The effectiveness of yoga in modifying risk factors for cardiovascular disease and metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials

• Published in: European journal of preventive cardiology 2016-02, Vol.23 (3), p.291-307
• Main Authors: Chu, Paula, Gotink, Rinske A, Yeh, Gloria Y, Goldie, Sue J, Hunink, MG Myriam
• Format: Article
• Language: English
• Subjects: Aged; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Chi-Square Distribution; Female; Health Status; Humans; Male; Metabolic Syndrome - diagnosis; Metabolic Syndrome - epidemiology; Metabolic Syndrome - prevention & control; Middle Aged; Protective Factors; Randomized Controlled Trials as Topic; Risk Assessment; Risk Factors; Treatment Outcome; Yoga
• ISSN: 2047-4873; 2047-4881
• DOI: 10.1177/2047487314562741

Background Yoga, a popular mind-body practice, may produce changes in cardiovascular disease (CVD) and metabolic syndrome risk factors. Design This was a systematic review and random-effects meta-analysis of randomized controlled trials (RCTs). Methods Electronic searches of MEDLINE, EMBASE, CINAHL, PsycINFO, and The Cochrane Central Register of Controlled Trials were performed for systematic reviews and RCTs through December 2013. Studies were included if they were English, peer-reviewed, focused on asana-based yoga in adults, and reported relevant outcomes. Two reviewers independently selected articles and assessed quality using Cochrane’s Risk of Bias tool. Results Out of 1404 records, 37 RCTs were included in the systematic review and 32 in the meta-analysis. Compared to non-exercise controls, yoga showed significant improvement for body mass index (−0.77 kg/m2 (95% confidence interval −1.09 to −0.44)), systolic blood pressure (−5.21 mmHg (−8.01 to −2.42)), low-density lipoprotein cholesterol (−12.14 mg/dl (−21.80 to −2.48)), and high-density lipoprotein cholesterol (3.20 mg/dl (1.86 to 4.54)). Significant changes were seen in body weight (−2.32 kg (−4.33 to −0.37)), diastolic blood pressure (−4.98 mmHg (−7.17 to −2.80)), total cholesterol (−18.48 mg/dl (−29.16 to −7.80)), triglycerides (−25.89 mg/dl (−36.19 to −15.60), and heart rate (−5.27 beats/min (−9.55 to −1.00)), but not fasting blood glucose (−5.91 mg/dl (−16.32 to 4.50)) nor glycosylated hemoglobin (−0.06% Hb (−0.24 to 0.11)). No significant difference was found between yoga and exercise. One study found an impact on smoking abstinence. Conclusions There is promising evidence of yoga on improving cardio-metabolic health. Findings are limited by small trial sample sizes, heterogeneity, and moderate quality of RCTs.