1 1345 165 HYPERTENSION ANALYSIS OF STRESS REDUCTION USING MINDFULNESS MEDITATION AND YOGA (THE HARMONY STUDY): STUDY PROTOCOL OF A RANDOMISED CONTROL TRIAL. INTRODUCTION: HYPERTENSION (HTN) IS A LEADING RISK FACTOR FOR PREVENTABLE CARDIOVASCULAR DISEASE, WITH OVER ONE IN FIVE ADULTS AFFECTED WORLDWIDE. LIFESTYLE MODIFICATION IS A KEY STRATEGY FOR THE PREVENTION AND TREATMENT OF HTN. STRESS HAS BEEN ASSOCIATED WITH GREATER CARDIOVASCULAR RISK, AND STRESS MANAGEMENT IS A RECOMMENDED INTERVENTION FOR HYPERTENSIVES. STRESS REDUCTION THROUGH RELAXATION THERAPIES HAS BEEN SHOWN TO HAVE AN EFFECT ON HUMAN PHYSIOLOGY, INCLUDING LOWERING BLOOD PRESSURE (BP). HOWEVER, INDIVIDUALISED BEHAVIOURAL INTERVENTIONS ARE RESOURCE INTENSIVE, AND GROUP STRESS MANAGEMENT APPROACHES HAVE NOT BEEN VALIDATED FOR REDUCING HTN. THE HARMONY STUDY IS A PILOT RANDOMISED CONTROLLED TRIAL DESIGNED TO DETERMINE IF MINDFULNESS-BASED STRESS REDUCTION (MBSR), A STANDARDISED GROUP THERAPY, IS AN EFFECTIVE INTERVENTION FOR LOWERING BP IN STAGE 1 UNMEDICATED HYPERTENSIVES. METHODS AND ANALYSIS: MEN AND WOMEN UNMEDICATED FOR HTN WITH MEAN DAYTIME AMBULATORY BLOOD PRESSURE (ABP) >/=135/85 MM HG OR 24 H ABP >/=130/80 MM HG ARE INCLUDED IN THE STUDY. SUBJECTS ARE RANDOMISED TO RECEIVE MBSR IMMEDIATELY OR AFTER A WAIT-LIST CONTROL PERIOD. THE PRIMARY OUTCOME MEASURE IS MEAN AWAKE AND 24 H ABP. THE PRIMARY OBJECTIVE OF THE HARMONY STUDY IS TO COMPARE ABP BETWEEN THE TREATMENT AND WAIT-LIST CONTROL ARM AT THE 12-WEEK PRIMARY ASSESSMENT PERIOD. RESULTS FROM THIS STUDY WILL DETERMINE IF MBSR IS AN EFFECTIVE INTERVENTION FOR LOWERING BP IN EARLY UNMEDICATED HYPERTENSIVES. ETHICS AND DISSEMINATION: THIS RESEARCH PROJECT WAS APPROVED BY THE SUNNYBROOK RESEARCH ETHICS BOARD AND THE UNIVERSITY HEALTH NETWORK RESEARCH ETHICS BOARD (TORONTO, CANADA). PLANNED ANALYSES ARE IN FULL COMPLIANCE WITH THE PRINCIPLES OF THE DECLARATION OF HELSINKI. DATA COLLECTION WILL BE COMPLETED BY EARLY SPRING 2012. PRIMARY AND SECONDARY ANALYSIS WILL COMMENCE IMMEDIATELY AFTER DATA MONITORING IS COMPLETED; DISSEMINATION PLANS INCLUDE PREPARING PUBLICATIONS FOR SUBMISSION DURING THE SUMMER OF 2012. TRIAL REGISTRATION NUMBER: THIS STUDY IS REGISTERED WITH HTTP://CLINICALTRIALS.GOV (NCT00825526).	2012	
                                                                                                                                                                                                                                                  
2 1346  59 HYPERTENSION ANALYSIS OF STRESS REDUCTION USING MINDFULNESS MEDITATION AND YOGA: RESULTS FROM THE HARMONY RANDOMIZED CONTROLLED TRIAL. BACKGROUND: THE HARMONY STUDY WAS A RANDOMIZED, CONTROLLED TRIAL EXAMINING THE EFFICACY OF AN 8-WEEK MINDFULNESS-BASED STRESS REDUCTION (MBSR) PROGRAM FOR BLOOD PRESSURE (BP) LOWERING AMONG UNMEDICATED STAGE 1 HYPERTENSIVE PARTICIPANTS. METHODS: PARTICIPANTS DIAGNOSED WITH STAGE 1 HYPERTENSION BASED ON AMBULATORY BP WERE RANDOMIZED TO EITHER IMMEDIATE TREATMENT OF MBSR FOR 8 WEEKS OR WAIT-LIST CONTROL. PRIMARY OUTCOME ANALYSIS EVALUATED WHETHER CHANGE IN