Abstract
Background: Chronic stress is estimated to increase the risk of cardiovascular (CV) events two‐fold. Although stress reduction has been linked to a reduction in CV events, little is known regarding its exact mechanism of benefit.
Hypothesis: Yoga and meditation will improve parameters of endothelial function.
Methods: We examined the effects of yoga and meditation on hemodynamic and laboratory parameters as well as on endothelial function in a 6‐week pilot study. Systolic and diastolic blood pressures, heart rate, body mass index (BMI), fasting glucose, lipids, hs C‐reactive protein (CRP), and endothelial function (as assessed by brachial artery reactivity) were all studied at baseline and after 6 weeks of yoga practice.
Results: A course in yoga and meditation was given to the subjects for 1.5 h three times weekly for 6 weeks and subjects were instructed to continue their efforts at home. This prospective cohort study included 33 subjects (mean age 55 ± 11 years) both with (30%) and without (70%) established coronary artery disease (CAD). There were significant reductions in blood pressure, heart rate, and BMI in the total cohort with yoga. None of the laboratory parameters changed significantly with yoga. For the total cohort there was no significant improvement in endothelial‐dependent vasodilatation with yoga training and meditation compared with baseline (16.7% relative improvement from 7.2‐8.4%; p = 0.3). In the group with CAD, endothelial‐dependent vasodilatation improved 69% with yoga training (6.38‐10.78%; p = 0.09).
Conclusion: Yoga and meditation appear to improve endothelial function in subjects with CAD.
Keywords: endothelial function, yoga, stress management
Full Text
The Full Text of this article is available as a PDF (72.2 KB).
References
- 1. Ornish D, Brown SE, Scherwitz LW, Billings JH, Armstrong WT, Ports TA, McLanahan SM, Kirkeeide RL, Brand RJ, Gould KL: Can lifestyle changes reverse coronary heart disease? Lancet 1990; 336: 129–133 [DOI] [PubMed] [Google Scholar]
- 2. Fuster V, Pearson A: 27th Bethesda Conference: Matching the intensity of risk factor management with the hazard for coronary disease events. J Am Coll Cardiol 1996; 27: 964–1047 [DOI] [PubMed] [Google Scholar]
- 3. Mittleman M, Maclure M, Sherwood JB, Mulry RP, Tofler GH, Jacobs SC, Friedman R, Benson H, Muller JE, for the Determinants of Myocardial Infarction Onset Study Investigators: Triggering of acute myocardial infarction onset by episodes of anger. Circulation 1995; 92: 1720–1725 [DOI] [PubMed] [Google Scholar]
- 4. Rozanski A, Blumenthal J, Davidson KW, Saab PG, Kubzansky L: The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiovascular practice: The emerging field of behavioral cardiology. J Am Coll Cardiol 2005; 45: 637–651 [DOI] [PubMed] [Google Scholar]
- 5. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ, Thompson PD, Williams MA, Lauer MS: Cardiac rehabilitation and secondary prevention of coronary heart disease. Circulation 2005; 111: 369–376 [DOI] [PubMed] [Google Scholar]
- 6. Ramachandruni S, Handberg E, Sheps D: Acute and chronic stress in coronary disease. Curr Opin Cardiol 2004; 19: 494–499 [DOI] [PubMed] [Google Scholar]
- 7. La Forge R: Mind‐body fitness: Encouraging prospects for primary and secondary prevention. J Cardiovasc Nurs 1997; 11(3): 53–65 [DOI] [PubMed] [Google Scholar]
- 8. Appels A, Bar F, Lasker J, Flamm U, Kop W: The effect of a psychological intervention program on the risk of a new coronary event after angioplasty: A feasibility study. J Psychosom Res 1997; 43(2): 209–217 [DOI] [PubMed] [Google Scholar]
