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Joshi AM, Raveendran AV, Arumugam M. Therapeutic role of yoga in hypertension. World J Methodol 2024; 14:90127. [PMID: 38577206 PMCID: PMC10989416 DOI: 10.5662/wjm.v14.i1.90127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/19/2023] [Accepted: 01/16/2024] [Indexed: 03/07/2024] Open
Abstract
Systemic hypertension is an established risk factor for coronary artery disease and cerebrovascular accident and control of blood pressure reduces the risk of a major cardiovascular event. Both non-pharmacological and pharmacological treatment options are available to treat hypertension. Yoga, recently received more attention as a treatment modality for various lifestyle disorders, even though practiced in India since ancient times. In this review, we are analyzing the role of yoga in the treatment of systemic hypertension.
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Affiliation(s)
- Anjali Mangesh Joshi
- Department of Psycho-Oncology, HCG NCHRI Cancer Center, Nagpur 440026, Maharashtra, India
| | - Arkiath Veettil Raveendran
- Department of Internal Medicine, Former Assistant Professor of Medicine, Govt. Medical College, Kozhikode 673010, Kerala, India
| | - Muruganathan Arumugam
- Department of Internal Medicine, Past president API Past Governor American College of Physicians Past President Hypertension Society of India Past Dean Indian College of Physicians, Tirupur 641602, Tamilnadu, India
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Ahuja N, Bhardwaj P, Pathania M, Sethi D, Kumar A, Parchani A, Chandel A, Phadke A. Yoga Nidra for hypertension: A systematic review and meta-analysis. J Ayurveda Integr Med 2024; 15:100882. [PMID: 38484438 PMCID: PMC10950755 DOI: 10.1016/j.jaim.2023.100882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/05/2023] [Accepted: 12/15/2023] [Indexed: 03/24/2024] Open
Abstract
BACKGROUND Hypertension is a prevalent chronic condition that affects a substantial proportion of the world's population. Medications are commonly prescribed for hypertension management, but non-pharmacological interventions like yoga are gaining popularity. OBJECTIVE The purpose of this systematic review and meta-analysis is to assess the efficacy of Yoga Nidra (YN) for the management of hypertension. METHODS A systematic review and meta-analysis of clinical trials, i.e., non-randomized and randomized controlled trials (RCTs) was conducted to investigate the effects of YN on hypertension. PubMed, the Cochrane Library, SCOPUS, and EBSCO were searched for relevant studies published up to September 2022. The quality of the included studies was assessed using the Cochrane risk of bias tool. The primary outcome measure was the change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) after YN intervention, analyzed as weighted mean difference (WMD), in comparison to control groups. The random-effects model was used for the meta-analysis. Risk of bias was assessed for RCTs and non-RCTs using Cochrane's RoB-2 and ROBINS-I tools, respectively. RESULTS Five RCTs and three Non-RCTs involving a total of 482 participants (239 for YN vs 243 for controls) were included in this review. The meta-analysis indicated that YN significantly reduced SBP (WMD = 12.03 mm Hg, 95% CI [7.12, 16.93], Z = 4.80, p < 0.00001) and DBP (WMD = 6.32 mm Hg, 95% CI [3.53, 9.12], Z = 4.43, p < 0.00001) compared to control groups. The overall risk of bias for the three RCTs was high, whereas for the five non-RCTs, one had an overall moderate risk while the other four had an overall serious risk of bias. DISCUSSION This systematic review and meta-analysis provides evidence supporting the efficacy of YN as a complementary therapy for hypertension management. YN is a safe, cost-effective, and easily accessible intervention that primarily relies on interoception and induces a deep relaxation response in practitioners, aiding them in coping with various components of high blood pressure, such as stress, vascular inflammation, peripheral vascular resistance, etc. Our understanding of the mechanisms of YN is constantly evolving, and there is a need for further research to fully explore and appreciate the significance of this ancient science and its potential efficacy on BP. Considering the results and the multifactorial role of YN, it can act as a safe and reliable adjuvant therapy to complement the pharmacological treatment of hypertension. However, further studies with larger sample sizes, longer follow-up periods, and homogenous populations are warranted. CONCLUSION This meta-analysis suggests that YN is effective in reducing SBP and DBP, particularly in individuals with hypertension. The results highlight the potential of YN as a complementary therapy for hypertension management. Healthcare providers may consider recommending YN to patients with hypertension as an adjuvant therapy to medication. Further studies are required to identify standardized optimal forms and durations of YN best suited for hypertension management.
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Affiliation(s)
- Navdeep Ahuja
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Praag Bhardwaj
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Monika Pathania
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
| | - Dilasha Sethi
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana - SVYASA, Bangaluru, Karnataka, India
| | - Arjun Kumar
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ashwin Parchani
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Akshita Chandel
- Dept. of General Medicine, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India
| | - Aashish Phadke
- Division of Endocrine and Metabolic Disorders - Lifestyle Modulations and Yoga Modules, Kasturba Health Society - Medical Research Centre, Mumbai, Maharashtra, India
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Garg P, Mendiratta A, Banga A, Bucharles A, Victoria P, Kamaraj B, Qasba RK, Bansal V, Thimmapuram J, Pargament R, Kashyap R. Effect of breathing exercises on blood pressure and heart rate: A systematic review and meta-analysis. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2024; 20:200232. [PMID: 38179185 PMCID: PMC10765252 DOI: 10.1016/j.ijcrp.2023.200232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/20/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024]
Abstract
Background Breathing exercises have been reported to have positive physiological effects on the body. The incidence of hypertension has become a major risk factor for cardiac complications leading to higher morbidity and mortality. Our aim was to conduct a systematic review and meta-analysis to study the effect of breathing exercises on blood pressure (BP) and heart rate (HR). Methods A systematic review and meta-analysis analyzing randomized clinical trials (RCTs) about the effect of breathing exercises on blood pressure was conducted (PROSPERO Registration ID: CRD42022316413). PubMed, ScienceDirect, WebofScience, and Cochrane Library databases were screened for RCTs from January 2017 to September 2022. The main search terms included "breathing exercise", "Pranayam", "Bhramari", "alternate nostril breathing", "deep breathing", "slow breathing", "hypertension", and "high blood pressure". The primary outcome was the value of the systolic blood pressure and diastolic blood pressure after the intervention. The effect on heart rate was also analyzed as a secondary outcome. Results A total of 15 studies were included in the meta-analysis. Breathing exercises have a modest but significant effect on decreasing systolic blood pressure (-7.06 [-10.20, -3.92], P = <0.01) and diastolic blood pressure (-3.43 [-4.89, -1.97], P = <0.01) mm Hg. Additionally, breathing exercises were also observed to cause a significant decrease in the heart rate (-2.41 [-4.53, -0.30], P = 0.03) beats/minute. Conclusion In a comprehensive systematic review and meta-analysis of breathing exercises and its effect on BP and HR, there is a moderate but significant positive effect. The studies are not deprived of bias.
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Affiliation(s)
- Piyush Garg
- Medanta-The Medicity, Gurgaon, HR, India
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
| | - Ayushi Mendiratta
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
- Parkview Health System, USA
| | - Akshat Banga
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
- Sawai Man Singh Medical College, Jaipur, RJ, India
| | - Anna Bucharles
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
- Universidade Positivo, Curitiba, Brazil
| | - Piccoli Victoria
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
- Universidade Positivo, Curitiba, Brazil
| | - Balakrishnan Kamaraj
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
- Madurai Medical College, Madurai, TN, India
| | - Rakhtan K. Qasba
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
- Green Life Medical College and Hospital, Dhaka, Bangladesh
| | - Vikas Bansal
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
- Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | - Rahul Kashyap
- Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, MA, USA
- Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
- Medical Director, Research, WellSpan Health, York, PA, USA
- GCSRT, Harvard Medical School, Boston, MA, USA
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Cota E Souza LA, Gouvea TM, Fernandes FC, Carrillo MRGG, Veloso VM, Santos Filho AF, Lima AA. Yoga practice can reduce metabolic syndrome and cardiovascular risk in climacteric women. J Behav Med 2024; 47:94-101. [PMID: 37294473 DOI: 10.1007/s10865-023-00420-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 03/20/2023] [Indexed: 06/10/2023]
Abstract
To evaluate the effect of yoga on the frequency of MetS and its impact on cardiovascular risk markers in climacteric women. We recruited 84 sedentary women between 40 and 65 years diagnosed with MetS. Participants were randomly assigned to a 24-week yoga intervention or control group. We evaluated the frequency of MetS and changes in the individual components of MetS at baseline and after 24 weeks. We also assessed the impact of yoga practices on cardiovascular risk through the following markers: High-sensitivity C-reactive Protein (hs-CRP), Lipid Accumulation Product (LAP), Visceral Adiposity Index (VAI), and Atherogenic Index of Plasma (AIP). The frequency of MetS reduced significantly after 24 weeks of yoga practice (- 34.1%; p < 0.001). Statistical analysis showed that the frequency of MetS was significantly lower in the yoga group (65.9%; n = 27) than in the control group (93.0%; n = 40) after 24 weeks (p = 0.002). Regarding the individual components of MetS, yoga practitioners had statistically lower waist circumference, systolic blood pressure, triglycerides, HDLc, and glucose serum concentrations than the control group after 24 weeks. Yoga practitioners also had a significant decrease in hs-CRP serum concentrations (3.27 ± 2.95 mg/L vs. 2.52 ± 2.14 mg/L; p = 0.040) and a lower frequency of moderate or high cardiovascular risk (48.8% vs. 34.1%; p = 0.001) after 24 weeks of practice. The yoga group had LAP values significantly lower than the control group after the intervention period (55.8 ± 38.04 vs. 73.9 ± 40.7; p = 0.039). Yoga practice demonstrated to be an effective therapeutic to manage MetS and reduce cardiovascular risk in climacteric women.
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Affiliation(s)
- Laura Alves Cota E Souza
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Brazil.
| | - Thiago Magalhães Gouvea
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Francielle Caroline Fernandes
- Departamento de Análises Clínicas (DEACL), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | | | - Vanja Maria Veloso
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
- Departamento de Farmácia (DEFAR), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | | | - Angélica Alves Lima
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
- Departamento de Análises Clínicas (DEACL), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
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Martín-Riobóo E, Turégano-Yedro M, Banegas JR. Evidence on the use of alternative substances and therapies in hypertension. HIPERTENSION Y RIESGO VASCULAR 2024; 41:40-57. [PMID: 38123388 DOI: 10.1016/j.hipert.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Review of some of the best-known biological and non-biological complementary/alternative therapies/medicines (CAM) and their relationship with blood pressure (BP) and hypertension (HT). SEARCH STRATEGY Narrative review assessing a recent series of systematic reviews, meta-analyses, and clinical trials published in recent years, focusing on the effects of CAM on BP and HT. SELECTION OF STUDIES We searched EMBASE, MEDLINE, Cochrane Library and Google Scholar, obtaining a total of 4336 articles, finally limiting the search to 181 after applying filters. SYNTHESIS OF RESULTS Some studies on biological therapies show some usefulness in BP reduction with an adequate benefit-risk balance, although there is a scarcity of high-quality trials that support these results. Some mind-body therapies have shown hypothetical benefit; in contrast, others lack robust evidence. CONCLUSIONS Although some therapies present a reasonable risk-benefit ratio, they should in no case replace pharmacological treatment when indicated.