AWAKE AND 24-HOUR AMBULATORY BP FROM BASELINE TO WEEK 12 WAS SIGNIFICANTLY DIFFERENT BETWEEN THE 2 GROUPS. A WITHIN-GROUP BEFORE AND AFTER MBSR ANALYSIS WAS ALSO PERFORMED. RESULTS: THE STUDY ENROLLED 101 ADULTS (38% MALE) WITH BASELINE AVERAGE 24-HOUR AMBULATORY BP OF 135+/-7.9/82+/-5.8MM HG AND DAYTIME AMBULATORY BP OF 140+/-7.7/87+/-6.3 MMHG. AT WEEK 12, THE CHANGE FROM BASELINE IN 24-HOUR AMBULATORY BP WAS 0.4+/-6.7/0.0+/-4.9MM HG FOR THE IMMEDIATE INTERVENTION AND 0.4+/-7.8/-0.4+/-4.6MM HG FOR THE WAIT-LIST CONTROL. THERE WERE NO SIGNIFICANT DIFFERENCES BETWEEN INTERVENTION AND WAIT-LIST CONTROL FOR ALL AMBULATORY BP PARAMETERS. THE SECONDARY WITHIN-GROUP ANALYSIS FOUND A SMALL REDUCTION IN BP AFTER MBSR COMPARED WITH BASELINE, A FINDING LIMITED TO FEMALE SUBJECTS IN A SEX ANALYSIS. CONCLUSIONS: MBSR DID NOT LOWER AMBULATORY BP BY A STATISTICALLY OR CLINICALLY SIGNIFICANT AMOUNT IN UNTREATED, STAGE 1 HYPERTENSIVE PATIENTS WHEN COMPARED WITH A WAIT-LIST CONTROL GROUP. IT LEAVES UNTESTED WHETHER MBSR MIGHT BE USEFUL FOR LOWERING BP BY IMPROVING ADHERENCE IN TREATED HYPERTENSIVE PARTICIPANTS. CLINICAL TRIALS REGISTRATION: NCT00825526.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
3 1352  34 IMMEDIATE EFFECT OF MIND SOUND RESONANCE TECHNIQUE (MSRT - A YOGA-BASED RELAXATION TECHNIQUE) ON BLOOD PRESSURE, HEART RATE, AND STATE ANXIETY IN INDIVIDUALS WITH HYPERTENSION: A PILOT STUDY. BACKGROUND MIND SOUND RESONANCE TECHNIQUE (MSRT) IS A YOGA-BASED RELAXATION TECHNIQUE. PREVIOUS STUDIES ON MSRT DEMONSTRATED ITS POTENTIAL HEALTH-BENEFITING EFFECTS IN BOTH CLINICAL AND NONCLINICAL POPULATION. PRESENT STUDY INTENDED TO ASSESS THE ACUTE EFFECT OF MSRT INTERVENTION ON BLOOD PRESSURE, HEART RATE (HR), AND STATE ANXIETY IN PATIENTS WITH ESSENTIAL HYPERTENSION (HTN). METHODS THIRTY PARTICIPANTS (13 FEMALES) WITH HTN, WITHIN THE AGE RANGE 30-60 YEARS (WITH MEAN+/-SD: 57.23+/-11.3 YEARS), WHO VISITED SVYASA UNIVERSITY CAMPUS TO ATTEND 1-WEEK RESIDENTIAL YOGA PROGRAM FOR HTN TREATMENT, WERE CONSIDERED FOR THIS STUDY BASED ON INCLUSION AND EXCLUSION CRITERIA. ALL PARTICIPANTS RECEIVED A 4-DAY MSRT ORIENTATION SESSIONS PRIOR TO THE STUDY. EACH PARTICIPANT UNDERWENT 30-MIN SESSION OF BOTH MSRT AND SUPINE REST (SR) ON 2 SUCCESSIVE DAYS. SYSTOLIC AND DIASTOLIC BLOOD PRESSURES, PULSE RATE, AND STATE ANXIETY WERE MEASURED BEFORE AND IMMEDIATELY AFTER BOTH MSRT AND SR SESSIONS. DATA WERE ANALYZED USING SPSS VERSION 16. REPEATED-MEASURE ANALYSIS OF VARIANCE WAS APPLIED TO ASSESS WITHIN-SUBJECTS CHANGES. RESULTS AFTER MSRT SESSION, SIGNIFICANT DECREASE IN SYSTOLIC BLOOD PRESSURE (SBP), DIASTOLIC BLOOD PRESSURE (DBP), HR, AND STATE ANXIETY WAS OBSERVED COMPARED TO BASELINE. SIMILARLY, AFTER SR SESSION, SIGNIFICANT CHANGES WERE FOUND IN HR AND STATE ANXIETY. NO SIGNIFICANT CHANGE WAS SEEN IN SBP AND DBP FOLLOWING SR COMPARED TO SR SESSION; MSRT SESSION SHOWED SIGNIFICANTLY BETTER IMPROVEMENT IN SBP, DBP, HR, AND STATE ANXIETY. CONCLUSION PRESENT STUDY DEMONSTRATED THE USEFULNESS OF SINGLE SESSION OF MSRT IN REDUCING BLOOD PRESSURE, HR, AND STATE ANXIETY AMONG INDIVIDUALS WITH HTN AS COMPARED TO SR. THESE FINDINGS ENCOURAGE THE FURTHER STUDIES WITH LARGER SAMPLE SIZE AND LONG-TERM INTERVENTION WITH A ROBUST RESEARCH DESIGN.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                
