Yoga for the prevention of cardiovascular disease

Abstract

Yoga has been associated with improvements in numerous cardiovascular risk factors and has the potential to address the unmet needs of current cardiovascular prevention strategies. Large and well-designed clinical trials are needed to assess the benefits of yoga across the spectrum of cardiovascular diseases and to provide the evidence required for its widespread implementation.

Comment

Yoga is popularly believed to denote a series of calisthenic exercises and physical postures that are practiced for physical fitness. However, this ancient Indian system also encompasses an array of philosophical precepts, mental attitudes and physical practices. Although practiced in many forms, yoga incorporates elements of physical poses, breathing exercises and meditation, as well as lifestyle habits such as moderation in diet and abstinence from smoking and alcohol. This multi-dimensional aspect of yoga is well established even in Western countries and the health benefits of yoga have extended to the prevention of disease, including cardiovascular diseases (CVD). Structured yoga practice has the potential to address the physical, psychological and health needs of patients with CVD.

The cardiovascular benefits of yoga have been explored extensively in the past five decades1 . The cardioprotective effects of yoga are believed to be mediated through stress reduction. Chronic stress can increase the activity of the hypothalamic–pituitary–adrenal axis, which results in the secretion of hormones, such as cortisol, glucagon, renin and angiotensin, and pro-inflammatory cytokines, culminating in increased blood-pressure levels, hyperglycaemia and a pro-atherogenic milieu2 . Furthermore, heightened sympathetic activity can elevate heart rate and increase myocardial workload. Stress also increases platelet aggregation and activates the clotting cascade to create a prothrombotic environment. Many yoga practices, such as slow breathing and meditation, can promote the activation of the parasympathetic nervous system, which can in turn putatively increase heart rate variability and improve vascular tone . Yoga can also reduce dopamine levels and increase serotonin levels, which has been linked to improvements in both physical and mental health. Additionally, yoga has been shown to reduce circulating levels of inflammatory markers such as IL-6 and C-reactive protein, as well as markers of oxidative stress. Of note, yoga practices were shown to be equal or superior to exercise for improving numerous health outcomes, such as autonomic function, antioxidant status, stress and patient-reported outcomes but not those involving physical fitness.

For More information, please visit: https://www.nature.com/articles/s41569-020-0412-x

Sources: Nature Reviews Cardiology volume 17, pages536–537 (2020)

Published: 09 July 2020

DOI: 10.1038/s41569-020-0412-x

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