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Affiliation(s)
- E Martín-Riobóo
- Especialista en Medicina Familiar y Comunitaria, UGC Poniente, Distrito Sanitario Córdoba-Guadalquivir, Córdoba, IMIBIC, Hospital Reina Sofía Córdoba, Spain.
| | - M Turégano-Yedro
- Especialista en Medicina Familiar y Comunitaria, Centro de Salud Casar de Cáceres, Cáceres, Spain
| | - J R Banegas
- Especialista en Medicina Preventiva y Salud Pública, Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz y CIBERESP, Madrid, Spain
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6
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Nalbant G, Hassanein ZM, Lewis S, Chattopadhyay K. Delivering yoga to people with hypertension in the UK: A qualitative study to explore yoga providers' knowledge, experiences, and attitudes. Health Sci Rep 2023; 6:e1260. [PMID: 37197088 PMCID: PMC10184140 DOI: 10.1002/hsr2.1260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/05/2023] [Accepted: 04/25/2023] [Indexed: 05/19/2023] Open
Abstract
Background and Aims Yoga has become increasingly popular in the world and the UK for improving health and well-being. A growing body of research suggests that yoga could be used to improve the management of hypertension in addition to current management strategies. Previous cross-sectional studies have also reported that hypertension is one of the most commonly disclosed health conditions in yoga sessions in the United Kingdom. Therefore, semi-structured qualitative interviews were conducted with yoga providers in the United Kingdom (n = 19) to explore their knowledge, experiences, and attitudes toward delivering yoga to people with hypertension. Methods Interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Results Eight themes were identified. Yoga providers were generally aware of the health conditions of their attendees, and they had a reasonable knowledge of the causes, signs and symptoms, and management of hypertension. While most had received some information about hypertension as part of their initial yoga teaching training, this was generally felt to be limited. They mentioned the biopsychosocial benefits of yoga on hypertension but also expressed their concerns about the lack of regulation, the wide disparity in what is being delivered under the label of yoga, and the competency of some yoga providers. Conclusion The findings suggest that yoga provision in the United Kingdom should be regulated with a better link with health service providers. A manual and training for yoga providers in the United Kingdom for managing hypertension using yoga would be helpful to address the training needs of yoga providers. However, there is a need for more robust studies before recommending the implementation of yoga in the management of hypertension in the United Kingdom.
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Affiliation(s)
- Gamze Nalbant
- Lifespan and Population Health Academic Unit, School of MedicineUniversity of NottinghamNottinghamUK
| | - Zeinab M. Hassanein
- Lifespan and Population Health Academic Unit, School of MedicineUniversity of NottinghamNottinghamUK
| | - Sarah Lewis
- Lifespan and Population Health Academic Unit, School of MedicineUniversity of NottinghamNottinghamUK
| | - Kaushik Chattopadhyay
- Lifespan and Population Health Academic Unit, School of MedicineUniversity of NottinghamNottinghamUK
- The Nottingham Centre for Evidence‐Based Healthcare: A JBI Centre of ExcellenceNottinghamUK
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Pal R, Adhikari D, Heyat MBB, Ullah I, You Z. Yoga Meets Intelligent Internet of Things: Recent Challenges and Future Directions. Bioengineering (Basel) 2023; 10:459. [PMID: 37106646 PMCID: PMC10135646 DOI: 10.3390/bioengineering10040459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/30/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
The physical and mental health of people can be enhanced through yoga, an excellent form of exercise. As part of the breathing procedure, yoga involves stretching the body organs. The guidance and monitoring of yoga are crucial to ripe the full benefits of it, as wrong postures possess multiple antagonistic effects, including physical hazards and stroke. The detection and monitoring of the yoga postures are possible with the Intelligent Internet of Things (IIoT), which is the integration of intelligent approaches (machine learning) and the Internet of Things (IoT). Considering the increment in yoga practitioners in recent years, the integration of IIoT and yoga has led to the successful implementation of IIoT-based yoga training systems. This paper provides a comprehensive survey on integrating yoga with IIoT. The paper also discusses the multiple types of yoga and the procedure for the detection of yoga using IIoT. Additionally, this paper highlights various applications of yoga, safety measures, various challenges, and future directions. This survey provides the latest developments and findings on yoga and its integration with IIoT.
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Affiliation(s)
- Rishi Pal
- Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Deepak Adhikari
- School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu 610056, China
| | - Md Belal Bin Heyat
- IoT Research Center, College of Computer Science and Software Engineering, Shenzhen University, Shenzhen 518060, China
| | - Inam Ullah
- Department of Computer Engineering, Gachon University, Sujeong-gu, Seongnam 13120, Republic of Korea
| | - Zili You
- Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
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Tsoi K, Lam A, Tran J, Hao Z, Yiu K, Chia YC, Turana Y, Siddique S, Zhang Y, Cheng HM, Wang JG, Kario K. The Western and Chinese exercise training for blood pressure reduction among hypertensive patients: An overview of systematic reviews. J Clin Hypertens (Greenwich) 2023. [PMID: 36946438 DOI: 10.1111/jch.14610] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/07/2022] [Accepted: 11/05/2022] [Indexed: 03/23/2023]
Abstract
Hypertension remains the world's leading cause of premature death. Interventions such as exercise, diet modification, and pharmacological therapy remain the mainstay of hypertension treatment. Numerous systematic reviews and meta-analyses demonstrated the effectiveness of western exercises, such as aerobic exercise and resistance exercise, in reducing blood pressure in hypertensive patients. There is recently emerging evidence of blood pressure reduction with Chinese exercises, such as Tai Chi, Baduanjin, and Qigong. The current overview of systematic reviews aims to evaluate the quality and descriptively summarize the evidence for the effectiveness of western and Chinese exercises for hypertension management. Thirty-nine systematic reviews were included in this overview, with 15 of those being on Chinese exercise. Evidence suggests that exercise training, regardless of Western or Chinese exercise, generally reduced both systolic and diastolic blood pressure. High-intensity intermittent training did not further reduce blood pressure when compared to moderate-intensity continuous training. Conflicting results on the effectiveness of blood pressure reduction when comparing Chinese and Western exercise training were observed. This suggests the comparable effectiveness of Chinese exercise training, in particularly Tai Chi, to general or aerobic exercise training in terms of blood pressure reduction. The Chinese exercise modality and intensity may be more suitable for the middle-aged and elderly population.
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Affiliation(s)
- Kelvin Tsoi
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Amy Lam
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Joshua Tran
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ziyu Hao
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Karen Yiu
- Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Yook-Chin Chia
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Bandar Sunway, Malaysia
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yuda Turana
- Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | | | - Yuqing Zhang
- Divisions of Hypertension and Heart Failure, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao-Min Cheng
- Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Ph.D. Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
- Institute of Public Health, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
- Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
| | - Ji-Guang Wang
- Department of Cardiovascular Medicine, the Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, State Key Laboratory of Medical Genomics, National Research Centre for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
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Welford P, Östh J, Hoy S, Rossell SL, Pascoe M, Diwan V, Hallgren M. Effects of Yoga and Aerobic Exercise on Verbal Fluency in Physically Inactive Older Adults: Randomized Controlled Trial (FitForAge). Clin Interv Aging 2023; 18:533-545. [PMID: 37021083 PMCID: PMC10069432 DOI: 10.2147/cia.s359185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/20/2022] [Indexed: 03/31/2023] Open
Abstract
Purpose To compare the effects on verbal fluency of a supported yoga-based exercise intervention to an aerobic exercise intervention and a wait-list control group. Participants and Methods Eighty-two physically-inactive but otherwise healthy adults (mean age 72.5 years, range 65-85, 77% female) were recruited into a 12-week, three-group, parallel randomized controlled trial. Participants were supported to complete ≥3 Hatha yoga classes per/week or ≥3 structured aerobic exercise sessions/week. A wait-list control group continued usual daily activities only. Verbal fluency, including total-FAS, animals, and verbs, was assessed before and after interventions. Group effects were assessed using analysis of covariance (ANCOVA). Results Twenty-seven participants were randomized to yoga, 29 to aerobic exercise and 26 to a waitlist. At 12-week follow-up, compared to baseline, there were increases in mean total-FAS in the yoga (+5.0 words, p=0.002) and aerobic exercise groups (+6.6 words, p=0.004). Mean total-FAS in the wait-list control group remained stable (-0.5 words, p=0.838). There were medium-magnitude estimated treatment effects on total-FAS for yoga versus wait-list control and aerobic exercise versus wait-list control: Hedges' g=0.51 (p=0.213) and 0.57 (p=0.098) respectively. In addition, small-to-medium magnitude estimated treatment effects were seen on animals and verbs for yoga versus wait-list control and aerobic exercise versus wait-list control: g=0.28 (p=0.155), 0.19 (p=0.766) and 0.50 (p=0.085), 0.59 (p=0.233) respectively. Conclusion Participation in yoga or aerobic exercise was associated with estimated improvements in verbal fluency compared to a non-active control group. Yoga and aerobic exercise may be promising approaches by which to promote cognitive function among older adults. Trial Registration DRKS00015093, U1111-1217-4248.
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Affiliation(s)
- Paul Welford
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Josefine Östh
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Sara Hoy
- Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden
| | - Susan L Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Victoria, Australia
| | - Michaela Pascoe
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Vinod Diwan
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Mats Hallgren
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Correspondence: Mats Hallgren, Department of Global Public Health, Karolinska Institutet, Level 6, 1e Solnavägen, Solna, 11365, Sweden, Tel +46852480000, Email
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Isath A, Kanwal A, Virk HUH, Bandyopadhyay D, Wang Z, Kumar A, Kalra A, Naidu SS, Lavie CJ, Virani SS, Krittanawong C. The Effect of Yoga on Cardiovascular Disease Risk Factors: A Meta-Analysis. Curr Probl Cardiol 2023; 48:101593. [PMID: 36681213 DOI: 10.1016/j.cpcardiol.2023.101593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/12/2023] [Indexed: 01/20/2023]
Abstract
Yoga has been increasingly popular yet has shown inconsistent benefits on cardiovascular disease (CVD) risk factors. We aimed to systematically analyze the effect of yoga on modifiable CVD risk factors. We systematically searched Ovid MEDLINE, Ovid Embase, Ovid Cochrane Database of Systematic Reviews, Scopus, and Web of Science from database inception in 1966 through June 2022 for studies evaluating the association between yoga and blood pressure, lipid profile, HbA1c and body mass index (BMI). Two investigators independently reviewed data. Conflicts were resolved through consensus. Random-effects meta-analyses were used. 64 RCTs including a total of 16,797 participants were eligible for inclusion in the meta-analysis. Yoga therapy improved both systolic as well as diastolic blood pressure (weight mean difference [WMD] (95% Confidence interval [CI]) of -4.56 [-6.37, -2.75] mm Hg, WMD [95% CI] - 3.39 [-5.01, -1.76] mm Hg respectively). There was also an improvement in BMI as well as hemoglobin A1c (HbA1c) (WMD [95% CI] of -0.57 [-1.05, -0.10] kg/m2, WMD [95% CI] of -0.14 [-0.24, -0.030] mmol/L respectively) . In addition, all parameters of the lipid profile, including low-density lipoprotein cholesterol (LDL-C) showed a significant improvement with yoga therapy (WMD [95% CI] -7.59 [-12.23, -2.95] mg/dL for LDL-C). Yoga has a modest yet positive effect on blood pressure, BMI, lipid profile and HbA1c and, therefore, may play an ancillary role in primary prevention of CVD.
