Yoga--a promising technique to control cardiovascular disease

Does Self-Reported Trait Mindfulness Contribute to Reducing Perceived Stress in Women Who Practice Yoga and Are Physically Active?

(1) Background: This study aimed to investigate whether yoga practice and physical activity level play an essential role in trait mindfulness and perceived stress reduction. Moreover, the study examined the differences in trait mindfulness and perceived stress between women who practiced yoga and those who engaged in other physical activities or were physically inactive, taking into account the time spent on physical activity in accordance with the World Health Organization recommendations. (2) Methods: A sample of 201 women participated in a cross-sectional online-based study, including 96 yoga practitioners and 105 non-practitioners of yoga (including physically active and inactive individuals). The average age of the participants was 36 years (range, 18-72 years; M = 36.19, SD = 11.64). Respondents completed the Mindful Attention Awareness Scale (MAAS) and the Perceived Stress Scale (PSS-10). (3) Results: Women who practiced yoga and were physically active had a significantly higher level of trait mindfulness and lower perceived stress levels than women who did not practice yoga and were physically inactive. An indirect effect of physical activity on perceived stress through mindfulness was shown only for women practicing yoga for at least 150 min per week. (4) Conclusions: This study revealed the importance of frequent yoga practice in reducing perceived stress and improving mindfulness traits. These findings may serve as a basis for implementing preventive actions in women experiencing high levels of everyday stress.

The optimal exercise intervention for sleep quality in adults: A systematic review and network meta-analysis

BACKGROUND

The impact of various exercise modalities on the improvement of sleep quality in adults remains controversial.

OBJECTIVE

This study aimed to perform a network meta-analysis to analyze the effects of different exercise interventions on sleep quality in adults.

METHODS

The PubMed, Cochrane, Embase, Web of Science, and EBSCO databases were searched for studies published from March 18, 1993, to March 18, 2023. The Cochrane risk of bias tool was used to assess the quality of the included studies. Then, a random-effects network meta-analysis was conducted within a frequentist framework.

RESULTS

A total of 2142 participants from 27 randomized controlled trials were included in the analysis. Exercise modalities such as Pilates, yoga, and traditional Chinese exercises were found to significantly improve sleep quality when compared to a no-exercise control group, with Pilates exhibiting the most potent effect at a 95.3% improvement level.

CONCLUSION

This study demonstrates that exercise interventions are effective in enhancing sleep quality in adults. Adapting exercise to individual preferences and needs may maximize the sleep-related benefits of the activity.

REGISTRATION

The review was registered with PROSPERO, registration number CRD42023434565.

Effects of yoga on anxiety, pain, inflammatory and stress biomarkers in patients undergoing cardiac surgery: A systematic review and meta-analysis

BACKGROUND

The most common surgical method of managing coronary artery disease is coronary artery bypass grafting (CABG). Stress, anxiety, and pain are commonly identified postoperative symptoms and are closely correlated to patient recovery.

OBJECTIVE

The purpose of this review was to investigate the effects of yoga interventions on anxiety, pain, inflammatory and stress biomarkers in CABG surgery patients.

METHODS

and analysis: The databases PUBMED, The Cochrane CENTRAL, EMBASE, CINAHL, Scopus, and Web of Science were comprehensively searched from the inception to December 2022. The quantitative research studies that evaluated the effects of yoga on anxiety, pain, inflammatory and stress biomarkers in CABG patients were included. This systematic review and meta-analysis followed the Cochrane guidelines and is reported using the PRISMA checklist. The RevMan 5.4 software was used for the meta-analysis.

RESULTS

Seventeen studies met the inclusion criteria, representing 1227 patients with a mean age of 58 years. All studies have reported that yoga interventions significantly reduced anxiety, pain, inflammatory and stress biomarkers in the experimental group compared to the control group. According to the GRADE criteria, moderate quality of evidence was found on effects of yoga intervention in CABG surgery patients.

CONCLUSION

Yoga has been shown to benefit patients undergoing CABG surgery. It can be used as an adjunctive intervention. However, more rigorous randomized controlled trials are required to generate high-quality evidence for yoga interventions.

REGISTRATION

PROSPERO CRD42020175833.

Prevention and Reversal of Morbidity in Today's Cardiovascular Patient: Role of Lifestyle Modification and Nutrition in the Current Era

PURPOSE OF REVIEW

The prevalence of cardiovascular disease despite good medical therapy is on the rise, driven by risk factors such as hypertension, diabetes, hypercholesterolemia, and obesity. As healthcare providers, we must seek to better advise patients on preventative strategies through lifestyle changes.

RECENT FINDINGS

Guideline recommendations have been published by professional societies on the prevention of heart disease through lifestyle changes; however, limited education and experience with these lifestyle-modifying methods hinders appropriate counseling and treatment of patients. Robust data support the use of lifestyle medicine to reduce cardiovascular morbidity and risk. These include, a more plant-based whole food diet, regular exercise, stress relief, connectedness, and other lifestyle approaches. This review will help further the understanding of the front-line clinician in cardiovascular prevention.

Effect of traditional yoga, mindfulness-based cognitive therapy, and cognitive behavioral therapy, on health related quality of life: a randomized controlled trial on patients on sick leave because of burnout

BACKGROUND

To explore if health related quality of life(HRQoL) increased after traditional yoga(TY), mindfulness based cognitive therapy(MBCT), or cognitive behavioral therapy(CBT), in patients on sick leave because of burnout.