4 2867  35 YOGA-BASED LIFESTYLE TREATMENT AND COMPOSITE TREATMENT GOALS IN TYPE 2 DIABETES IN A RURAL SOUTH INDIAN SETUP- A RETROSPECTIVE STUDY. THIS MULTICENTRE RETROSPECTIVE STUDY EXAMINED THE EFFECTS OF ADJUNCT YOGA-TREATMENT IN ACHIEVING COMPOSITE CARDIOVASCULAR GOALS FOR TYPE 2 DIABETES (T2D), SET FORTH BY THE AMERICAN DIABETES ASSOCIATION (ADA) IN RURAL INDIAN SETTINGS. RECORDS WERE EXTRACTED FOR 146 T2D PATIENTS, AGED >/=20-70 YEARS, AND TREATED UNDER THE "APOLLO TOTAL HEALTH PROGRAMME" FOR RURAL DIABETES MANAGEMENT, FOR THE PERIOD APRIL 2016 TO NOVEMBER 2016. THE STUDY COHORT COMPRISED OF TWO TREATMENT GROUPS (N = 73 EACH); NON-YOGA GROUP (STANDARD OF CARE) AND YOGA GROUP (ADJUNCT YOGA-TREATMENT). PROPENSITY SCORE MATCHING WAS APPLIED BETWEEN THE STUDY GROUPS TO DEFINE THE COHORT. COMPOSITE CARDIOVASCULAR SCORES WERE BASED ON THE COMBINATION OF INDIVIDUAL ADA GOALS; A1C < 7%, BLOOD PRESSURE (BP) < 140/90 MMHG, STRINGENT BP (<130/80 MMHG) AND LIPID, LDL-C < 100 MG/DL [RISK FACTOR FOR ATHEROSCLEROTIC CARDIOVASCULAR DISEASE]. LOGISTIC REGRESSION WAS USED TO COMPARE BETWEEN THE TWO TREATMENT GROUPS. COMPARED TO STANDARD OF CARE, ADJUNCT YOGA-TREATMENT WAS FOUND TO SIGNIFICANTLY FACILITATE THE ATTAINMENT OF ADA COMPOSITE SCORE BY 8-FOLD; A1C, ~2-FOLD; LDL-C, ~2-FOLD; BP < 140/90 MMHG AND <130/80 MMHG BY ~8-AND ~6-FOLD RESPECTIVELY. THIS STUDY PROVIDES THE FIRST EVIDENCE FOR SIGNIFICANT EFFICACY OF ADJUNCT YOGA-TREATMENT FOR THE ATTAINMENT OF FAVOURABLE TREATMENT GOALS FOR T2D IN RURAL INDIAN SETTINGS. CLINICAL TRIAL REGISTRATION NUMBER: CTRI/2020/02/0232790.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
5 1533  40 IYENGAR YOGA VERSUS ENHANCED USUAL CARE ON BLOOD PRESSURE IN PATIENTS WITH PREHYPERTENSION TO STAGE I HYPERTENSION: A RANDOMIZED CONTROLLED TRIAL. THE PREVALENCE OF PREHYPERTENSION AND STAGE 1 HYPERTENSION CONTINUES TO INCREASE DESPITE BEING AMENABLE TO NON-PHARMACOLOGIC INTERVENTIONS. IYENGAR YOGA (IY) HAS BEEN PURPORTED TO REDUCE BLOOD PRESSURE (BP) THOUGH EVIDENCE FROM RANDOMIZED TRIALS IS LACKING. WE CONDUCTED A RANDOMIZED CONTROLLED TRIAL TO ASSESS THE EFFECTS OF 12 WEEKS OF IY VERSUS ENHANCED USUAL CARE (EUC) (BASED ON INDIVIDUAL DIETARY ADJUSTMENT) ON 24-H AMBULATORY BP IN YOGA-NAIVE ADULTS WITH UNTREATED PREHYPERTENSION OR STAGE 1 HYPERTENSION. IN TOTAL, 26 AND 31 SUBJECTS IN THE IY AND EUC ARMS, RESPECTIVELY, COMPLETED THE STUDY. THERE WERE NO DIFFERENCES IN BP BETWEEN THE GROUPS AT 6 AND 12 WEEKS. IN THE EUC GROUP, 24-H SYSTOLIC BP (SBP), DIASTOLIC BP (DBP) AND MEAN ARTERIAL PRESSURE (MAP) SIGNIFICANTLY DECREASED BY 5, 3 AND 3 MMHG, RESPECTIVELY, FROM BASELINE AT 6 WEEKS (P < .05), BUT WERE NO LONGER SIGNIFICANT AT 12 WEEKS. IN THE IY GROUP, 24 H SBP WAS REDUCED BY 6 MMHG AT 12 WEEKS COMPARED TO BASELINE (P = .05). 24 H DBP (P < .01) AND MAP (P < .05) DECREASED SIGNIFICANTLY EACH BY 5 MMHG. NO DIFFERENCES WERE OBSERVED IN CATECHOLAMINE OR CORTISOL METABOLISM TO EXPLAIN THE DECREASE IN BP IN THE IY GROUP AT 12 WEEKS. TWELVE WEEKS OF IY PRODUCES CLINICALLY MEANINGFUL IMPROVEMENTS IN 24 H SBP AND DBP. LARGER STUDIES ARE NEEDED TO ESTABLISH THE LONG TERM EFFICACY, ACCEPTABILITY, UTILITY AND POTENTIAL MECHANISMS OF IY TO CONTROL BP.	2011	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