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Affiliation(s)
- Ameesh Isath
- Department of Cardiology, Westchester Medical Centre, New York Medical College, Valhalla, NY
| | - Arjun Kanwal
- Department of Cardiology, Westchester Medical Centre, New York Medical College, Valhalla, NY
| | - Hafeez Ul Hassan Virk
- Harrington Heart & Vascular Institute, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, OH
| | | | - Zhen Wang
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Ashish Kumar
- Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH
| | - Ankur Kalra
- Division of Cardiovascular Medicine, Krannert Cardiovascular Research Center Indiana University School of Medicine, Indianapolis, IN
| | - Srihari S Naidu
- Department of Cardiology, Westchester Medical Centre, New York Medical College, Valhalla, NY
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA
| | - Salim S Virani
- Section of Cardiology, Baylor College of Medicine, Michael E. DeBakey Veterans Affairs Medical Center Houston, TX
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11
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Alves AJ, Wu Y, Lopes S, Ribeiro F, Pescatello LS. Exercise to Treat Hypertension: Late Breaking News on Exercise Prescriptions That FITT. Curr Sports Med Rep 2022; 21:280-288. [PMID: 35946847 DOI: 10.1249/jsr.0000000000000983] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Hypertension is the leading risk factor for cardiovascular disease and an independent predictor of mortality. The prevalence of hypertension has doubled in the last two decades and evidence suggests that almost half the individuals are unaware of their condition. The antihypertensive effects of exercise are now undisputable, and exercise training is recommended by the major professional and scientific societies, including the American College of Sports Medicine (ACSM), as first-line treatment to prevent, treat, and control hypertension. This review aims to overview the evidence supporting the current ACSM Frequency, Intensity, Time, and Type exercise recommendations for hypertension, discuss new and emerging evidence on exercise in the treatment of hypertension from our laboratories; and propose future directions of research integrating this new and emerging evidence.
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Affiliation(s)
- Alberto J Alves
- Research Center in Sports Sciences, Health and Human Development (CIDESD), University of Maia, Maia, Porto, PORTUGAL
| | - Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT
| | - Susana Lopes
- Institute of Biomedicine, (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Porto, PORTUGAL
| | - Fernando Ribeiro
- Institute of Biomedicine, (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Porto, PORTUGAL
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12
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Amitani M, Amitani H, Owaki T, Monuki T, Adachi S, Kawazu S, Fukumoto T, Suzuki H, Yoshimura T, Mizuma K, Nishida Y, Watanabe H, Hirose M, Funakoshi K, Ota K, Murotani K, Asakawa A. The Effect of Mindfulness Yoga in Children With School Refusal: A Study Protocol for an Exploratory, Cluster-Randomized, Open, Standard Care-Controlled, Multicenter Clinical Trial. Front Public Health 2022; 10:881303. [PMID: 35910937 PMCID: PMC9325992 DOI: 10.3389/fpubh.2022.881303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background School refusal occurs in about 1–2% of young people. Anxiety and depression are considered to be the most common emotional difficulties for children who do not attend school. However, at present, no definitive treatment has been established for school refusal, although interventions such as cognitive behavioral therapy have been used. This paper reports a protocol for a cluster-randomized controlled trial of a mindfulness yoga intervention for children with school refusal. Methods This study is a multicenter, exploratory, open cluster-randomized controlled trial. This study will recruit children aged 10–15 years with school refusal. After a 2-week baseline, participants for each cluster will be randomly assigned to one of two groups: with or without mindfulness yoga for 4 weeks. Mindfulness yoga will be created for schoolchildren for this protocol and distributed to the participants on DVD. The primary outcome is anxiety among children with school refusal using the Spence Children's Anxiety Scale-Children. Discussion For this study, we developed a mindfulness yoga program and protocol, and examine whether mindfulness yoga can improve anxiety in children with school refusal. Our mindfulness yoga program was developed based on the opinions of children of the same age, and is a program that children can continue to do every day without getting bored. In this way, we believe that we can contribute to the smooth implementation of support to reduce the anxiety of children with school refusal, and to the reduction of the number of children who refuse to go to school.
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Affiliation(s)
- Marie Amitani
- Education Center for Doctors in Remote Islands and Rural Areas, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
- Division of Community-Based Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
- *Correspondence: Marie Amitani
| | - Haruka Amitani
- Division of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Tetsuhiro Owaki
- Education Center for Doctors in Remote Islands and Rural Areas, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
- Division of Community-Based Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takako Monuki
- Multidisciplinary Pain Center, Kyushu University Hospital, Fukuoka, Japan
| | - Satomi Adachi
- Division of Community-Based Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Suguru Kawazu
- Division of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takamasa Fukumoto
- Division of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hajime Suzuki
- Division of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takuya Yoshimura
- Division of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kimiko Mizuma
- Education Center for Doctors in Remote Islands and Rural Areas, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yuko Nishida
- Division of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hiroko Watanabe
- Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
| | - Masayuki Hirose
- Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
| | - Kouta Funakoshi
- Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
| | - Keiko Ota
- Center for Clinical Research and Innovation, Osaka City University Hospital, Osaka, Japan
| | | | - Akihiro Asakawa
- Division of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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13
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Souza LACE, Lima AA. Anthropometric, biochemical and clinical parameters in climacteric yoga practitioners. Climacteric 2022; 25:293-299. [PMID: 34423699 DOI: 10.1080/13697137.2021.1965115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/18/2021] [Accepted: 07/25/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This study aimed to evaluate anthropometric, biochemical and clinical parameters in climacteric yoga practitioners. METHODS This study investigated 108 climacteric women. We recruited 28 women between 40 and 65 years old who started yoga practices in premenopause and had already practiced for at least 5 years. As controls, we selected 30 physical activity (PA) practitioners who had practiced for at least 5 years and 50 sedentary women in the same age range. We conduced anthropometric, biochemical and blood pressure measurements. RESULTS The yoga group had significantly lower fasting blood glucose than the PA practitioners and sedentary women. Yoga practitioners also had lower weight, body mass index, waist circumference, body fat percentage and waist-to-height ratio; higher levels of high-density lipoprotein cholesterol; lower levels of triglycerides, insulin, Homeostasis Model Assessment of Insulin Resistance, uric acid, apolipoprotein B and high-sensitivity C-reactive protein; and lower frequency of metabolic syndrome, lipid accumulation product, visceral adiposity index and systolic blood pressure than the sedentary women. CONCLUSION Yoga practitioners had lower glucose serum concentrations than the PA practitioners and sedentary women. Overall, the yoga group also had better anthropometric, biochemical and clinical variables than the other groups. Although further investigation is required, yoga practice in premenopause seems to be beneficial for women when they reach menopause.
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Affiliation(s)
- L A Cota E Souza
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - A A Lima
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
- Departamento de Análises Clínicas (DEACL), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
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14
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Nalbant G, Hassanein ZM, Lewis S, Chattopadhyay K. Content, Structure, and Delivery Characteristics of Yoga Interventions for Managing Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Public Health 2022; 10:846231. [PMID: 35419342 PMCID: PMC8995771 DOI: 10.3389/fpubh.2022.846231] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/28/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives This systematic review aimed to synthesize the content, structure, and delivery characteristics of effective yoga interventions used for managing hypertension and to compare these characteristics with ineffective interventions. Design and Method The JBI and the PRISMA guidelines were followed in this systematic review. RCTs conducted among hypertensive adults were included. RCTs reporting at least one of the major components of yoga (i.e., asana, pranayama, and dhyana and relaxation practices) and comparing them with no intervention or any intervention were eligible. Sixteen databases were searched for published and unpublished studies without any date and language restrictions till March 15, 2021. Results The literature search yielded 13,130 records. 34 RCTs (evaluating 38 yoga interventions) met the inclusion criteria. Overall, included studies had low methodological quality mostly due to inadequate reporting. Yoga reduced SBP and DBP compared to a control intervention (MD -6.49 and -2.78; 95CI% -8.94- -4.04 and -4.11- -1.45, respectively). Eighteen, 14 and 20 interventions were effective in improving SBP, DBP, or either, respectively. 13 out of 20 effective interventions incorporated all the 3 major components of yoga and allocated similar durations to each component whereas ineffective interventions were more focused on the asana and duration of asana practice was longer. The most common duration and frequency of effective interventions were 45 min/session (in 5 interventions), 7 days/week (in 5 interventions), and 12 weeks (in 11 interventions) whereas the most common session frequency was 2 days a week (in 7 interventions) in ineffective interventions. Effective interventions were mostly center-based (in 15 interventions) and supervised (in 16 interventions) and this was similar with ineffective interventions. Conclusion Despite the low quality and heterogeneity of included studies, our findings suggest yoga interventions may effectively manage hypertension. The differences between the effective and ineffective interventions suggest that effective yoga interventions mostly incorporated asana, pranayama, and dhyana and relaxation practices and they had a balance between these three components and included regular practice. They were mostly delivered in a center and under supervision. Future studies should consider developing and evaluating an intervention for managing hypertension using the synthesized findings of the effective interventions in this review. Systematic Review Registration [PROSPERO], identifier [CRD42019139404].
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Affiliation(s)
- Gamze Nalbant
- Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,The Nottingham Centre for Evidence-Based Healthcare, A JBI Centre of Excellence, Nottingham, United Kingdom
| | - Zeinab M Hassanein
- Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,The Nottingham Centre for Evidence-Based Healthcare, A JBI Centre of Excellence, Nottingham, United Kingdom
| | - Sarah Lewis
- Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Kaushik Chattopadhyay
- Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,The Nottingham Centre for Evidence-Based Healthcare, A JBI Centre of Excellence, Nottingham, United Kingdom
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15
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Welford P, Östh J, Hoy S, Diwan V, Hallgren M. Effects of yoga and aerobic exercise on wellbeing in physically inactive older adults: randomized controlled trial (FitForAge). Complement Ther Med 2022; 66:102815. [PMID: 35143970 DOI: 10.1016/j.ctim.2022.102815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/10/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To compare the effects of yoga and aerobic exercise (AE) on wellbeing in physically inactive, but otherwise healthy older adults. A secondary objective was to assess and compare the frequency of adverse events associated with yoga and AE. DESIGN Twelve-week, three-group, parallel randomized controlled trial with blinded follow-up assessment. INTERVENTIONS Participants were supported to complete ≥3 Hatha yoga classes/week or ≥3 AE sessions/week. A wait-list control (WLC) group continued usual daily activities. MAIN OUTCOME MEASURE Change in wellbeing, assessed using the Satisfaction with Life Scale (SWLS) and Life Satisfaction Index-Z (LSI),at baseline and at 12-week follow up. RESULTS In total, 82 adults (mean age 72.5 years, range 65-85, 77% female) were recruited. Of these, 27 were randomized to yoga, 29 to aerobic exercise and 26 to wait-list control. Medium-magnitude treatment effects (Hedges' g) were seen for yoga versus WLC and AE versus WLC(SWLS, g = 0.65 and 0.56; LSI, g = 0.54 and 0.54, respectively). In per-protocol analyses, larger effect sizes were found (SWLS, g = 0.72 and 0.66; LSI, g = 0.76 and 0.76, respectively). Adverse events were less frequent in the yoga group (6/27; 22%) compared to AE (10/27; 37%). CONCLUSIONS Among physically inactive older adults, participation in yoga or AE was associated with beneficial effects on subjective wellbeing when compared to a non-active control group. Yoga was associated with fewer injuries and may be especially suitable for older adults (DRKS 00015093).
