Exercise as it relates to Disease/Effects of Yoga on Cardiovascular Health

Cardiovascular disease: definition and significance Cardiovascular disease is defined by a physiological dysfunction in the heart and/or the blood vessels. The following is a list of common cardiovascular diseases:World Health Organization. Cardiovascular diseases (CVDs) [Internet]. 2013 [updated 2013 Mar; cited 2014 Sep 26]. Fact sheet no.:317. Available from: http://www.who.int/mediacentre/factsheets/fs317/en/ • Coronary heart disease • Cerebrovascular disease • Peripheral arterial disease • Rheumatic heart disease • Congenital heart disease • Deep vein thrombosis and pulmonary embolism Cardiovascular disease is a leading cause of mortality worldwide, taking 17.5 million lives in 2012 World Health Organization. The top 10 causes of death [Internet]. 2011 [updated 2011 June; cited 2014 Sep 26]. Fact sheet no.:310. Available from: http://www.who.int/mediacentre/factsheets/fs310/en/ Yoga: definition and benefits The practice of yoga is thought to have originated in India and has been used for mind-body engagement for thousands of years. Yoga pairs meditation with balance, body weight movements and stretches. It’s believed that yoga alters the hormonal and sympathetic neuronal pathways in the body to bring a sense of general wellbeing Manchanda SC, Madan K. Yoga and meditation in cardiovascular disease. Clin Res Cardiol. 2014;103:675–680. doi:10.1007/s00392-014-0663-9Sengupta P. Health impacts of yoga and pranayama: a state-of-the-art review. Int J Prev Med [Internet]. 2012 [cited 2014 Sep 25];3(7):444-458. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3415184/ while improving metabolic status and reducing inflammatory action.Manchanda SC, Madan K. Yoga and meditation in cardiovascular disease. Clin Res Cardiol. 2014;103:675–680. doi:10.1007/s00392-014-0663-9 It has also been suggested that yoga alters the body’s preference toward the parasympathetic nervous system, resulting in improved cardiac vagal reactivity, energy levels and mood.Manchanda SC, Madan K. Yoga and meditation in cardiovascular disease. Clin Res Cardiol. 2014;103:675–680. doi:10.1007/s00392-014-0663-9 Yoga in cardiovascular disease: prevention and treatment Due to the range of factors that can contribute to the development of cardiovascular disease, many studies have been conducted to determine whether yoga assists with different physiological functions. Research has found that yoga may protect against/improve cardiovascular disease.Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: a systematic review. J Am Board Fam Pract. 2005;18(6):491-519Jayasinghe SR. Yoga in cardiac health (a review). Eur J Cardiovasc Prev Rehabil. 2004;11(5):369-375Yang K. A review of yoga programs for four leading risk factors of chronic diseases. Evid Based Complement. 2007;4(4):487-491 Specific mechanisms include: • Improving serum lipid levelsMahajan AS, Reddy KS, Sachdeva U. Lipid profiles of coronary risk subjects following yogic lifestyle intervention. Indian Heart J. 1999;51:37–40 • Decreasing blood pressure,Aivazyan TA, Zaitsev VP, Salenko BB, Yurenev AP, Patrusheva IF. Efficacy of relaxation techniques in hypertensive patients. Health Psychol. 1988;(7 Suppl):193–200Andrews G, Macmahon SW, Austin A, Byrne DG. Hypertension: comparison of drug and non-drug treatments. BMJ [Internet]. 1982 [cited 2014 Sep 25];284:15231526. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1498486/pdf/bmjcred00607-0023.pdfCohen DL, Bloedon LT, Rothman RL, Farrar JT, Galantino ML, Volger S, Mayor C, Szapary PO, Townsend RR. Iyengar yoga versus enhanced usual care on blood pressure in patients with stage I hypertension: a randomized controlled trial. Evid Based Complement Alternat Med. 2011. doi:10.1093/ecam/nep130Dhameja K, Singh S, Mustafa MD, Singh KP, Banerjee BD, Agarwal M, Ahmed RS. Therapeutic effect of yoga in patients with hypertension with reference to GST gene polymorphism. J Altern Complement Med. 2012;18:1-7. doi:10.1089/acm.2011.0961Deepa T, Sethu G, Thirrunavukkarasu N. Effect of yoga and meditation on mild to moderate essential hypertensives. J Clinical Diagn Res. 2012;6: 21-26Frumkin K, Nathan RJ, Prout MF, Cohen MC. Nonpharmacologic control of essential hypertension in man: a critical review of the experimental literature. Psychosom Med. 1978;40:294–320Krishna BH, Pal P, Pal GK, Balachander J, Jayasettiaseelon E, Sreekanth Y, Sridhar MG, Gaur GS. Effect of yoga therapy on heart rate, blood pressure and cardiac autonomic function in heart failure. J Clin Diagn Res. 2014;8(1):12-16. doi:10.7860/JCDR/2014/7844.3983Madanmohan, Udupa K, Bhavanani AB, Shatapathy CC, Sahai A. Modulation of cardiovascular response to exercise by yoga training. Indian J Physiol Pharmacol. 