438 Yoga may be beneficial for primary prevention of cardiovascular disease

July 15, 2014

PEARLS 438, July 2014, written by Brian R McAvoy

Clinical question
Is yoga effective in the primary prevention of cardiovascular disease (CVD)?

Bottom line
There was some evidence yoga had favourable effects on diastolic blood pressure, HDL-cholesterol and triglycerides, and uncertain effects on LDL-cholesterol. Quality of life was measured in 3 trials, but the results were inconclusive. It was not possible to say which types of yoga were effective in preventing CVD, or if the frequency, duration and physiological intensity of yoga impacted on its effectiveness. No studies reported adverse events or the occurrence of type 2 diabetes. Costs were also not examined in any of the included studies.

Caveat
No study reported cardiovascular mortality, all-cause mortality or non-fatal events, and most studies were small and short-term (<6 months’ duration). There was substantial heterogeneity between studies, making it impossible to combine studies statistically for systolic blood pressure and total cholesterol. There was a high degree of heterogeneity between trials, from different sources (participants, type of yoga, duration of intervention and follow-up, outcome data), which precluded statistical pooling for some outcomes.

Context
Sedentary lifestyle and stress are major risk factors for CVD. Since yoga involves exercise, and is thought to help in stress reduction, it may be an effective strategy in the primary prevention of CVD. Small reductions in CVD risk factors throughout a whole population may lead to large reductions in CVD incidence.1

Cochrane Systematic Review
Hartley L et al. Yoga for primary prevention of cardiovascular disease. Cochrane Reviews, 2014, Issue 5. Art. No.: CD010072.DOI: 10.1002/14651858. CD010072 .pub2. This review contains 11 studies involving 800 participants.

1. Emberson J et al. Eur Heart J 2004;25:484–91.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.