiac secondary prevention, resting heart rate and a validated stress score monthly. The protocol specifies TM practice twice daily for 20 minutes.
Safety
Harms suspected from case reports, none documented in trials. Each caution on this record, sorted by what it rests on.
None recorded.
- 2 published case reports of harm, described in the record's reports of harm (PMID 36316997 PMID 34426774)
None recorded.
None recorded.
Does not apply: human harm data are listed above.
Grade history
How this letter has changedLatest: No. 170 · October 2026 · Corrected.
The question put to the editor was whether the C should rest on independent trials only or on all of them with the investigator affiliation stated. Decided: as built. Schneider et al. (Circ Cardiovasc Qual Outcomes, 2012; PMID 23149426) and Norris et al. (Front Med (Lausanne), 2025; PMID 40177279) both count, the Maharishi affiliation of the investigators is stated in the record, and the Cochrane extraction (Rees et al., 2024; PMID 38358047) showing no clear difference stands beside the positive trial. Letter unchanged. Decided October 2026 by editor adjudication (Arnold Sandlow, D.C.).PMID 23149426 PMID 38358047 PMID 40177279
The TM record held a B on one trial, Schneider et al. (Circ Cardiovasc Qual Outcomes 2012; PMID 23149426), 201 adults with coronary heart disease. No independent trial has repeated it. The Cochrane review (Rees et al., Cochrane Database Syst Rev 2024; PMID 38358047) extracts the same trial as null, and a later trial from the same group (Norris et al., Front Med 2025; PMID 40177279) missed its primary endpoint. A single positive trial nobody has repeated is C. Editor adjudication, October 2026.PMID 23149426 PMID 38358047 PMID 40177279
Every change to a letter on this site is dated and published. The full evidence log →
Sources
- Citations
- Every paper cited on this page is matched to its PubMed record on every build.
- Retractions
- None of these papers is retracted or under a journal expression of concern. PubMed is checked again on every build.
- Read against the papers
- October 2026. By the EBL editor, Arnold Sandlow, DC.
- Outside review
- Not yet done. No reviewer outside EBL has checked this record.
What each of these checks can and cannot show: evidence integrity.
The evidence, in fullThree papers, each linked to its PubMed record.
Schneider et al. (Circ Cardiovasc Qual Outcomes, 2012; PMID 23149426): randomized trial, 201 Black adults with coronary heart disease, mean 5.4 years; composite of death, myocardial infarction and stroke reduced against health education (HR 0.52). The paper was withdrawn by another journal shortly before publication and appeared later with a different event count. Rees et al. (Cochrane Database Syst Rev, 2024; PMID 38358047): Cochrane review of meditation for cardiovascular prevention; its extraction of the same trial shows no clear difference in events. Norris et al. (Front Med (Lausanne), 2025; PMID 40177279): randomized trial from the same group; carotid intima-media thickness, the primary endpoint, did not differ, and the event result was secondary. The C counts every randomized trial, including those run through the Maharishi institute, and states the affiliation beside the evidence rather than discounting the trials; confirmed October 2026 by editor adjudication.
How EBL searched for the trials (1 search)
The search that was run, what it returned, and what was left out and why, so the absence of evidence can be checked as well as its presence.
"transcendental meditation"[tiab] AND (cardiovascular[tiab] OR coronary[tiab] OR mortality[tiab]) AND randomized controlled trial[pt]PubMed watch: does a new study change the grade? (nothing new)
No new paper matching the search behind this grade has been added to PubMed since October 2026.
Last run October 2026. A letter on EBL moves only after a logged review. A new paper never moves a letter by arriving: it is read, the answer is written here, and any change to the letter is published in the evidence log.
Disclosure
Educational use only · Not medical advice · EBL grades published human evidence and does not recommend treatment. Stopping a prescription is a decision for your physician.
Evidence Based Longevity, Inc. is owner-operated and edited by Arnold Sandlow, D.C., a California-licensed chiropractor. Evidence Based Longevity publishes in English only · Machine translations are not produced or reviewed by EBL for accuracy
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