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 →
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How this letter has changedLatest: 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 The one outcome a trial names in advance as its main test. Results on other outcomes carry less weight.. A single positive trial nobody has repeated is C. Editor adjudication, October 2026.PMID 23149426 PMID 38358047 PMID 40177279
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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.
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 outcome a trial measures to decide whether the treatment worked, such as heart attacks, blood pressure or a symptom score.. Most TM research is affiliated with Maharishi University, the organization that teaches the practice.
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 (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 →
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.
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, also track resting heart rate and a validated stress score monthly. TM practice is occurring twice daily for 20 minutes as the protocol specifies.
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: July 2026
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.
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"transcendental meditation"[tiab] AND (cardiovascular[tiab] OR coronary[tiab] OR mortality[tiab]) AND randomized controlled trial[pt]Grades move when new trials publish. A free monthly email lists every grade EBL moved, with the reason and the trial behind it: the sign-up is on the Evidence Log →