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Affiliation(s)
- Paul Welford
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Josefine Östh
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Sara Hoy
- Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden
| | - Vinod Diwan
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Mats Hallgren
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden.
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16
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Kohl-Heckl WK, Schröter M, Cramer H. Complementary medicine use in US adults with hypertension: a nationally representative survey. Complement Ther Med 2022; 65:102812. [DOI: 10.1016/j.ctim.2022.102812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 11/29/2022] Open
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17
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The Effect of Behavioral Changes on the Treatment of Hypertension. Curr Hypertens Rep 2021; 23:43. [PMID: 34820738 DOI: 10.1007/s11906-021-01164-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE OF REVIEW Hypertension is one of the leading causes of preventable premature death. RECENT FINDINGS Strongly advocating for lifestyle changes to improve blood pressure control is of paramount importance in the successful management of hypertension. In this review, we will discuss the effect of various behavioral and lifestyle changes and review the evidence to support these changes to improve blood pressure control. These include dietary modifications, alcohol consumption, weight loss, various types of exercise, device-guided breathing, relaxation, and biofeedback techniques.
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18
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Khanthong P, Natason A, Dechakhamphu A. Benefit of Ruesi Dadton on Oxidative Stress and Physical Performance: Quasi-Experimental Study. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021. [DOI: 10.1080/02703181.2021.1980480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Phaksachiphon Khanthong
- Faculty of Thai Traditional and Alternative Medicine, Ubon Ratchathani Rajabhat University, Ubon Ratchathani, Thailand
| | - Amornrat Natason
- Faculty of Nursing, Ubon Ratchathani University, Ubon Ratchathani, Thailand
| | - Ananya Dechakhamphu
- Faculty of Thai Traditional and Alternative Medicine, Ubon Ratchathani Rajabhat University, Ubon Ratchathani, Thailand
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19
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A Randomized Controlled Trial on the Efficacy of Integrated Yoga on Pregnancy Outcome. Holist Nurs Pract 2021; 35:273-280. [PMID: 34407025 DOI: 10.1097/hnp.0000000000000472] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Physiological and biochemical changes occur in pregnancy to nurture the developing fetus. Pregnancy-related experience is unique to every woman. Pregnancy symptoms and complications can range from mild to severe. Many women can lower their risk by performing different therapies. In this context, the present study targets to evaluate the efficacy of integrated yoga consisting of (asanas and pranayama) on pregnancy to reduce the risk of complications. This study is a prospective randomized controlled single-blinded trial with parallel arms: the intervention arm received specific integrated yoga therapy; the control arm received routine standard care from 18 to 22 weeks of gestation until delivery. The incidence of preeclampsia and preterm delivery was lower in the intervention arm. Women in the intervention arm delivered at higher gestational age. Apgar scores and birth weights of neonates were significantly higher in the intervention arm. The findings suggest that yoga is a safe and effective intervention during pregnancy to reduce or prevent pregnancy-related complications. However, further randomized controlled trials are needed to provide firmer evidence regarding the utility and validity of yoga intervention during pregnancy.
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20
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Zhang Y, Lauche R, Cramer H, Munk N, Dennis JA. Increasing Trend of Yoga Practice Among U.S. Adults From 2002 to 2017. J Altern Complement Med 2021; 27:778-785. [PMID: 34076530 DOI: 10.1089/acm.2020.0506] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Benefits, risks, and the increasing popularity of yoga use warrant assessing yoga practice prevalence and users' profiles. This study describes trends in yoga practice exclusively among American adults from 2002 to 2017, compares the profile of yoga users, and identifies factors related to yoga use over time. Materials and Methods: This study is a secondary analysis done in 2019 and 2020 using the National Health Interview Survey (NHIS) 2002, 2007, 2012, and 2017 data. Population weights were used to obtain statistically accurate estimates of yoga use prevalence for the U.S. population. Descriptive statistics were used to profile the sociodemographic and health-related characteristics of yoga users. Multivariable logistic regression was used to identify factors associated with yoga use in each cohort defined by the NHIS year. Results: Yoga practice prevalence nearly tripled from 5.1% in 2002 to 13.7% in 2017 (weighted estimate 10,386,456 and 32,761,194 American adults, respectively). Typical yoga users were young non-Hispanic single white female adults with bachelor or higher education and health insurance, and resided in the west region of the United States. Yoga use pattern change over time was significantly related to only younger age (p < 0.001) but not to other sociodemographic or health-related factors. Conclusions: Yoga has gained increasing popularity in the past two decades among American adults, with younger adults being the driving force. Yoga appears to be adopted for general well-being or prevention more than for specific disease treatment. Future research should evaluate how yoga can be effectively and safely integrated into preventive medicine strategies.
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Affiliation(s)
- Yan Zhang
- Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX, USA.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, NSW, Australia
| | - Romy Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, NSW, Australia.,National Centre for Naturopathic Medicine (NCNM), Southern Cross University, Lismore, NSW, Australia
| | - Holger Cramer
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, NSW, Australia.,National Centre for Naturopathic Medicine (NCNM), Southern Cross University, Lismore, NSW, Australia.,Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
| | - Niki Munk
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, NSW, Australia.,National Centre for Naturopathic Medicine (NCNM), Southern Cross University, Lismore, NSW, Australia.,Department of Health Sciences, Indiana University School of Health and Human Sciences, Indianapolis, IN, USA
| | - Jeff A Dennis
- Department of Public Health, Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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21
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Dhungana RR, Pedisic Z, Joshi S, Khanal MK, Kalauni OP, Shakya A, Bhurtel V, Panthi S, Ramesh Kumar KC, Ghimire B, Pandey AR, Bista B, Khatiwoda SR, McLachlan CS, Neupane D, de Courten M. Effects of a health worker-led 3-month yoga intervention on blood pressure of hypertensive patients: a randomised controlled multicentre trial in the primary care setting. BMC Public Health 2021; 21:550. [PMID: 33743622 PMCID: PMC7981931 DOI: 10.1186/s12889-021-10528-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 02/28/2021] [Indexed: 01/10/2023] Open
Abstract
Background Hypertension control remains a major challenge globally. A recent systematic review suggested that yoga has beneficial effects on reducing blood pressure. However, the role of yoga in hypertension management in primary health care has received little attention, and no studies have evaluated the impact of a yoga program fully delivered by health care staff on hypertension. This study, therefore, assessed the effects of a health worker-led yoga intervention on blood pressure reduction among hypertensives patients in the primary care setting. Methods This was a multicentric, two-arm, randomised trial conducted among hypertensive patients in seven Ayurveda Health Centres in Nepal between March 2017 and June 2018. One hundred and twenty-one participants who were on or without medications were randomised to intervention (n = 61) and wait-list control (n = 60) groups using stratified block randomisation. Participants in the intervention arm received an intervention consisting of an initial five-day structured yoga training at the centres and then a further home-based practice of yoga for five days a week for the following 90 days. Both intervention and control groups also participated in a 2-h health education session. The primary outcome of this trial was systolic blood pressure at 90-day follow-up. Data were analysed on an intention-to-treat basis using linear mixed-effects regression models. Results We included all 121 study participants (intervention/control = 61/60) in the primary analysis (52.1% males; mean ± SD age = 47.8 ± 10.8 years). The difference in systolic blood pressure between the intervention group and the control group was − 7.66 mmHg (95% CI: − 10.4, − 4.93). For diastolic blood pressure, the difference was − 3.86 mmHg (95% CI: − 6.65, − 1.06). No adverse events were reported by the participants. Conclusions A yoga program for hypertensive patients consisting of a five-day training in health centres and 90 days of practice at home is effective for reducing blood pressure. Significant benefits for hypertensive patients could be expected if such programmes would become a part of the standard treatment practice. Trial registration This trial was prospectively registered with the Clinical Trial Registry of India [CTRI/2017/02/007822] on 10/02/2017. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10528-y.
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Affiliation(s)
- Raja Ram Dhungana
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
| | - Zeljko Pedisic
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | | | | | | | | | | | | | | | - Binod Ghimire
- Nepal Ayurveda Research and Training Center, Kathmandu, Nepal
| | | | | | | | | | - Dinesh Neupane
- Welch Center for Prevention, Epidemiology and Clinical Research, Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.,Nepal Development Society, Bharatpur, Chitwan, Nepal
| | - Maximilian de Courten
- Institute for Health and Sport, Victoria University, Melbourne, Australia.,Mitchell Institute for Education and Health Policy, Victoria University, Melbourne, Chitwan, Australia
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22
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Ghelman R, Sibinga EMS, von Schoen-Angerer T, Vagedes J, Seifert G. The São Paulo agreement on integrative pediatrics: A consensus-based document fostering integrative health of children and adolescents globally. Complement Ther Med 2021; 58:102677. [PMID: 33548479 DOI: 10.1016/j.ctim.2021.102677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Ricardo Ghelman
- Instituto de Tratamento do Câncer Infantil (ITACI), Departamento de Pediatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; Brazilian Academic Consortium for Integrative Health, Brazil.
| | | | - Tido von Schoen-Angerer
- Center for Integrative Paediatrics, Fribourg Hospital and Dept for Community Health, Fribourg University, Switzerland; ARCIM Institute, Filderklinik, Filderstadt, Germany
| | - Jan Vagedes
- ARCIM Institute, Filderklinik, Filderstadt, Germany; Department of Neonatology, University Hospital, Tübingen University, Germany; Department of Pediatrics, Filderklinik, Filderstadt, Germany
| | - Georg Seifert
- Instituto de Tratamento do Câncer Infantil (ITACI), Departamento de Pediatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
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23
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Stretching is Superior to Brisk Walking for Reducing Blood Pressure in People With High-Normal Blood Pressure or Stage I Hypertension. J Phys Act Health 2021; 18:21-28. [PMID: 33338988 DOI: 10.1123/jpah.2020-0365] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/29/2020] [Accepted: 10/06/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Aerobic exercise is recommended for reducing blood pressure; however, recent studies indicate that stretching may also be effective. The authors compared 8 weeks of stretching versus walking exercise in men and women with high-normal blood pressure or stage 1 hypertension (ie, 130/85-159/99 mm Hg). METHODS Forty men and women (61.6 y) were randomized to a stretching or brisk walking exercise program (30 min/d, 5 d/wk for 8 wk). Blood pressure was assessed during sitting and supine positions and for 24 hours using a portable monitor before and after the training programs. RESULTS The stretching program elicited greater reductions than the walking program (P < .05) for sitting systolic (146 [9] to 140 [12] vs 139 [9] to 142 [12] mm Hg), supine diastolic (85 [7] to 78 [8] vs 81 [7] to 82 [7] mm Hg), and nighttime diastolic (67 [8] to 65 [10] vs 68 [8] to 73 [12] mm Hg) blood pressures. The stretching program elicited greater reductions than the walking program (P < .05) for mean arterial pressure assessed in sitting (108 [7] to 103 [6] vs 105 [6] vs 105 [8] mm Hg), supine (102 [9] to 96 [9] vs 99 [6] to 99 [7] mm Hg), and at night (86 [9] to 83 [10] vs 88 [9] to 93 [12] mm Hg). CONCLUSIONS An 8-week stretching program was superior to brisk walking for reducing blood pressure in individuals with high-normal blood pressure or stage 1 hypertension.
