The practice of meditation dates back as far as 5000 BC. While meditation is associated with certain philosophies and religions, today it’s practiced by people from many walks of life as a way to improve focus and relaxation, Levine and colleagues note in the Journal of the American Heart Association. The guidelines don’t address mind-body practices such as yoga and Tai Chi because the physical activity in these pursuits has been proven to help lower the risk of heart disease. Instead, the AHA focused on sitting meditation, including a variety of common forms such as: Samatha; Vipassana (Insight Meditation); Mindful Meditation; Zen Meditation (Zazen); Raja Yoga; Loving-Kindness (Metta); Transcendental Meditation; and Relaxation Response. Among other things, these inactive forms of meditation may be associated with decreased levels of stress, anxiety and depression, and improved sleep and overall wellbeing, the AHA guidelines note.

Meditation might also help lower blood pressure, but there isn’t enough evidence yet to show whether or how much blood pressure might decline for individuals. Some studies have also suggested that meditation might help people quit smoking, the guidelines conclude. Meditation may help lower the risk of heart disease by countering the impact of stress on the body, said Dr James Stahl, a researcher at the Geisel Medical School at Dartmouth College and at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire. When people are under stress, their fight or flight response can kick in, leading to a release of stress hormones as well as spikes in blood pressure, heart rate, oxygen consumption and a release of inflammatory chemicals in the body, Stahl, who wasn’t involved in the guidelines, said by email. “This is perfectly appropriate when confronted by a tiger but not so much if ordinary things like traffic trigger this response,” Stahl said.

Meditation can trigger the opposite of a fight or flight response, encouraging the body to slow down and improving risk factors for heart disease like metabolic problems or inflammation. Some patients may even be able to try meditation along with diet and lifestyle changes before they move on to drugs, Stahl said. Meditation will work best, however, if people practice with the help of a trained professional. With regular practice, meditation may also help improve quality of life, especially emotional and spiritual aspects, said Bei-Hung Chang, a researcher at the University of Massachusetts Medical School in Worcester who wasn’t involved in the guidelines. “Meditation generally has low risks, and low costs,” Chang said by email. “Once learned, the technique can be practiced anytime and in any place, and integrated into one’s way of life.”