6  274  41 ADDITIONAL BENEFIT OF YOGA TO STANDARD LIFESTYLE MODIFICATION ON BLOOD PRESSURE IN PREHYPERTENSIVE SUBJECTS: A RANDOMIZED CONTROLLED STUDY. HIGH BLOOD PRESSURE (BP) IS A KNOWN RISK FACTOR FOR CARDIOVASCULAR DISEASE MORBIDITY. CONSIDERING THE GROWING EVIDENCE OF NONPHARMACOLOGICAL INTERVENTIONS IN THE MANAGEMENT OF HIGH BP, WE DESIGNED A RANDOMIZED, PARALLEL ACTIVE-CONTROLLED STUDY ON THE EFFECT OF YOGA AND STANDARD LIFESTYLE MODIFICATION (LSM) ON BP AND HEART RATE IN INDIVIDUALS WITH PREHYPERTENSION (SYSTOLIC BP 120-139 MM HG AND/OR DIASTOLIC BP 80-89 MM HG). VOLUNTEERS (20-60 YEARS) OF BOTH GENDERS WITHOUT ANY KNOWN CARDIOVASCULAR DISEASE WERE RANDOMIZED INTO EITHER LSM GROUP (N = 92) OR LSM+YOGA GROUP (N = 92). BEFORE THE INTERVENTION, AGE, WAIST CIRCUMFERENCE, PHYSICAL ACTIVITY, BP AND FASTING PLASMA GLUCOSE AND LIPIDS WERE COMPARABLE BETWEEN THE GROUPS. AFTER 12 WEEKS OF INTERVENTION, WE OBSERVED A SIGNIFICANT REDUCTION IN THE BP AND HEART RATE IN BOTH THE GROUPS. FURTHER, THE REDUCTION IN SYSTOLIC BP WAS SIGNIFICANTLY MORE IN LSM+YOGA GROUP (6 MM HG) AS COMPARED WITH LSM GROUP (4 MM HG). IN ADDITION, 13 PREHYPERTENSIVES BECAME NORMOTENSIVES IN LSM+YOGA GROUP AND FOUR IN LSM GROUP. THE RESULTS INDICATE EFFICACY OF NONPHARMACOLOGICAL INTERVENTION AND THE ADDITIONAL BENEFIT OF YOGA TO STANDARD LSM. FURTHER RESEARCH IN THIS FIELD MAY ADD TO THE LEVEL OF EVIDENCE ON THE BENEFIT OF YOGA, IN THE REDUCTION OF BP IN HIGH BP SUBJECTS, IN THE SCIENTIFIC LITERATURE.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
7  528  41 COMPARISON OF MINDFULNESS-BASED STRESS REDUCTION VERSUS YOGA ON URINARY URGE INCONTINENCE: A RANDOMIZED PILOT STUDY. WITH 6-MONTH AND 1-YEAR FOLLOW-UP VISITS. OBJECTIVES: THE OBJECTIVE OF THIS STUDY IS TO COMPARE THE EFFECTS OF MINDFULNESS-BASED STRESS REDUCTION (MBSR) VERSUS YOGA ON URINARY URGE INCONTINENCE (UI) AT 8 WEEKS, 6 MONTHS, AND 1 YEAR AFTER BEGINNING AN 8-WEEK PROGRAM. MATERIALS AND METHODS: PARTICIPANTS IN THIS PROSPECTIVE RANDOMIZED SINGLE-MASKED PILOT STUDY WERE WOMEN AGED 18 YEARS OR OLDER WITH URGE-PREDOMINANT INCONTINENCE, 5 OR MORE UI EPISODES (UIES) ON A 3-DAY VOIDING DIARY, AND NO RECENT ANTICHOLINERGIC USE. WOMEN WERE RANDOMIZED TO MBSR OR YOGA. THE PRIMARY OUTCOME WAS THE PERCENT CHANGE OF UIE. RESULTS: OF 30 ENROLLEES (15 IN MBSR, 15 IN YOGA), 24 COMPLETED AT LEAST 5 OF 8 SESSIONS (13 IN MBSR AND 11 IN YOGA). TWENTY AND 21 WOMEN COMPLETED THE 6-MONTH AND 12-MONTH FOLLOW-UP VISITS, RESPECTIVELY. AT 8 WEEKS, 6 MONTHS, AND 12 MONTHS, THE MEDIAN PERCENT CHANGE FROM THE BASELINE IN UIE ON THE INTENTION-TO-TREAT ANALYSIS WAS GREATER FOR THE MBSR GROUP (-55.6, -71.4, AND -66.7, RESPECTIVELY) COMPARED WITH THAT FOR THE YOGA GROUP (-33.3, -11.8, AND -16.7, RESPECTIVELY), WITH P VALUES RANGING FROM 0.01 TO 0.08. ON INTENTION-TO-TREAT ANALYSIS, THE MEDIAN PERCENT CHANGE IN THE OVERACTIVE BLADDER SYMPTOM AND QUALITY OF LIFE-SHORT FORM AND THE HEALTH-RELATED QUALITY OF LIFE WAS GREATER AT EACH TIME POINT FOR MBSR THAN FOR YOGA BUT WAS STATISTICALLY SIGNIFICANT ONLY AT 8 WEEKS (P = 0.003 AND 0.02, RESPECTIVELY). AS PER PROTOCOL ANALYSIS, AT 8 WEEKS, 6/13 AND 0/11 WOMEN IN MBSR AND YOGA, RESPECTIVELY, REPORTED THEY WERE VERY MUCH OR MUCH BETTER (P = 0.02), WHEREAS AT 1 YEAR, 6/12 AND 1/9 WOMEN IN MBSR AND YOGA, RESPECTIVELY, DID SO (P = 0.16). DISCUSSION: THESE RESULTS SUPPORT LARGER SCALE TRIALS TO EVALUATE MBSR, WHICH SEEMS TO BE A PROMISING TREATMENT OF UI.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
8  174  41 A RANDOMIZED CONTROLLED TRIAL COMPARING THE EFFECTS OF YOGA WITH AN ACTIVE CONTROL ON AMBULATORY BLOOD PRESSURE IN INDIVIDUALS WITH PREHYPERTENSION AND STAGE 1 HYPERTENSION. THE PURPOSE OF THIS STUDY WAS TO COMPARE THE EFFECTS OF YOGA WITH AN ACTIVE CONTROL (NONAEROBIC EXERCISE) IN INDIVIDUALS WITH PREHYPERTENSION AND STAGE 1 HYPERTENSION. A RANDOMIZED CLINICAL TRIAL WAS PERFORMED USING TWO ARMS: (1) YOGA AND (2) ACTIVE CONTROL. PRIMARY OUTCOMES WERE 24-HOUR DAY AND NIGHT AMBULATORY SYSTOLIC AND DIASTOLIC BLOOD PRESSURES. WITHIN-GROUP AND BETWEEN-GROUP ANALYSES WERE PERFORMED USING PAIRED T TESTS AND REPEATED-MEASURES ANALYSIS OF VARIANCE (TIME X GROUP), RESPECTIVELY. EIGHTY-FOUR PARTICIPANTS ENROLLED, WITH 68 PARTICIPANTS COMPLETING THE TRIAL. WITHIN-GROUP ANALYSES FOUND 24-HOUR DIASTOLIC, NIGHT DIASTOLIC, AND MEAN ARTERIAL PRESSURE ALL SIGNIFICANTLY REDUCED IN THE YOGA GROUP (-3.93, -4.7, -4.23 MM HG, RESPECTIVELY) BUT NO SIGNIFICANT WITHIN-GROUP CHANGES IN THE ACTIVE CONTROL GROUP. DIRECT COMPARISONS OF THE YOGA INTERVENTION WITH THE CONTROL GROUP FOUND A SINGLE BLOOD PRESSURE VARIABLE (DIASTOLIC NIGHT) TO BE SIGNIFICANTLY DIFFERENT (P=.038). THIS STUDY HAS DEMONSTRATED THAT A YOGA INTERVENTION CAN LOWER BLOOD PRESSURE IN PATIENTS WITH MILD HYPERTENSION. ALTHOUGH THIS STUDY WAS NOT ADEQUATELY POWERED TO SHOW BETWEEN-GROUP DIFFERENCES, THE SIZE OF THE YOGA-INDUCED BLOOD PRESSURE REDUCTION APPEARS TO JUSTIFY PERFORMING A DEFINITIVE TRIAL OF THIS INTERVENTION TO TEST WHETHER IT CAN PROVIDE MEANINGFUL THERAPEUTIC VALUE FOR THE MANAGEMENT OF HYPERTENSION.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
9 1552  52 LIFESTYLE MODIFICATION IN BLOOD PRESSURE STUDY II (LIMBS): STUDY PROTOCOL OF A RANDOMIZED CONTROLLED TRIAL ASSESSING THE EFFICACY OF A 24 WEEK STRUCTURED YOGA PROGRAM VERSUS LIFESTYLE MODIFICATION ON BLOOD PRESSURE REDUCTION. HYPERTENSION IS A MAJOR PUBLIC HEALTH ISSUE AFFECTING 68 MILLION ADULTS IN THE UNITED STATES. LIFESTYLE MODIFICATIONS INCLUDING COMPLEMENTARY THERAPIES SUCH AS THE MOVEMENT BASED MIND BODY PRACTICE OF YOGA HAVE BECOME INCREASINGLY POPULAR IN THE UNITED STATES AND HAVE BEEN CONSIDERED AS A POTENTIAL ALTERNATIVE TO MEDICATION IN BLOOD PRESSURE REDUCTION. WE COMPLETED A PILOT STUDY IN 2009 WHICH SHOWED MEANINGFUL DECREASES IN 24-HOUR AMBULATORY BLOOD PRESSURE