Effects of yoga on cardiovascular disease risk factors: A systematic review and meta-analysis

• Published in: International journal of cardiology 2014-05, Vol.173 (2), p.170-183
• Main Authors: Cramer, Holger, Lauche, Romy, Haller, Heidemarie, Steckhan, Nico, Michalsen, Andreas, Dobos, Gustav
• Format: Article
• Language: English
• Subjects: Arterial hypertension. Arterial hypotension; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Heart; Humans; Hypertension; Medical sciences; Meta-analysis; Metabolic diseases; Metabolic syndrome; Miscellaneous; Other metabolic disorders; Randomized Controlled Trials as Topic; Risk Factors; Risk Reduction Behavior; Type 2 diabetes; Yoga
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2014.02.017

Abstract Background The aim of this review was to systematically assess and meta-analyze the effects of yoga on modifiable biological cardiovascular disease risk factors in the general population and in high-risk disease groups. Methods MEDLINE/PubMed, Scopus, the Cochrane Library, and IndMED were screened through August 2013 for randomized controlled trials (RCTs) on yoga for predefined cardiovascular risk factors in healthy participants, non-diabetic participants with high risk for cardiovascular disease, or participants with type 2 diabetes mellitus. Risk of bias was assessed using the Cochrane risk of bias tool. Results Forty-four RCTs with a total of 3168 participants were included. Risk of bias was high or unclear for most RCTs. Relative to usual care or no intervention, yoga improved systolic (mean difference (MD) = − 5.85 mm Hg; 95% confidence interval (CI) = − 8.81, − 2.89) and diastolic blood pressure (MD = − 4.12 mm Hg; 95%CI = − 6.55, − 1.69), heart rate (MD = − 6.59 bpm; 95%CI = − 12.89, − 0.28), respiratory rate (MD = − 0.93 breaths/min; 95%CI = − 1.70, − 0.15), waist circumference (MD = − 1.95 cm; 95%CI = − 3.01, − 0.89), waist/hip ratio (MD = − 0.02; 95%CI = − 0.03, − 0.00), total cholesterol (MD = − 13.09 mg/dl; 95%CI = − 19.60, − 6.59), HDL (MD = 2.94 mg/dl; 95%CI = 0.57, 5.31), VLDL (MD = − 5.70 mg/dl; 95%CI = − 7.36, − 4.03), triglycerides (MD = − 20.97 mg/dl; 95%CI = − 28.61, − 13.32), HbA1c (MD = − 0.45%; 95%CI = − 0.87, − 0.02), and insulin resistance (MD = − 0.19; 95%CI = − 0.30, − 0.08). Relative to exercise, yoga improved HDL (MD = 3.70 mg/dl; 95%CI = 1.14, 6.26). Conclusions This meta-analysis revealed evidence for clinically important effects of yoga on most biological cardiovascular disease risk factors. Despite methodological drawbacks of the included studies, yoga can be considered as an ancillary intervention for the general population and for patients with increased risk of cardiovascular disease.