Poster Presentations

P-21: The Effects of Yoga on Global Cardiovascular Risk: A Three Month Intervention

Mr. Ashok Pandey

Ashok Pandey*
Nisar Huq
Mike Chapman
Antonio Fongang
Paul Poirier

Cambridge Cardiac Care Centre
Cardiac Rehabilitation

Topic: Health Services, Population and Public Health

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death worldwide, accounting for 31% of all deaths in 2015. Many factors including diabetes, high blood pressure, high cholesterol, smoking and family history contribute to this risk.  Recent studies have suggested vascular inflammation may also be an important contributor and interventions that lower this inflammation may reduce ASCVD risk. The process of vascular inflammation is an immunological response evoked by the body to injury of atherosclerosis. High sensitivity C reactive protein (hs-CRP) is a reliable indicator of inflammatory atherosclerosis. Regular physical activity may modify the inflammatory process and be cardio-protective. Yoga is a form of exercise that incorporates stretching, deep breathing and relaxation techniques. Studies suggest yoga may have cardiovascular benefits.  The effects of yoga on vascular inflammation and global cardiovascular risk have not been adequately described. An individual’s global cardiovascular risk can be estimated through cardiovascular risk scoring systems, which incorporate parameters like cholesterol, blood pressure, lifestyle choices, family history and demographics. The Reynold’s Risk Scoring System is a modern cardiovascular risk calculator that is widely utilized to estimate an individual’s 10-year risk of a cardiovascular event such as a myocardial infarction or stroke and incorporates the effects of vascular inflammation on cardiovascular risk. The purpose of this study is to determine whether the addition of yoga to a regular exercise regimen reduces global cardiovascular risk as determined by the Reynold’s Risk Score.

After written informed consent, 60 consecutive individuals with essential (idiopathic) hypertension who were being treated with lifestyle intervention alone were recruited from a local cardiovascular rehabilitation centre. All individuals taking medications or supplements that affected blood pressure, cholesterol or vascular inflammation were excluded. Participants were randomized 1:1 to either a yoga group or similar duration stretching control group. Individuals in each group performed 15 minutes of either yoga or stretching in addition to the standard routine of 30 minutes of aerobic exercises 3 days per week, over a 3-month intervention period. They then had assessments of blood pressure, cholesterol and hs-CRP at baseline and at the end of the 3-month intervention and the Reynold’s Risk Score was calculated.

At baseline the control stretching group had an average 10-year calculated Reynold’s Risk Score of a cardiovascular event of 9.0%, compared to 8.2% in the yoga intervention group (p=NS). After the three-month intervention period, there was a 6.5% relative risk reduction in the control stretching group, lowering their cardiovascular risk to 8.4% compared to a 13.2% relative risk reduction in the intervention yoga group, lowering their average cardiovascular risk to 7.0% (p<0.05).

In patients with essential hypertension or no medications and with no end organ damage, the practice of yoga incorporated in a 3-month intervention program was associated with significant greater improvement in the Reynold’s Risk Score when compared to the control stretching group.