The objective of this study was to determine the impact of stress reduction on blood pressure (BP) in adolescents by the Transcendental Meditation (TM) program. African-American adolescents (aged 16.2 +/- 1.3 years) with high normal systolic BP were randomly assigned to either 4-month TM (n = 50) or health education control (n = 50) groups. Ambulatory 24-h BP measures were recorded at pretest, 2- and 4-month post-tests, and 4-month follow-up. Greater decreases in daytime systolic BP (P < .04) and diastolic BP (P < .06) in the TM group compared with the control group across the visits demonstrate a beneficial impact of the TM program in youth at risk for the development of hypertension.