- 9. Peng CK, Mietus JE, Liu Y, Khalsa G, Douglas PS, Benson H, Goldberger AL: Exaggerated heart rate oscillations during two meditation techniques. Int J Cardiol 1999; 70: 101–107 [DOI] [PubMed] [Google Scholar]
- 10. Gandhi A, Bagga OP: A comparative study of the effect of transcendental meditation and shavasana practice on cardiovascular system. Indian Heart J 1983; 35(1): 39–45 [PubMed] [Google Scholar]
- 11. Lakshmikanthan C, Alagesan R, Thanikachalam S, Ramamurthi B, Elangovan D, Viswanathan TR, Kumar S: Long‐term effects of yoga on hypertension and/or coronary artery disease. Jr Assoc Phys Ind 1979; 27: 1055–1058 [PubMed] [Google Scholar]
- 12. Benson H, Rosner BA, Marzetta BR, Klemchuk HM: Decreased blood pressure in pharmacologically treated hypertensive patients who regularly elicited the relaxation response. Lancet 1974; I (7852): 289–291 [DOI] [PubMed] [Google Scholar]
- 13. Patel C, North WRS: Randomised controlled trial of yoga and bio‐feedback in the management of hypertension. Lancet 1975; I (7925): 93–95 [DOI] [PubMed] [Google Scholar]
- 14. Mahajan A, Reddy K, Sachdeva U: Lipid profile of coronary subjects following yogic lifestyle intervention. Indian Heart J 1999; 51: 37–40 [PubMed] [Google Scholar]
- 15. Raghuraj P, Ramakrishnan AG, Nagendra HR, Telles S: Effect of two selected yogic breathing techniques on heart rate variability. Indian J Physiol Pharmacol 1998; 42(4): 467–472 [PubMed] [Google Scholar]
- 16. Selvamurthy W, Sridharan K, Ray US, Tiwary RS, Hegde KS, Radhakrish‐nan U, Sinha KC: A new physiological approach to control essential hypertension. Indian J Physiol Pharmacol 1998; 42(2): 205–213 [PubMed] [Google Scholar]
- 17. Ornish D, Scherwitz L, Billings J, Gould L, Merritt T, Sparler S, Armstrong W, Ports T, Kirkeeide R, Hogeboom C, Brand R: Intensive lifestyle changes for reversal of coronary heart disease. J Am Med Assoc 1998; 280(23): 2001–2007 [DOI] [PubMed] [Google Scholar]
- 18. Dusseldorp E, van Elderen T, Maes S, Meulman J, Kraaij V: A meta‐analysis of psychoeducational programs for coronary heart disease patients. Health Psychol 1999; 18: 506–519 [DOI] [PubMed] [Google Scholar]
- 19. Blumenthal J, Sherwood A, Babyak M, Watkins LL, Waugh R, Georgiades A, Bacon SL, Hayano J, Coleman RE, Hinderliter A: Effects of exercise and stress management training on markers of cardiovascular risk in patients with ischemic heart disease. J Am Med Assoc 2005; 293: 1626–1634 [DOI] [PubMed] [Google Scholar]
- 20. Writing Committee for the ENRICHD Investigators : Effects of treating depression and low perceived social support on clinical events after myocardial infarction. J Am Med Assoc 2003; 289: 3106–3116 [DOI] [PubMed] [Google Scholar]
- 21. Corretti MC, Anderson TJ, Benjamin EJ, Celermajer D, Charbonneau F, Creager MA, Deanfield J, Drexler H, Gerhard‐Herman M, Herrington D, Vallance P, Vita J, Vogel R: Guidelines for the ultrasound assessment of en‐dothelial‐dependent flow‐mediated vasodilation of the brachial artery. A report of the international brachial artery reactivity task force. J Am Coll Cardiol 2002; 39(2): 257–265 [DOI] [PubMed] [Google Scholar]
- 22. Ghiadoni L, Donald A, Cropley M, Mullens MJ, Oakley G, Taylor M, O'Connor G, Betteridge J, Klein N, Steptoe A, Deanfield JE: Mental stress induces transient endothelial dysfunction in humans. Circulation 2000; 102: 2473–2478 [DOI] [PubMed] [Google Scholar]