READINGS AFTER A 12 WEEK PERIOD OF YOGA PARTICIPATION. BASED ON DATA FROM OUR PILOT STUDY WE ARE NOW COMPLETING THE LIFESTYLE MODIFICATION AND BLOOD PRESSURE STUDY (LIMBS II) WHICH IS A PHASE 2 RANDOMIZED CONTROLLED TRIAL DESIGNED TO DETERMINE THE EFFECTS OF YOGA THERAPY AND ENHANCED LIFESTYLE MODIFICATION ON LOWERING BLOOD PRESSURE IN PRE-HYPERTENSIVE AND STAGE 1 HYPERTENSIVE SUBJECTS. USING 24-HOUR AMBULATORY BLOOD PRESSURE MONITORING, LIMBS II AIMS TO COMPARE THE EFFECTS ON BLOOD PRESSURE REDUCTION IN SUBJECTS RANDOMIZED FOR 24 WEEKS TO ONE OF THE THREE FOLLOWING GROUPS: YOGA THERAPY VERSUS BLOOD PRESSURE EDUCATION PROGRAM (SODIUM RESTRICTION AND WALKING PROGRAM) VERSUS A COMBINATION PROGRAM THAT INVOLVES COMPONENTS OF BOTH GROUPS. LIMBS II WILL ALSO EXAMINE THE IMPACT THAT CHANGES IN BLOOD PRESSURE HAVE ON CEREBRAL BLOOD FLOW. IF SUCCESSFUL, THE LIMBS STUDY WILL DETERMINE IF YOGA THERAPY COMBINED WITH ENHANCED LIFESTYLE MODIFICATION WILL RESULT IN CLINICALLY MEANINGFUL DECREASES IN BLOOD PRESSURE AND THUS CAN BE IMPLEMENTED AS AN ALTERNATIVE TO DRUG THERAPY FOR PATIENTS WITH PREHYPERTENSION AND STAGE 1 HYPERTENSION.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
10 2491  44 YOGA AS ANTIHYPERTENSIVE LIFESTYLE THERAPY: A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVE: TO INVESTIGATE THE EFFICACY OF YOGA AS ANTIHYPERTENSIVE LIFESTYLE THERAPY AND IDENTIFY MODERATORS THAT ACCOUNT FOR VARIABILITY IN THE BLOOD PRESSURE (BP) RESPONSE TO YOGA. METHODS: WE SYSTEMATICALLY SEARCHED 6 ELECTRONIC DATABASES FROM INCEPTION THROUGH JUNE 4, 2018, FOR ARTICLES PUBLISHED IN ENGLISH LANGUAGE JOURNALS ON TRIALS OF YOGA INTERVENTIONS THAT INVOLVED ADULT PARTICIPANTS, REPORTED PREINTERVENTION AND POSTINTERVENTION BP, AND HAD A NONEXERCISE/NONDIET CONTROL GROUP. OUR SEARCH YIELDED 49 QUALIFYING CONTROLLED TRIALS (56 INTERVENTIONS). WE (1) EVALUATED THE RISK OF BIAS AND METHODOLOGICAL STUDY QUALITY, (2) PERFORMED META-REGRESSION ANALYSIS FOLLOWING RANDOM-EFFECTS ASSUMPTIONS, AND (3) GENERATED ADDITIVE MODELS THAT REPRESENTED THE LARGEST POSSIBLE CLINICALLY RELEVANT BP REDUCTIONS. RESULTS: ON AVERAGE, THE 3517 TRIAL PARTICIPANTS WERE MIDDLE-AGED (49.2+/-19.5 YEARS), OVERWEIGHT (27.9+/-3.6 KG/M(2)) ADULTS WITH HIGH BP (SYSTOLIC BP, 129.3+/-13.3 MM HG; DIASTOLIC BP, 80.7+/-8.4 MM HG). YOGA WAS PRACTICED 4.8+/-3.4 SESSIONS PER WEEK FOR 59.2+/-25.0 MINUTES PER SESSION FOR 13.2+/-7.5 WEEKS. ON AVERAGE, YOGA ELICITED MODERATE REDUCTIONS IN SYSTOLIC BP (WEIGHTED MEAN EFFECT SIZE, -0.47; 95% CI, -0.62-0.32, -5.0 MM HG) AND DIASTOLIC BP (WEIGHTED MEAN EFFECT SIZE, -0.47; 95% CI, -0.61 TO -0.32; -3.9 MM HG) COMPARED WITH CONTROLS (P<.001 FOR BOTH SYSTOLIC BP AND DIASTOLIC BP). CONTROLLING FOR PUBLICATION BIAS AND METHODOLOGICAL STUDY QUALITY, WHEN YOGA WAS PRACTICED 3 SESSIONS PER WEEK AMONG SAMPLES WITH HYPERTENSION, YOGA INTERVENTIONS THAT INCLUDED BREATHING TECHNIQUES AND MEDITATION/MENTAL RELAXATION ELICITED BP REDUCTIONS OF 11/6 MM HG COMPARED WITH THOSE THAT DID NOT (IE, 6/3 MM HG). CONCLUSION: OUR RESULTS INDICATE THAT YOGA IS A VIABLE ANTIHYPERTENSIVE LIFESTYLE THERAPY THAT PRODUCES THE GREATEST BP BENEFITS WHEN BREATHING TECHNIQUES AND MEDITATION/MENTAL RELAXATION ARE INCLUDED.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