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Seifert G, Jeitler M, Stange R, Michalsen A, Cramer H, Brinkhaus B, Esch T, Kerckhoff A, Paul A, Teut M, Ghadjar P, Langhorst J, Häupl T, Murthy V, Kessler CS. The Relevance of Complementary and Integrative Medicine in the COVID-19 Pandemic: A Qualitative Review of the Literature. Front Med (Lausanne) 2020; 7:587749. [PMID: 33363186 PMCID: PMC7761649 DOI: 10.3389/fmed.2020.587749] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/17/2020] [Indexed: 01/07/2023] Open
Abstract
Background: During the COVID-19 pandemic people are facing risks of adverse health effects due to the restrictions implemented such as quarantine measures, reduced social contact, and self-isolation. In this qualitative review, we collected data on potential preventive and therapeutic health benefits of Complementary and Integrative Medicine (CIM) that might be useful during the COVID-19 pandemic. We have reviewed the scientific literature to summarize CIM practices that could be beneficial for improving physical and mental health and well-being of the population under the current pandemic circumstances. It must be noted that this review is not SARS-CoV-2 specific and we explicitly do not intend to make any SARS-CoV-2 specific health claims in this article. Methods and Findings: A qualitative, non-systematic literature review was conducted in Medline to identify literature describing preventive and therapeutic CIM approaches for strengthening mental and physical health. For a variety of CIM approaches clinical evidence was identified, indicating beneficial effects. CIM approaches include specific dietary measures and selected micronutrients, physical activity, techniques from Mind-Body Medicine, single botanicals or botanical compounds, and spending time in nature among others. The effects of CIM measures on conditions like obesity and hypertension are of special relevance here, as these conditions are considered as risk factors for a severe course of COVID-19. Moreover, a possibly direct effect of CIM approaches on immune functions and clinical parameters in respiratory tract infections, such as influenza, were identified. The findings of this review could be helpful for clinicians, patients, and the general population during the current pandemic when discussing and/or considering CIM options. Conclusions: CIM offers a variety of preventive and therapeutic options for strengthening physical and mental resilience, which could also be useful in the current COVID-19 pandemic. The evidence of CIM approaches with a potential benefit in the COVID-19 pandemic in different areas is worth to be analyzed. While this qualitative review has several obvious limitations, it might serve as useful starting point for further research on this topic.
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Affiliation(s)
- Georg Seifert
- Department of Paediatric Oncology/Haematology, Otto-Heubner Centre for Paediatric and Adolescent Medicine (OHC), Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany,Department of Pediatrics, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,*Correspondence: Georg Seifert
| | - Michael Jeitler
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany,Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Rainer Stange
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany,Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andreas Michalsen
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany,Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany,National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Tobias Esch
- Institute for Integrative Health Care and Health Promotion, University Clinic for Integrative Health Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Annette Kerckhoff
- Institute for Integrative Health Care and Health Promotion, University Clinic for Integrative Health Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Anna Paul
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Michael Teut
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Pirus Ghadjar
- Department of Radiation Oncology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Klinikum Bamberg, Chair for Integrative Medicine, University of Duisburg-Essen, Bamberg, Germany
| | - Thomas Häupl
- Department of Rheumatology and Clinical Immunology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Vijay Murthy
- Faculty of Medicine, Primary Care and Population Sciences, University of Southampton, Southampton, United Kingdom
| | - Christian S. Kessler
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany,Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Nalbant G, Lewis S, Chattopadhyay K. Content, Structure, and Delivery Characteristics of Yoga Interventions for Managing Hypertension: A Systematic Review Protocol. Int J Yoga 2020; 13:111-114. [PMID: 32669764 PMCID: PMC7336941 DOI: 10.4103/ijoy.ijoy_88_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/16/2020] [Accepted: 03/24/2020] [Indexed: 11/04/2022] Open
Abstract
AIMS This systematic review aims to summarize the content, structure, and delivery characteristics of yoga interventions used for managing hypertension. INTRODUCTION Globally, hypertension-related morbidity and mortality are high. Yoga might be a potential solution for managing hypertension. Several systematic reviews have evaluated the effectiveness of yoga interventions for managing hypertension. There is a need to summarize the content, structure, and delivery characteristics of yoga interventions used for managing hypertension. INCLUSION CRITERIA Randomized controlled trials assessing the effectiveness of yoga interventions for managing hypertension in adults and reporting either the content, structure, or delivery characteristics will be included in this systematic review. METHODS The Joanna Briggs Institute systematic review methodology will be followed to conduct the review. We aim to search for a wide range of sources to find both published and unpublished studies. The following databases will be searched: MEDLINE, Embase, CINAHL, PsycINFO, Allied and Complementary Medicine (AMED), Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Turning Research Into Practice (TRIP), AYUSH Research Portal, A Bibliography of Indian Medicine (ABIM), Digital Helpline for Ayurveda Research Articles (DHARA), CAM-QUEST, and Directory of Open Access Journals (DOAJ). The search for unpublished studies will include OpenGrey, EThOS, and ProQuest Dissertations and Theses. Databases will be searched from their inception dates, and no language restrictions will be applied. A narrative description of the findings will be written, structured around the aims of this systematic review. SYSTEMATIC REVIEW REGISTRATION NUMBER CRD42019139404.
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Affiliation(s)
- Gamze Nalbant
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Sarah Lewis
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Kaushik Chattopadhyay
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
- The Nottingham Centre for Evidence-Based Healthcare, A Joanna Briggs Institute Centre of Excellence, Nottingham, UK
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Thanalakshmi J, Maheshkumar K, Kannan R, Sundareswaran L, Venugopal V, Poonguzhali S. Effect of Sheetali pranayama on cardiac autonomic function among patients with primary hypertension - A randomized controlled trial. Complement Ther Clin Pract 2020; 39:101138. [DOI: 10.1016/j.ctcp.2020.101138] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 02/07/2020] [Accepted: 03/04/2020] [Indexed: 12/28/2022]
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27
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Wu Y, Pescatello LS. The Clinical Utility of Neuromotor Exercise as Antihypertensive Lifestyle Therapy. Curr Sports Med Rep 2020; 19:133-136. [PMID: 32282457 DOI: 10.1249/jsr.0000000000000700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT
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Rijal A, Nielsen EE, Hemmingsen B, Neupane D, Gæde PH, Olsen MH, Jakobsen JC. Adding exercise to usual care in patients with hypertension, type 2 diabetes mellitus and/or cardiovascular disease: a protocol for a systematic review with meta-analysis and trial sequential analysis. Syst Rev 2019; 8:330. [PMID: 31847918 PMCID: PMC6918663 DOI: 10.1186/s13643-019-1233-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 11/12/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Hypertension, type 2 diabetes mellitus and cardiovascular disease are among the leading causes of mortality globally. Exercise is one of the commonly recommended interventions/preventions for hypertension, type 2 diabetes mellitus and cardiovascular disease. However, the previous reviews have shown conflicting evidence on the effects of exercise. Our objective is to assess the beneficial and harmful effects of adding exercise to usual care for people with hypertension, type 2 diabetes mellitus and/or cardiovascular disease. METHODS This protocol for a systematic review was undertaken using the recommendations of The Cochrane Collaboration, the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) and the eight-step assessment procedure suggested by Jakobsen et al. We plan to include all relevant randomised clinical trials and cluster-randomised trials assessing the effects of adding exercise to usual care for people with hypertension, type 2 diabetes mellitus and/or cardiovascular disease. We will search the Cochrane Central Register of Controlled Trials (CENTRAL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Latin American and Caribbean Health Sciences Literature (LILACS), Science Citation Index Expanded on Web of Science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Science Journal Database (VIP) and BIOSIS. We will systematically assess the risks of random errors using Trial Sequential Analysis as well as risks of bias of all included trials. We will create a 'Summary of Findings' table in which we will present our primary and secondary outcomes, and we will assess the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). DISCUSSION The present systematic review will have the potential to aid patients, clinicians and decision-makers recommending exercise and thereby, benefit patients with hypertension, type 2 diabetes mellitus and/or cardiovascular disease. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019142313.
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Affiliation(s)
- Anupa Rijal
- Department of Internal Medicine, Holbæk Hospital, Holbæk, Denmark
- Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Emil Eik Nielsen
- Department of Internal Medicine, Holbæk Hospital, Holbæk, Denmark
- Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Bianca Hemmingsen
- Department of Endocrinology and Nephrology, Nordsjællands Hospital, Hillerød, Denmark
| | - Dinesh Neupane
- Welch Center for Prevention, Epidemiology, and Clinical Research, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Peter Haulund Gæde
- Department of Cardiology and Endocrinology, Næstved-Slagelse-Ringsted (NSR) Hospital, Slagelse, Denmark
| | - Michael Hecht Olsen
- Department of Internal Medicine, Holbæk Hospital, Holbæk, Denmark
- Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Center for Individualized Medicine in Arterial Diseases, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Janus Christian Jakobsen
- Department of Internal Medicine, Holbæk Hospital, Holbæk, Denmark
- Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Copenhagen Trial Unit, Rigshospitalet, Copenhagen, Denmark
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Cramer H, Sellin C, Schumann D, Dobos G. Yoga in Arterial Hypertension. DEUTSCHES ARZTEBLATT INTERNATIONAL 2019; 115:833-839. [PMID: 30722837 DOI: 10.3238/arztebl.2018.0833] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 04/12/2018] [Accepted: 08/14/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Yoga seems to exert its effect against arterial hypertension mainly through the associated breathing and meditation techniques, and less so through yoga postures. The goal of this trial was to compare the blood pressure-lowering effect of yoga interventions with and without yoga postures in patients with arterial hypertension. METHODS 75 patients taking medications for arterial hypertension (72% women, mean age 58.7 ± 9.5 years) were randomized into three groups: a yoga intervention group with yoga postures (25 patients, of whom 5 dropped out of the trial before its end), a yoga intervention group without yoga postures (25 patients, 3 dropouts), and a wait list control group (25 patients, one dropout). The interventions consisted of 90 minutes of yoga practice per week for twelve weeks. The data collectors, who were blinded to the intervention received, assessed the primary outcome measures "systolic 24-hour blood pressure" and "diastolic 24-hour blood pressure" before and after the intervention. In this report, we also present the findings on secondary outcome measures, including follow-up data. RESULTS After the intervention, the systolic 24-hour blood pressure in the yoga intervention group without yoga postures was significantly lower than in the control group (group difference [Δ]= -3.8 mmHg; [95% confidence interval (CI): (-0.3; -7.4) p = 0.035]); it was also significantly lower than in the yoga intervention group with yoga postures (Δ = -3.2 mmHg; 95% CI: [-6.3; -0.8]; p = 0.045). Diastolic blood pressures did not differ significantly across groups. No serious adverse events were encountered in the course of the trial. CONCLUSION In accordance with the findings of earlier studies, we found that only yoga without yoga postures induced a short-term lowering of ambulatory systolic blood pressure. Yoga is safe and effective in patients taking medications for arterial hypertension and thus can be recommended as an additional treatment option for persons in this category.
