Yoga as Antihypertensive Lifestyle Therapy: A Systematic Review and Meta-analysis.

Author: Wu Y1, Johnson BT2, Acabchuk RL2, Chen S3, Lewis HK4, Livingston J5, Park CL2, Pescatello LS6
Author Information:
1Department of Kinesiology, University of Connecticut, Storrs, CT; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT. Electronic address: yin.2.wu@uconn.edu.
2Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT; Department of Psychological Sciences, University of Connecticut, Storrs, CT.
3Department of Kinesiology, University of Connecticut, Storrs, CT.
4Department of Physical Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences, PA.
5Homer Babbidge Library, Health Sciences, University of Connecticut, Storrs, CT.
6Department of Kinesiology, University of Connecticut, Storrs, CT; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT.
Conference/Journal: Mayo Clin Proc.
Date published: 2019 Feb 6
Other: Pages: S0025-6196(18)30939-X , Special Notes: doi: 10.1016/j.mayocp.2018.09.023. [Epub ahead of print] , Word Count: 273


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.

Copyright © 2018 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

PMID: 30792067 DOI: 10.1016/j.mayocp.2018.09.023

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