11 2660  46 YOGA IN ARTERIAL HYPERTENSION. BACKGROUND: YOGA SEEMS TO EXERT ITS EFFECT AGAINST ARTERIAL HYPERTENSION MAINLY THROUGH THE ASSOCIATED BREATHING AND MEDITATION TECHNIQUES, AND LESS SO THROUGH YOGA POSTURES. THE GOAL OF THIS TRIAL WAS TO COMPARE THE BLOOD PRESSURE-LOWERING EFFECT OF YOGA INTERVENTIONS WITH AND WITHOUT YOGA POSTURES IN PATIENTS WITH ARTERIAL HYPERTENSION. METHODS: 75 PATIENTS TAKING MEDICATIONS FOR ARTERIAL HYPERTENSION (72% WOMEN, MEAN AGE 58.7 +/- 9.5 YEARS) WERE RANDOMIZED INTO THREE GROUPS: A YOGA INTERVENTION GROUP WITH YOGA POSTURES (25 PATIENTS, OF WHOM 5 DROPPED OUT OF THE TRIAL BEFORE ITS END), A YOGA INTERVENTION GROUP WITHOUT YOGA POSTURES (25 PATIENTS, 3 DROPOUTS), AND A WAIT LIST CONTROL GROUP (25 PATIENTS, ONE DROPOUT). THE INTERVENTIONS CONSISTED OF 90 MINUTES OF YOGA PRACTICE PER WEEK FOR TWELVE WEEKS. THE DATA COLLECTORS, WHO WERE BLINDED TO THE INTERVENTION RECEIVED, ASSESSED THE PRIMARY OUTCOME MEASURES "SYSTOLIC 24-HOUR BLOOD PRESSURE" AND "DIASTOLIC 24-HOUR BLOOD PRESSURE" BEFORE AND AFTER THE INTERVENTION. IN THIS REPORT, WE ALSO PRESENT THE FINDINGS ON SECONDARY OUTCOME MEASURES, INCLUDING FOLLOW-UP DATA. RESULTS: AFTER THE INTERVENTION, THE SYSTOLIC 24-HOUR BLOOD PRESSURE IN THE YOGA INTERVENTION GROUP WITHOUT YOGA POSTURES WAS SIGNIFICANTLY LOWER THAN IN THE CONTROL GROUP (GROUP DIFFERENCE [DELTA]= -3.8 MMHG; [95% CONFIDENCE INTERVAL (CI): (-0.3; -7.4) P = 0.035]); IT WAS ALSO SIGNIFICANTLY LOWER THAN IN THE YOGA INTERVENTION GROUP WITH YOGA POSTURES (DELTA = -3.2 MMHG; 95% CI: [-6.3; -0.8]; P = 0.045). DIASTOLIC BLOOD PRESSURES DID NOT DIFFER SIGNIFICANTLY ACROSS GROUPS. NO SERIOUS ADVERSE EVENTS WERE ENCOUNTERED IN THE COURSE OF THE TRIAL. CONCLUSION: IN ACCORDANCE WITH THE FINDINGS OF EARLIER STUDIES, WE FOUND THAT ONLY YOGA WITHOUT YOGA POSTURES INDUCED A SHORT-TERM LOWERING OF AMBULATORY SYSTOLIC BLOOD PRESSURE. YOGA IS SAFE AND EFFECTIVE IN PATIENTS TAKING MEDICATIONS FOR ARTERIAL HYPERTENSION AND THUS CAN BE RECOMMENDED AS AN ADDITIONAL TREATMENT OPTION FOR PERSONS IN THIS CATEGORY.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                           
12  658  51 EFFECT OF 1-WEEK YOGA-BASED RESIDENTIAL PROGRAM ON CARDIOVASCULAR VARIABLES OF HYPERTENSIVE PATIENTS: A COMPARATIVE STUDY. INTRODUCTION: HYPERTENSION (HTN) IS AN IMPORTANT PUBLIC HEALTH CONCERN AND A LEADING CAUSE OF MORBIDITY AND MORTALITY WORLDWIDE. YOGA IS A FORM OF MIND-BODY MEDICINE SHOWN TO BE EFFECTIVE IN CONTROLLING BLOOD PRESSURE (BP) AND REDUCES CARDIAC RISK FACTORS IN HTN. INTEGRATED APPROACH OF YOGA THERAPY (IAYT) IS A RESIDENTIAL YOGA-BASED LIFESTYLE INTERVENTION PROVEN TO BE BENEFICIAL IN SEVERAL HEALTH CONDITIONS. AIM: TO STUDY THE EFFICACY OF 1 WEEK OF RESIDENTIAL IAYT INTERVENTION ON CARDIOVASCULAR PARAMETERS IN HYPERTENSIVE PATIENTS. METHODOLOGY: TWENTY HYPERTENSIVE INDIVIDUALS (7 FEMALES) WITHIN AGE RANGE BETWEEN 30 AND 60 YEARS (AVERAGE; 46.62 +/- 9.9 