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Affiliation(s)
- Holger Cramer
- Department of Naturopathy and Integrative Medicine, Essen Central Hospitals, Faculty of Medicine,Duisburg-Essen University
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30
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Cramer H, Haller H, Klose P, Ward L, Chung VC, Lauche R. The risks and benefits of yoga for patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Clin Rehabil 2019; 33:1847-1862. [PMID: 31353959 DOI: 10.1177/0269215519860551] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To determine the effectiveness and safety of yoga interventions on disease symptoms, quality of life and function in patients diagnosed with chronic obstructive pulmonary disease (COPD). DATA SOURCES Medline/PubMed, Scopus, and CENTRAL (Cochrane Central Register of Controlled Trials) were searched through 6 June 2019. REVIEW METHODS Randomized controlled trials assessing the effects of yoga on quality of life, dyspnea, exercise capacity, and pulmonary function (FEV1) in patients with COPD were included. Safety was defined as secondary outcome. Mean differences (MD) and standardized mean differences (SMD) with 95% confidence intervals (CIs) were computed. Risk of bias was assessed using the Cochrane tool. RESULTS Eleven randomized controlled trials with a total of 586 patients were included. Meta-analysis revealed evidence for effects of yoga compared to no treatment on quality of life on the COPD Assessment Test (MD = 3.81; 95% CI = 0.97 to 6.65; P = 0.009, I2 = 70%), exercise capacity assessed by the 6-minute walk test (MD = 25.53 m; 95% CI = 12.16 m to 38.90 m; P = 0.001, I2 = 0%), and pulmonary function assessed by FEV1 predicted (MD = 3.95%; 95% CI = 2.74% to 5.17%; P < 0.001, I2 = 0%). Only the effects on exercise capacity and pulmonary function were robust against methodological bias. Effects were only present in breathing-focused yoga interventions but not in interventions including yoga postures. Adverse events were reported infrequently. CONCLUSION This meta-analysis found robust effects of yoga on exercise capacity and pulmonary function in patients with COPD. Yoga, specifically yoga breathing techniques, can be an effective adjunct intervention for patients with COPD. Yoga's safety needs to be assessed in more depth in future studies.
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Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Heidemarie Haller
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Petra Klose
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Lesley Ward
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.,Centre for Rehabilitation Research in Oxford (RRIO), Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Vincent Ch Chung
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.,Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Romy Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.,Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany
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Penrod NM, Moore JH. Why mind-body medicine is poised to set a new standard for clinical research. J Clin Epidemiol 2019; 116:167-170. [PMID: 31112802 DOI: 10.1016/j.jclinepi.2019.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 04/12/2019] [Accepted: 05/14/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Nadia M Penrod
- Institute for Biomedical Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - Jason H Moore
- Institute for Biomedical Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Wu Y, Johnson BT, Acabchuk RL, Chen S, Lewis HK, Livingston J, Park CL, Pescatello LS. Yoga as Antihypertensive Lifestyle Therapy: A Systematic Review and Meta-analysis. Mayo Clin Proc 2019; 94:432-446. [PMID: 30792067 DOI: 10.1016/j.mayocp.2018.09.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 08/22/2018] [Accepted: 09/19/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the efficacy of yoga as antihypertensive lifestyle therapy and identify moderators that account for variability in the blood pressure (BP) response to yoga. METHODS We systematically searched 6 electronic databases from inception through June 4, 2018, for articles published in English language journals on trials of yoga interventions that involved adult participants, reported preintervention and postintervention BP, and had a nonexercise/nondiet control group. Our search yielded 49 qualifying controlled trials (56 interventions). We (1) evaluated the risk of bias and methodological study quality, (2) performed meta-regression analysis following random-effects assumptions, and (3) generated additive models that represented the largest possible clinically relevant BP reductions. RESULTS On average, the 3517 trial participants were middle-aged (49.2±19.5 years), overweight (27.9±3.6 kg/m2) adults with high BP (systolic BP, 129.3±13.3 mm Hg; diastolic BP, 80.7±8.4 mm Hg). Yoga was practiced 4.8±3.4 sessions per week for 59.2±25.0 minutes per session for 13.2±7.5 weeks. On average, yoga elicited moderate reductions in systolic BP (weighted mean effect size, -0.47; 95% CI, -0.62-0.32, -5.0 mm Hg) and diastolic BP (weighted mean effect size, -0.47; 95% CI, -0.61 to -0.32; -3.9 mm Hg) compared with controls (P<.001 for both systolic BP and diastolic BP). Controlling for publication bias and methodological study quality, when yoga was practiced 3 sessions per week among samples with hypertension, yoga interventions that included breathing techniques and meditation/mental relaxation elicited BP reductions of 11/6 mm Hg compared with those that did not (ie, 6/3 mm Hg). CONCLUSION Our results indicate that yoga is a viable antihypertensive lifestyle therapy that produces the greatest BP benefits when breathing techniques and meditation/mental relaxation are included.
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Affiliation(s)
- Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT.
| | - Blair T Johnson
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT; Department of Psychological Sciences, University of Connecticut, Storrs, CT
| | - Rebecca L Acabchuk
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT; Department of Psychological Sciences, University of Connecticut, Storrs, CT
| | - Shiqi Chen
- Department of Kinesiology, University of Connecticut, Storrs, CT
| | - Holly K Lewis
- Department of Physical Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences, PA
| | - Jill Livingston
- Homer Babbidge Library, Health Sciences, University of Connecticut, Storrs, CT
| | - Crystal L Park
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT; Department of Psychological Sciences, University of Connecticut, Storrs, CT
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT
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Niu JF, Zhao XF, Hu HT, Wang JJ, Liu YL, Lu DH. Should acupuncture, biofeedback, massage, Qi gong, relaxation therapy, device-guided breathing, yoga and tai chi be used to reduce blood pressure?: Recommendations based on high-quality systematic reviews. Complement Ther Med 2018; 42:322-331. [PMID: 30670261 DOI: 10.1016/j.ctim.2018.10.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/04/2018] [Accepted: 10/19/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This review aims to rate the quality of evidence and the strength of recommendations in high-quality systematic reviews of non-drug therapies. Hypertensive patients who are resistant or non-adherent to antihypertensive drugs may be easier to manage if they choose alternative non-drug therapies for hypertension, based on this review. METHODS P: Adults (>18 years), except pregnant women, with essential hypertension. I: Cupping, moxibustion, acupuncture, acupoint stimulation, yoga, meditation, tai chi, Qi gong, Chinese massage, massage, spinal manipulation, biofeedback, device-guided breathing therapy, aromatherapy, music therapy, and relaxation approaches. C: 1. No treatment. 2. Sham therapy. 3. Conventional treatment, including antihypertensive drugs and lifestyle modification (e.g., exercise). O: 1. Change in the incidence of cardiovascular death. 2. Change in the incidence of myocardial infarction. 3. Change in the incidence of stroke. 4. Change in blood pressure (BP). 5. Efficacy rate of BP lowering. 6. Adverse effects (review specific). S: Systematic reviews of randomized controlled trials, including meta-analyses and assessments of the methodological quality/risk of bias. INFORMATION SOURCES Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane library, PubMed, Web of Science, China National Knowledge Infrastructure, and Chinese Scientific Journal Database were searched. The bibliographies of the included articles were also searched for relevant systematic reviews. GRADE criteria were used to rate the quality of evidence in systematic reviews considering 6 factors, including risk of bias. RESULTS This review ultimately included 13 systematic reviews of 14 non-drug therapies (acupuncture, wet cupping, Baduanjin, blood letting, auricular acupuncture, music, massage, Qi gong, moxibustion, relaxation therapies, biofeedback, device-guided breathing, yoga and tai chi) based on the inclusion criteria. The quality of evidence was generally low, and weak recommendations were given for most therapies except massage and acupuncture plus antihypertensive drug. Based on the analyzed evidence, massage and acupuncture plus antihypertensive drug could benefit people who want to lower their BP and do not have contraindications for massage and acupuncture plus antihypertensive drug. DISCUSSION/STRENGTH The GRADE approach makes this review a unique reference for people who are considering the grade of quality of evidence in systematic reviews, the balance of desirable and undesirable consequences and the strength of recommendations to decide which intervention should be used to reduce BP. LIMITATIONS Many non-drug therapies were excluded due to the low methodological quality of their systematic reviews, and only 14 therapies were evaluated in this review. As no patient-important outcomes were reviewed, surrogate outcomes were used to rate the strength of recommendations. This approach may cause a decrease in evidence quality according to GRADE, but we argue that this is appropriate in the context of this review.
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Affiliation(s)
- Jian-Fei Niu
- VIP Ward of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiao-Feng Zhao
- VIP Ward of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Han-Tong Hu
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejing Province, China
| | - Jia-Jie Wang
- Department of Traditional Chinese Medicine, Peoples' Hospital of Shuozhou, Shanxi Province, China
| | - Yan-Ling Liu
- The Affiliated Hospital of Shandong University of TCM, Shandong Province, China
| | - De-Hua Lu
- The Second hospital of Dalian Medical University, Liaoning Province, China
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Dhungana RR, Khanal MK, Joshi S, Kalauni OP, Shakya A, Bhrutel V, Panthi S, KC RK, Ghimire B, Pandey AR, Bista B, Sapkota B, Khatiwoda SR, McLachlan CS, Neupane D. Impact of a structured yoga program on blood pressure reduction among hypertensive patients: study protocol for a pragmatic randomized multicenter trial in primary health care settings in Nepal. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:207. [PMID: 29976188 PMCID: PMC6034305 DOI: 10.1186/s12906-018-2275-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 06/28/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND Hypertension control remains a major global challenge. The behavioral approaches recommended for blood pressure reduction are stress reduction, increased exercise and healthy dietary habits. Some study findings suggest that yoga has a beneficial effect in reducing blood pressure. However, the role of yoga on blood pressure has received little attention in existing health care practices in developing countries. This study will be conducted in primary health care facilities in Nepal to assess the effectiveness of a pragmatic yoga intervention to complement standard practice in further reducing blood pressure. METHODS This will be multicentric, two arms, randomized, nonblinded, pragmatic trial. It will be conducted in seven District Ayurveda Health Centers (DAHCs) in Nepal between July 2017 and June 2018. The study participants will consist of hypertensive patients with or without antihypertensive medication attending to the outpatient department (OPD). One hundred and forty participants will be randomized to treatment or control groups by using a stratified block randomization. At the study site, the treatment arm participants will receive an intervention consisting of five days of structured yoga training and practice of the same package at home with a recommendation of five days a week for the following 90 days. Both the intervention and control groups will receive two hours of health education on lifestyle modifications. The primary outcome of this trial will be the change in systolic blood pressure and it will be assessed after 90 days of the intervention. DISCUSSION This study will establish the extent to which a yoga intervention package can help reduce blood pressure in hypertensive patients. If proven effective, study findings may be used to recommend the governing bodies and other stakeholders for the integration of yoga in the national healthcare system for the treatment and control of hypertension. TRIAL REGISTRATION Clinical Trial Registry- India (CTRI); CTRI Reg. No- CTRI/2017/02/007822 . Registered on 10/02/2017.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Binod Ghimire
- Nepal Ayurveda Research and Training Center, Kathmandu, Nepal
| | | | | | | | - Shiva Ram Khatiwoda
- Patanjali Ayurveda Medical College and Research Center, Dulikhel, Kathmandu Nepal
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The effects of yoga exercise on lipid peroxidation and antioxidant status in pregnant women. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2018. [DOI: 10.1016/j.injms.2018.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Nyer M, Nauphal M, Roberg R, Streeter C. Applications of Yoga in Psychiatry: What We Know. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2018; 16:12-18. [PMID: 31975895 PMCID: PMC6519580 DOI: 10.1176/appi.focus.20170055] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Yoga has been in use for thousands of years in the East as a healing modality. Western practitioners are now starting to recognize the potential of yoga-based treatments. The purpose of this article is to explore the evidence-base of yoga-based treatments for depression and anxiety with the purpose of furthering the integration of yoga into conventional Western mental health treatment plans.
