We agree with Persaud that other types of stress management techniques could also be effective. It is possible that other forms of stress reduction can elicit similar responses; however, we can only comment on TM, the form of stress reduction we tested in our trial.
We chose TM as opposed to other forms of meditation as our intervention purely for scientific reasons. An important aspect in selecting TM for the intervention was its highly protocolized nature, which enabled us to control for several factors that could potentially influence our outcomes of interest. For example, TM is taught the same exact way each time, helping to ensure uniform teaching over time, which in our case, was over a 3-year period. There is also a clearly defined way that meditation is practiced during each session, helping ensure consistency in the intervention over the 4-month period of treatment intervention. In addition, many of our participants were elderly and all had CHD, and TM allowed them to sit comfortably in chairs to meditate rather than sitting in a lotus position, for example. Finally, several forms of meditation have religious affiliations, but because TM is considered secular, we believed that it would appeal more to the population of patients from whom we would recruit.