2004;48:461–5McCaffrey R, Ruknui P, Hatthakit U, Kasetsomboon P. The effects of yoga on hypertensive persons in Thailand. Holist Nurs Pract. 2005;19:173-180. doi:10.1097/00004650-200507000-00009Murugesan R, Govindarajulu N, Bera TK. Effect of selected yogic practices on the management of hypertension. Indian J Physiol Pharmacol. 2000;44(2): 207-210Saptharishi L, Soudarssanane M, Thiruselvakumar D, Navasakthi D, Mathanraj S, Karthigeyan M, Sahai A. Community-based randomized controlled trial of non-pharmacological interventions in prevention and control of hypertension among young adults. Indian J Community Med. 2009;34:329–34. doi: 10.4103/0970-0218.58393Schwickert M, Langhorst J, Paul A, Michalsen A, Dobos GJ. Stress management in the treatment of essential arterial hypertension. MMW Fortschr Med. 2006;148:40–2Subramanian H, Soudarssanane MB, Jayalakshmy R, Thiruselvakumar D, Navasakthi D, Sahai A, Saptharishi LG. Non-pharmacological interventions in hypertension: a community-based cross-over randomized controlled trial. Indian J Community Med. 2011;36(3):191-196. doi:10.4103/0970-0218.86519 including in type 2 diabeticsSingh S, Malhotra V, Singh KP, Madhu SV, Tandon OP. Role of yoga in modifying certain cardiovascular functions in type 2 diabetic patients. J Assoc Physicians India. 2004;52:203–6 • Controlling LDL cholesterolMahajan AS, Reddy KS, Sachdeva U. Lipid profiles of coronary risk subjects following yogic lifestyle intervention. Indian Heart J. 1999;51:37–40 • Improving parasympathetic activity in heart failure patientsKrishna BH, Pal P, Pal GK, Balachander J, Jayasettiaseelon E, Sreekanth Y, Sridhar MG, Gaur GS. Effect of yoga therapy on heart rate, blood pressure and cardiac autonomic function in heart failure. J Clin Diagn Res. 2014;8(1):12-16. doi:10.7860/JCDR/2014/7844.3983 • Regressing atherosclerosisManchanda SC, Narang R, Reddy KS, Sachdeva U, Prabhakaran D, Dharmanand S. Rajani M, Bijlani R. Retardation of coronary atherosclerosis with yoga lifestyle intervention. J Assoc Physicians India. 2000;48:687–94 • Reducing peripheral vascular resistance and blood pressure-rise in response to stressAivazyan TA, Zaitsev VP, Salenko BB, Yurenev AP, Patrusheva IF. Efficacy of relaxation techniques in hypertensive patients. Health Psychol. 1988;(7 Suppl):193–200 Recommendations As research on this topic is inconclusive and a dose-response relationship has not been established, there is currently no prescription for improving cardiovascular health by practicing yoga. Most research settings have been loosely controlled or contained small sample sizes. Some publications have also been heavily biased.Wang J, Xiong X, Liu W. Yoga for essential hypertension: a systematic review. PLoS ONE. 2013;8(10):e76357. doi:10.1371/journal.pone. 0076357 In spite of this, the positive effects that yoga may have on cardiovascular and general health justify its popularity and far outweigh the risk of injury from practicing yoga. The recommended approach is to incorporate yoga into a physical activity regime that also includes aerobic and strength training in an independent or social setting. All individuals should consult with their physician before commencing a new physical activity program. Further reading “Yoga and heart health” by the American Heart Association: http://www.heart.org/HEARTORG/GettingHealthy/PhysicalActivity/Yoga-and-Heart-Health_UCM_434966_Article.jsp “Yoga: fight stress and find serenity” by Mayo Clinic: http://www.mayoclinic.org/healthy-living/stress-management/in-depth/yoga/art-20044733 “A holistic approach to heart disease” by Yoga Journal: http://www.yogajournal.com/article/health/straight-heart/ “Top 10 ways to reduce your risk of heart disease” by Gaiam Life: http://life.gaiam.com/article/top-10-ways-reduce-your-risk-heart-disease References 1