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Affiliation(s)
- Maren Nyer
- Dr. Nyer is with the Department of Psychiatry, Harvard Medical School, and the Department of Psychiatry, Massachusetts General Hospital, Boston. Ms. Nauphal and Ms. Roberg are with the Department of Psychiatry, Massachusetts General Hospital, Boston. Dr. Streeter is with the Departments of Psychiatry and Neurology, and Harvard Medical School, Boston
| | - Maya Nauphal
- Dr. Nyer is with the Department of Psychiatry, Harvard Medical School, and the Department of Psychiatry, Massachusetts General Hospital, Boston. Ms. Nauphal and Ms. Roberg are with the Department of Psychiatry, Massachusetts General Hospital, Boston. Dr. Streeter is with the Departments of Psychiatry and Neurology, and Harvard Medical School, Boston
| | - Regina Roberg
- Dr. Nyer is with the Department of Psychiatry, Harvard Medical School, and the Department of Psychiatry, Massachusetts General Hospital, Boston. Ms. Nauphal and Ms. Roberg are with the Department of Psychiatry, Massachusetts General Hospital, Boston. Dr. Streeter is with the Departments of Psychiatry and Neurology, and Harvard Medical School, Boston
| | - Chris Streeter
- Dr. Nyer is with the Department of Psychiatry, Harvard Medical School, and the Department of Psychiatry, Massachusetts General Hospital, Boston. Ms. Nauphal and Ms. Roberg are with the Department of Psychiatry, Massachusetts General Hospital, Boston. Dr. Streeter is with the Departments of Psychiatry and Neurology, and Harvard Medical School, Boston
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Wolff M, Brorsson A, Midlöv P, Sundquist K, Strandberg EL. Yoga - a laborious way to well-being: patients' experiences of yoga as a treatment for hypertension in primary care. Scand J Prim Health Care 2017; 35:360-368. [PMID: 29124990 PMCID: PMC5730034 DOI: 10.1080/02813432.2017.1397318] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE The aim of the study was to describe patients' experience of yoga as a treatment for hypertension, as well as their experience of living with hypertension. DESIGN Qualitative interview study Method and materials: In 2013-2014, in southern Sweden, patients with hypertension from three health care centres were invited to participate in a randomised controlled trial on yoga for hypertension. After completion of the study, eight women and five men (aged 35-79), who had practiced the yoga intervention, were interviewed about their experiences. We used a semi-structured interview guide according to Kvale. Qualitative analysis was conducted by systematic text condensation inspired by Malterud. RESULTS Two main themes emerged during the analysis process: Yoga - a laborious way to well-being and hypertension - a silent disease. The positive experiences of doing yoga were described in terms of tranquillity and increased agility. The drawbacks were mainly linked to the time required to perform the exercises. Living with high blood pressure and having to take medication can imply a stigma and cause concerns for future cardiovascular events. Most patients that we interviewed expressed a wish to find alternative ways to treat their high blood pressure. Participating in the yoga study was seen as a good possibility to try such an alternative way. CONCLUSIONS Many patients with hypertension in Swedish primary care seem to be interested in trying alternative treatments to control blood pressure. The patients in our study experienced several benefits from doing yoga, but they also pointed out difficulties in implementing yoga as a regular and permanent lifestyle change.
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Affiliation(s)
- Moa Wolff
- CONTACT Moa Wolff Department of Clinical Sciences, Lund University, Box 50332, 202 13 Malmö, Sweden
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Hassan MS, Hadad KEE, El Refaye GI. The effect of relaxation techniques on hypertension secondary to menopause. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2017. [DOI: 10.4103/1110-7782.212932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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The Effect of Three Different Meditation Exercises on Hypertension: A Network Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:9784271. [PMID: 28529532 PMCID: PMC5424182 DOI: 10.1155/2017/9784271] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/08/2017] [Accepted: 03/22/2017] [Indexed: 01/03/2023]
Abstract
We aimed to use the pairwise and network meta-analysis to estimate the effects of different meditation exercises on the control of systolic blood pressure (SBP) and diastolic blood pressure (DBP). Randomized controlled trials (RCTs) were retrieved from PubMed and Embase up to June 2016, which are published in English and reported on meditation exercise for hypertensive patients. Risks of bias assessment of the included studies were assessed by Cochrane Collaboration Recommendations and network meta-analysis was performed by ADDIS. Mean difference (MD) and its 95% confidence interval (CI) were used as the effect size. A number of 19 RCTs were included in this study. Results of pairwise comparisons indicated that meditation exercise could significantly decrease the SBP and DBP, compared with other interventions (MD = −7.10, 95% CI: −10.82 to −3.39; MD = −4.02, 95% CI: −6.12 to −1.92). With good consistence and convergence, network meta-analysis showed that there were no significant differences between meditation and other interventions on SBP. For DBP, Qigong was significantly lower than “no intervention” (MD = −11.73, 95% CI: −19.85 to −3.69). Qigong may be the optimal exercise way in lowering SBP and DBP of hypertensive patients, but a detailed long-term clinical research should be needed in the future.
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Koch AK, Rabsilber S, Lauche R, Kümmel S, Dobos G, Langhorst J, Cramer H. The effects of yoga and self-esteem on menopausal symptoms and quality of life in breast cancer survivors-A secondary analysis of a randomized controlled trial. Maturitas 2017; 105:95-99. [PMID: 28551083 DOI: 10.1016/j.maturitas.2017.05.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 04/13/2017] [Accepted: 05/04/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Previous research has found that yoga can enhance quality of life and ease menopausal symptoms of breast cancer survivors. The study examined whether self-esteem mediated the effects of yoga on quality of life, fatigue and menopausal symptoms, utilizing validated outcome measures. STUDY DESIGN This is a secondary analysis of a randomized controlled trial comparing the effects of yoga with those of usual care in 40 breast cancer survivors who suffered from menopausal symptoms. All participants completed all 3 assessments (week 0, week 12, and week 24) and provided full data. MAIN OUTCOME MEASURES Outcomes were measured using self-rating instruments. Mediation analyses were performed using SPSS. RESULTS Self-esteem mediated the effect of yoga on total menopausal symptoms (B=-2.11, 95% BCI [-5.40 to -0.37]), psychological menopausal symptoms (B=-0.94, 95% BCI [-2.30 to -0.01]), and urogenital menopausal symptoms (B=-0.66, 95% BCI [-1.65 to -0.15]), quality of life (B=8.04, 95% BCI [3.15-17.03]), social well-being (B=1.80, 95% BCI [0.54-4.21]), emotional well-being (B=1.62, 95% BCI [0.70-3.34]), functional well-being (B=1.84, 95% BCI [0.59-4.13]), and fatigue (B=4.34, 95% BCI [1.28-9.55]). Self-esteem had no effect on somatovegetative menopausal symptoms (B=-0.50, 95% BCI n.s.) or on physical well-being (B=0.79, 95% BCI n.s.). CONCLUSIONS Findings support the assumption that self-esteem plays a vital role in the beneficial effect of yoga and that yoga can have long-term benefits for women diagnosed with breast cancer and undergoing menopausal transition.
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Affiliation(s)
- Anna K Koch
- Centre of Integrative Gastroenterology, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany; Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
| | - Sybille Rabsilber
- Department of Gynecology, Certified Breast Center, Malteser Hospital St. Anna, Duisburg, Germany; Breast Unit, Kliniken Essen-Mitte, Essen, Germany
| | - Romy Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany; Australian Research Center in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | | | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Jost Langhorst
- Centre of Integrative Gastroenterology, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany; Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany; Australian Research Center in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, Australia
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The hypotensive effect of Yoga's breathing exercises: A systematic review. Complement Ther Clin Pract 2017; 28:38-46. [PMID: 28779935 DOI: 10.1016/j.ctcp.2017.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 05/08/2017] [Indexed: 11/20/2022]
Abstract
The aim of this review was to evaluate the effect of pranayama (Yoga's breathing exercises) on BP and its applicability in the treatment of hypertension. Thirteen trials, assessing acute (eight studies) and chronic (five studies) BP response to pranayama were included. Significant BP reductions after pranayama were found in both acute (2-10 mmHg mean SBP reduction, N = 5 studies; 1 mmHg mean DBP reduction, N = 1 study) and chronic studies (4-21 mmHg mean SBP reduction, N = 3 studies; 4-7 mmHg mean DBP reduction, N = 2 studies). The pranayama's effect on BP were not robust against selection bias due to the low quality of studies. But, the lowering BP effect of pranayama is encouraging. The pranayama with slower rhythms and manipulation of the nostrils, mainly with breaths by the left, present better results when compared with the other types and should be the main pranayama applied when the goal is to reduce blood pressure especially in hypertensive patients.