METHODS

Randomized controlled trial, blinded, in ninety-four primary health care patients, block randomized to TY, MBCT or CBT (active control) between September 2007 and November 2009. Patients were living in the Stockholm metropolitan area, Sweden, were aged 18-65 years and were on 50%-100% sick leave. A group treatment for 20 weeks, three hours per week, with homework four hours per week. HRQoL was measured by the SWED-QUAL questionnaire, comprising 67 items grouped into 13 subscales, each with a separate index, and scores from 0 (worse) to 100 (best). SWED-QUAL covers aspects of physical and emotional well-being, cognitive function, sleep, general health and social and sexual functioning. Statistics: Wilcoxon's rank sum and Wilcoxon's sign rank tests, Bonett-Price for medians and confidence intervals, and Cohen's D.

RESULTS

Twenty-six patients in the TY (21 women), and 27 patients in both the MBCT (24 women) and in the CBT (25 women), were analyzed. Ten subscales in TY and seven subscales in MBCT and CBT showed improvements, p < 0.05, in several of the main domains affected in burnout, e.g. emotional well-being, physical well-being, cognitive function and sleep. The median improvement ranged from 0 to 27 points in TY, from 4 to 25 points in CBT and from 0 to 25 points in MBCT. The effect size was mainly medium or large. Comparison of treatments showed no statistical differences, but better effect (small) of both TY and MBCT compared to CBT. When comparing the effect of TY and MBCT, both showed a better effect (small) in two subscales each.

CONCLUSIONS

A 20 week group treatment with TY, CBT or MBCT had equal effects on HRQoL, and particularly on main domains affected in burnout. This indicates that TY, MBCT and CBT can be used as both treatment and prevention, to improve HRQoL in patients on sick leave because of burnout, reducing the risk of future morbidity.

TRIAL REGISTRATION

July 22, 2012, retrospectively registered. ClinicalTrails.gov NCT01168661 .

FUNDING

Stockholm County Council, grant 2003-5.

Yoga-Based Postoperative Cardiac Rehabilitation Program for Improving Quality of Life and Stress Levels: Fifth-Year Follow-up through a Randomized Controlled Trial

Objectives:

This study was aimed to assess the efficacy of yoga-based lifestyle program (YLSP) in improving quality of life (QOL) and stress levels in patients after 5 years of coronary artery bypass graft (CABG).

Methodology:

Three hundred patients posted for elective CABG in Narayana Hrudayalaya Super Speciality Hospital, Bengaluru, were randomized into two groups: YLSP and conventional lifestyle program (CLSP), and follow-up was done for 5 years.

Intervention:

In YLSP group, all practices of integrative approach of yoga therapy such as yama, niyama, asana, pranayama, and meditation were used as an add-on to conventional cardiac rehabilitation. The control group (CLSP) continued conventional cardiac rehabilitation only.

Outcome Measures:

World Health Organization (WHO)-QOL BREF Questionnaire, Perceived Stress Scale, Positive and Negative Affect Scale (PANAS), and Hospital Anxiety and Depression Scale (HADS) were assessed before surgery and at the end of the 5^th year after CABG. As data were not normally distributed, Mann–Whitney U-test was used for between-group comparisons and Wilcoxon's signed-rank test was used for within-group comparisons.

Results:

At the end of 5 years, mental health (P = 0.05), perceived stress (P = 0.01), and negative affect (NA) (P = 0.05) have shown significant improvements. WHO-QOL BREF score has shown improvements in physical health (P = 0.046), environmental health (P = 0.04), perceived stress (P = 0.001), and NA (P = 0.02) in YLSP than CLSP. Positive affect has significantly improved in CLSP than YLSP. Other domains of WHO-QOL-BREF, PANAS, and HADS did not reveal any significant between-group differences.

Conclusion:

Addition of long-term YLSP to conventional cardiac rehabilitation brings better improvements in QOL and reduction in stress levels at the end of 5 years after CABG.

Medical Yoga Therapy

Medical yoga is defined as the use of yoga practices for the prevention and treatment of medical conditions. Beyond the physical elements of yoga, which are important and effective for strengthening the body, medical yoga also incorporates appropriate breathing techniques, mindfulness, and meditation in order to achieve the maximum benefits. Multiple studies have shown that yoga can positively impact the body in many ways, including helping to regulate blood glucose levels, improve musculoskeletal ailments and keeping the cardiovascular system in tune. It also has been shown to have important psychological benefits, as the practice of yoga can help to increase mental energy and positive feelings, and decrease negative feelings of aggressiveness, depression and anxiety.

History of Cardiology in India

History as a science revolves around memories, travellers' tales, fables and chroniclers' stories, gossip and trans-telephonic conversations. Medicine itself as per the puritan's definition is a non-exact science because of the probability-predictability-sensitivity-specificity factors. Howsoever, the chronicles of Cardiology in India is quite interesting and intriguing. Heart and circulation was known to humankind from pre-Vedic era. Various therapeutics measures including the role of Yoga and transcendental meditation in curing cardiovascular diseases were known in India. Only recently there has been resurgence of the same globally. There have been very few innovations in Cardiology in India. The cause of this paucity possibly lie in the limited resources. This has a vicious effect on the research mentality of the population who are busy in meeting their daily requirements. This socio-scientific aspect needs a thorough study and is beyond the scope of the present documentation. Present is the future of past and so one must not forget the history which is essentially past that give the present generation the necessary fulcrum to stand in good stead. The present article essentially aims to pay tribute to all the workers and pioneers in the field of Cardiology in India, who in spite of limited resources ventured in an unchartered arena.