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Yoga may improve CVD risk factors, cardiometabolic health
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Results of a new systematic review and meta-analysis suggest that yoga may improve risk factors for CVD and cardiometabolic health.
“In recent years, clinical literature has reported cardiovascular health benefits from mind-body therapies. Yoga, one type of mind-body therapy, has been increasing in popularity in the United States and in many parts of the world,” M.G. Miriam Hunink, MD, PhD, from Erasmus University Medical Center, Rotterdam, the Netherlands, and the Harvard School of Public Health, and colleagues wrote.
The most common type of yoga practiced in the United States is Hatha, which consists of a series of physical exercises focused on stretching and stimulation of the muscles and spine combined with breath control. Other research has suggested that approximately 15 million Americans reported having practiced yoga at least once, according to background information in the study.
The systematic review and meta-analysis included randomized controlled trials that examined the association between yoga and changes in levels of modifiable risk factors for CVD and metabolic syndrome. Primary outcomes included changes in BMI, systolic BP, and LDL and HDL cholesterol. Secondary outcomes included changes in body weight, diastolic BP, total cholesterol, triglycerides, fasting blood glucose, HbA1c, heart rate and smoking status.
Hunink and colleagues included 37 randomized controlled trials in the systematic review and 32 in the meta-analysis. Studies ranged from 3 to 52 weeks (median, 12 weeks). The studies included 2,768 participants (mean age, 50 years). Thirty-eight percent of the studies were conducted in healthy participants, 22% in participants with CVD risk factors, 27% in participants with diabetes or metabolic syndrome, and 13% in participants with CAD.
Compared with non-exercise controls, individuals who participated in yoga had improvements in BMI (–0.77 kg/m2; 95% CI, –1.09 to –0.44), systolic BP (–5.21 mm Hg; 95% CI, –8.01 to –2.42), LDL (–12.14 mg/dL; 95% CI, –21.8 to –2.48) and HDL (3.2 mg/dL; 95% CI, 1.86-4.54).
Yoga was associated with significant changes in body weight (–2.32 kg; 95% CI, –4.33 to –0.37), diastolic BP (–4.98 mm Hg; 95% CI, –7.17 to –2.8), total cholesterol (–18.48 mg/dL; 95% CI, –29.16 to –7.8), triglycerides (–25.89 mg/dL; 95% CI, –36.19 to –15.6) and heart rate (–5.27 beats/minute; 95% CI, –9.55 to –1).
The researchers found no association between yoga and changes in fasting blood glucose (–5.91 mg/dL; 95% CI, –16.32 to 4.5) or HbA1c (–0.06%; 95% CI, –0.24 to 0.11).
Further, the analyses yielded no significant differences between yoga and aerobic exercise, which were compared in nine studies, on any of the primary or secondary outcomes.
Only one study evaluated the effect of yoga on smoking status. Individuals who participated in yoga were more likely than controls to abstain from smoking at 8 weeks, but not at 6 months.
The physiological explanation of the beneficial effect of yoga is unclear, and “also unclear are the dose-response relationship and the relative costs and benefits of yoga when compared to exercise and medication,” Hunink said in a press release. “However, these results indicate that yoga is potentially very useful and … worth pursuing as a risk-improvement practice.”
The researchers noted that these results “should be cautiously interpreted as the [randomized controlled trials] included were of limited sample size, heterogeneous and had an unclear or high risk of bias on several domains.”
Disclosure: The researchers report no relevant financial disclosures.
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