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Edla SR, Kumar AM, Srinivas B, Raju MS, Gupta V. ‘Integrated Naturopathy and Yoga’ reduces blood pressure and the need for medications among a cohort of hypertensive patients in South India: 3-months follow-up study. ADVANCES IN INTEGRATIVE MEDICINE 2016. [DOI: 10.1016/j.aimed.2016.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Cramer H, Langhorst J, Dobos G, Lauche R. Yoga for metabolic syndrome: A systematic review and meta-analysis. Eur J Prev Cardiol 2016; 23:1982-1993. [DOI: 10.1177/2047487316665729] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Romy Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia
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Yoga for Risk Reduction of Metabolic Syndrome: Patient-Reported Outcomes from a Randomized Controlled Pilot Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:3094589. [PMID: 27847524 PMCID: PMC5101386 DOI: 10.1155/2016/3094589] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 08/08/2016] [Accepted: 10/05/2016] [Indexed: 11/18/2022]
Abstract
Lifestyle change is recommended as treatment for adults at risk for metabolic syndrome (MetS), although adoption of new behavioral patterns is limited. In addition, most existing lifestyle interventions do not address psychological stress or quality of life, both of which impact the burden of MetS. Yoga, a form of physical activity that incorporates psychological components (e.g., maintaining attention, relaxation), is a promising intervention for improving the burden of MetS. This randomized controlled trial assessed the feasibility and preliminary efficacy of a 12-week yoga program coupled with an evidence-based health education program (HED) compared to HED alone. A secondary, exploratory aim examined perceived stress, quality of life, and related psychological outcomes (mindfulness, perceived health competence, and mood). Sixty-seven adults at risk for MetS enrolled (mean age [SD]: 58 [10] years; 50% male; 79% non-Hispanic White). Preliminary results revealed significantly larger improvements in two quality of life domains (role-physical and general health perceptions) in the HED plus yoga group versus HED alone (ps < 0.05). This is the first study that implemented lifestyle education along with yoga to evaluate the potential unique effects of yoga on participants at risk for MetS. A larger clinical trial is warranted to further investigate these promising patient-reported outcomes.
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Field T. Yoga research review. Complement Ther Clin Pract 2016; 24:145-61. [PMID: 27502816 DOI: 10.1016/j.ctcp.2016.06.005] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 06/15/2016] [Indexed: 12/12/2022]
Abstract
This paper is a review of empirical studies, review and meta-analysis publications on yoga from the last few years. The review includes demographics/prevalence of yoga as a practice, bibliometric analyses of the yoga publications and the use of yoga for physical fitness and cognitive function. Most of the studies reviewed here involve yoga effects on psychiatric and medical conditions. These include pregnancy, prenatal and postpartum depression; stress, PTSD, anxiety, and obesity; cardiovascular conditions including hypertension; pain syndromes including arthritis, headaches and low back pain; autoimmune conditions including asthma, type II diabetes and multiple sclerosis; immune conditions including HIV and breast cancer; and aging problems including balance, osteoporosis and Parkinson's. The methods and results of those studies are briefly summarized along with their limitations and suggestions for future research. Basically yoga has been more effective than control and waitlist control conditions, although not always more effective than treatment comparison groups such as other forms of exercise. More randomized controlled studies are needed in which yoga is compared to active exercise groups. Having established the physical and mental health benefits of yoga makes it ethically questionable to assign participants to inactive control groups. Shorter sessions should be investigated for cost-effectiveness and for daily practice. Multiple physical and physiological measures need to be added to the self-report research protocols and potential underlying mechanisms need to be further explored. In the interim, the studies reviewed here highlight the therapeutic effects of yoga, a practice that could come to be called yoga therapy.
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Affiliation(s)
- Tiffany Field
- Touch Research Institute, University of Miami, Miller School of Medicine, United States; Fielding Graduate University, United States.
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Cramer H, Ward L, Steel A, Lauche R, Dobos G, Zhang Y. Prevalence, Patterns, and Predictors of Yoga Use: Results of a U.S. Nationally Representative Survey. Am J Prev Med 2016; 50:230-5. [PMID: 26497261 DOI: 10.1016/j.amepre.2015.07.037] [Citation(s) in RCA: 179] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 07/22/2015] [Accepted: 07/31/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The purpose of this study was to investigate the prevalence, patterns, and predictors of yoga use in the U.S. general population. METHODS Using cross-sectional data from the 2012 National Health Interview Survey Family Core, Sample Adult Core, and Adult Complementary and Alternative Medicine questionnaires (N=34,525), weighted frequencies for lifetime and 12-month prevalence of yoga use and patterns of yoga practice were analyzed. Using logistic regression analyses, sociodemographic predictors of lifetime yoga use were analyzed. Analyses were conducted in 2015. RESULTS Lifetime and 12-month prevalence of yoga use were 13.2% and 8.9%, respectively. Compared with nonpractitioners, lifetime yoga practitioners were more likely female, younger, non-Hispanic white, college educated, higher earners, living in the West, and of better health status. Among those who had practiced in the past 12 months, 51.2% attended yoga classes, 89.9% used breathing exercises, and 54.9% used meditation. Yoga was practiced for general wellness or disease prevention (78.4%), to improve energy (66.1%), or to improve immune function (49.7%). Back pain (19.7%), stress (6.4%), and arthritis (6.4%) were the main specific health problems for which people practiced yoga. CONCLUSIONS About 31 million U.S. adults have ever used yoga, and about 21 million practiced yoga in the past 12 months. Disease prevention and back pain relief were the most important health reasons for yoga practice. Yoga practice is associated with age, gender, ethnicity, SES, and health status.
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Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany; Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
| | - Lesley Ward
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia; Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia; Endeavour College of Natural Health, Brisbane, Queensland, Australia
| | - Romy Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany; Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Yan Zhang
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia; Department of Family and Community Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
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Impact of a short home-based yoga programme on blood pressure in patients with hypertension: a randomized controlled trial in primary care. J Hum Hypertens 2016; 30:599-605. [DOI: 10.1038/jhh.2015.123] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 11/04/2015] [Accepted: 11/23/2015] [Indexed: 11/09/2022]
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Cohen DL, Boudhar S, Bowler A, Townsend RR. Blood Pressure Effects of Yoga, Alone or in Combination With Lifestyle Measures: Results of the Lifestyle Modification and Blood Pressure Study (LIMBS). J Clin Hypertens (Greenwich) 2016; 18:809-16. [PMID: 26773737 DOI: 10.1111/jch.12772] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 11/20/2015] [Accepted: 11/23/2015] [Indexed: 01/13/2023]
Abstract
The authors conducted a study to assess the effects of yoga on blood pressure (BP). Patients were randomized to yoga (Blood Pressure Education Program [BPEP]), or a combined program (COMBO). Ambulatory BP was measured at baseline and at 12 and 24 weeks. Data are presented for all enrolled patients (n=137) and for completers only (n=90). Systolic BP (SBP) and diastolic BP (DBP) were significantly decreased within all groups at 12 and 24 weeks (P<.001) for enrolled patients and completers. SBP was significantly reduced in the yoga and COMBO groups as compared with the BPEP group at 12 weeks in all enrolled and completers. SBP differences were no longer significant at 24 weeks between groups in all enrolled patients; however, there was a greater reduction in SBP at 24 weeks in completers favoring BPEP over yoga. No differences in DBP between groups or in BP between the yoga and COMBO groups were present. The authors did not observe an additive benefit from combining yoga with BPEP measures. Reasons for this are unclear at this time. BP lowering with yoga, however, was similar to that achieved with lifestyle measures.
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Affiliation(s)
- Debbie L Cohen
- Renal, Electrolyte and Hypertension Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Sanaa Boudhar
- Renal, Electrolyte and Hypertension Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Anne Bowler
- Renal, Electrolyte and Hypertension Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Raymond R Townsend
- Renal, Electrolyte and Hypertension Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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Innes KE, Selfe TK. Yoga for Adults with Type 2 Diabetes: A Systematic Review of Controlled Trials. J Diabetes Res 2015; 2016:6979370. [PMID: 26788520 PMCID: PMC4691612 DOI: 10.1155/2016/6979370] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 08/19/2015] [Accepted: 08/26/2015] [Indexed: 12/29/2022] Open
Abstract
A growing body of evidence suggests yogic practices may benefit adults with type 2 diabetes (DM2). In this systematic review, we evaluate available evidence from prospective controlled trials regarding the effects of yoga-based programs on specific health outcomes pertinent to DM2 management. To identify qualifying studies, we searched nine databases and scanned bibliographies of relevant review papers and all identified articles. Controlled trials that did not target adults with diabetes, included only adults with type 1 diabetes, were under two-week duration, or did not include quantitative outcome data were excluded. Study quality was evaluated using the PEDro scale. Thirty-three papers reporting findings from 25 controlled trials (13 nonrandomized, 12 randomized) met our inclusion criteria (N = 2170 participants). Collectively, findings suggest that yogic practices may promote significant improvements in several indices of importance in DM2 management, including glycemic control, lipid levels, and body composition. More limited data suggest that yoga may also lower oxidative stress and blood pressure; enhance pulmonary and autonomic function, mood, sleep, and quality of life; and reduce medication use in adults with DM2. However, given the methodological limitations of existing studies, additional high-quality investigations are required to confirm and further elucidate the potential benefits of yoga programs in populations with DM2.
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Affiliation(s)
- Kim E. Innes
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV 26506, USA
- Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, Charlottesville, VA 22903, USA
| | - Terry Kit Selfe
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV 26506, USA
- Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, Charlottesville, VA 22903, USA
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McDermott K, Kumar D, Goldman V, Feng H, Mehling W, Moskowitz JT, Souza RB, Hecht FM. Training in ChiRunning to reduce blood pressure: a randomized controlled pilot study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 15:368. [PMID: 26471194 PMCID: PMC4608185 DOI: 10.1186/s12906-015-0895-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 10/05/2015] [Indexed: 02/07/2023]
Abstract
Background People with prehypertension (120–130/80–90 mmHg) are at increased risk of progressing to hypertension. Recommendations for prehypertension include engaging in regular physical activity. We aimed to assess feasibility and acceptability and collect preliminary outcome data on ChiRunning for people with elevated blood pressure. ChiRunning is a commercially available running program based on the mindful movements of Tai Chi, which is aimed at decreasing injury by both increasing body awareness and modifying running form. Methods We enrolled adults with elevated systolic (130–150 mmHg) or diastolic (80–100 mmHg) blood pressure in a 12-week pilot trial. Participants were randomized 2:1:1 to 8 weeks of: 1) intervention—a trainer-led ChiRunning group (n = 10); 2) active control—a trainer-led running group (n = 6); or 3) educational control—a self-directed running group (n = 6) and followed for 4 more weeks. The active control and educational control groups were combined for analysis. Results This study was feasible, meeting recruitment, retention and adherence goals, and acceptable to participants. Systolic and diastolic blood pressure did not change significantly over the study for either the ChiRunning or control groups. Changes in BMI over time were significantly different from zero in the ChiRunning group (p = 0.04) but not in the control group (slope for ChiRunning −0.05 [−0.1 to −0.002] vs. control −0.01 [−0.06 to 0.04], between slope difference, p = 0.22). Self-reported running-related injury (i.e. discomfort leading to a decrease in running) was similar between groups (ChiRunning, 4 [1.2 to 8.4] vs. control, 3 [0.7 to 7.1] injuries per 100 h of running, p = 0.72) although self-reported running-related discomfort (i.e. discomfort that does not lead to changes in running) trended higher in the ChiRunning group (ChiRunning, 10 [5.4 to 16.8] vs. control, 4 [1.5 to 9] reports of discomfort per 100 h of running, p = 0.06). Conclusion ChiRunning appears to be a feasible and acceptable exercise program for people with elevated blood pressure. We did not find that ChiRunning had a significant impact on blood pressure or self reported injury, but did see a positive change in BMI over time. ChiRunning warrants further investigation in a larger trial. Trial registration ClinicalTrials.gov Identifier: NCT01587183
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