Cardiometabolic, Physiological and Objective‐Sleep Responses to Transcendental Meditation: Secondary Analysis of a Randomised Controlled Trial Among University Staff

Background and Aims

Chronic stress contributes to cardiometabolic risk, and stress‐reduction interventions have been proposed to improve stress‐sensitive physiology and cardiometabolic health, though evidence remains inconsistent. This study examined the effects of a Transcendental Meditation (TM) intervention on cardiometabolic health and upstream physiological outcomes.

Methods

This two‐arm, open‐label RCT compared TM ( n  = 65) with control (access to university well‐being resource, n  = 64) among Australian university staff. Secondary outcomes included blood pressure (BP), fasting glucose, HOMA insulin resistance (IR), lipids, C‐reactive protein, salivary cortisol, heart rate variability (HRV), sympathetic arousal, and a post hoc composite cardiometabolic risk (CMR) score. Post hoc exploratory analyses tested whether burnout, sex and baseline metabolic risk moderated TM effects on HRV, total cholesterol, cortisol slope and IR. Primary analyses were intention‐to‐treat.

Results

TM was associated with a small diastolic BP reduction (−1.18 mmHg [95% CI: −2.35, −0.01], interaction p  = 0.036), with a non‐significant trend in the endpoint‐only analysis ( p  = 0.064); no other outcomes differed between groups. Burnout moderated the HRV response ( p  = 0.02), favouring higher‐burnout participants and sex moderated the cholesterol response ( p  = 0.011), with TM attenuating the control‐group rise in females, with uncertainty on LDL and HDL. Interactions for cortisol slope (by sex) and HOMA‐IR (by metabolic risk) were non‐significant; stratified comparisons suggested numerically greater improvement in TM males and higher‐risk participants, respectively. Given no multiplicity correction, all findings are hypothesis‐generating only.

Conclusion

TM was associated with small, non‐robust diastolic BP reduction with no effect on other outcomes. Burnout may modify HRV response, but this finding requires confirmation in adequately powered trials.

Trial Registration: ACTRN12625000134426