YEARS), WHO UNDERWENT 1 WEEK OF IAYT TREATMENT FOR HTN, WERE COMPARED WITH AGE- GENDER-MATCHED NON-IAYT GROUP (5 FEMALES; AVERAGE AGE; 47.08 +/- 9.69 YEARS) IN TERMS OF SYSTOLIC BP (SBP), DIASTOLIC BP (DBP), MEAN ARTERIAL PRESSURE (MAP), CARDIAC OUTPUT (CO), STROKE VOLUME (SV), BAROREFLEX SENSITIVITY (BRS), AND TOTAL PERIPHERAL VASCULAR RESISTANCE (TPVR), IAYT PROGRAM CONSISTED OF SESSIONS OF ASANAS, BREATHING PRACTICES, MEDITATION AND RELAXATION TECHNIQUES, LOW SALT, LOW-CALORIE DIET, DEVOTIONAL SESSION, AND COUNSELING. INDIVIDUALS IN NON-IAYT GROUP FOLLOWED THEIR NORMAL ROUTINE. ALL THE VARIABLES WERE ASSESSED BEFORE AND AFTER ONE WEEK. DATA WERE ANALYZED USING SPSS VERSION 16. RM-ANOVA WAS APPLIED TO ASSESS WITHIN GROUP AND BETWEEN GROUP CHANGES AFTER INTERVENTION. RESULTS: THERE WAS A SIGNIFICANT IMPROVEMENT IN SBP (P = 0.004), DBP (P = 0.008), MAP (0.03), BRS (P < 0.001), AND TPVR (P = 0.007) IN IAYT, GROUP WHEREAS IN CONTROL GROUP, WE DID NOT FIND SIGNIFICANT DIFFERENCE IN ANY OF THE VARIABLES. BETWEEN-GROUP COMPARISON SHOWED A SIGNIFICANT IMPROVEMENT IN SBP (P = 0.038), BRS (P = 0.034), AND TPVR (P = 0.015) IN IAYT GROUP AS COMPARED TO NON-IAYT GROUP. CONCLUSION: ONE-WEEK IAYT INTERVENTION SHOWED AN IMPROVEMENT IN BAROREFLEX SENSITIVITY, SYSTOLIC BP, AND TOTAL PERIPHERAL VASCULAR RESISTANCE IN HYPERTENSIVE PATIENTS. HOWEVER, FURTHER RANDOMIZED CONTROL TRIALS NEED TO BE PERFORMED TO CONFIRM THE PRESENT FINDINGS.	2018	
                                                                                                                                                                                                                                                                           
13  412  37 BLOOD PRESSURE EFFECTS OF YOGA, ALONE OR IN COMBINATION WITH LIFESTYLE MEASURES: RESULTS OF THE LIFESTYLE MODIFICATION AND BLOOD PRESSURE STUDY (LIMBS). THE AUTHORS CONDUCTED A STUDY TO ASSESS THE EFFECTS OF YOGA ON BLOOD PRESSURE (BP). PATIENTS WERE RANDOMIZED TO YOGA (BLOOD PRESSURE EDUCATION PROGRAM [BPEP]), OR A COMBINED PROGRAM (COMBO). AMBULATORY BP WAS MEASURED AT BASELINE AND AT 12 AND 24 WEEKS. DATA ARE PRESENTED FOR ALL ENROLLED PATIENTS (N=137) AND FOR COMPLETERS ONLY (N=90). SYSTOLIC BP (SBP) AND DIASTOLIC BP (DBP) WERE SIGNIFICANTLY DECREASED WITHIN ALL GROUPS AT 12 AND 24 WEEKS (P<.001) FOR ENROLLED PATIENTS AND COMPLETERS. SBP WAS SIGNIFICANTLY REDUCED IN THE YOGA AND COMBO GROUPS AS COMPARED WITH THE BPEP GROUP AT 12 WEEKS IN ALL ENROLLED AND COMPLETERS. SBP DIFFERENCES WERE NO LONGER SIGNIFICANT AT 24 WEEKS BETWEEN GROUPS IN ALL ENROLLED PATIENTS; HOWEVER, THERE WAS A GREATER REDUCTION IN SBP AT 24 WEEKS IN COMPLETERS FAVORING BPEP OVER YOGA. NO DIFFERENCES IN DBP BETWEEN GROUPS OR IN BP BETWEEN THE YOGA AND COMBO GROUPS WERE PRESENT. THE AUTHORS DID NOT OBSERVE AN ADDITIVE BENEFIT FROM COMBINING YOGA WITH BPEP MEASURES. REASONS FOR THIS ARE UNCLEAR AT THIS TIME. BP LOWERING WITH YOGA, HOWEVER, WAS SIMILAR TO THAT ACHIEVED WITH LIFESTYLE MEASURES.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
14  953  55 EFFECTS OF A HEALTH WORKER-LED 3-MONTH YOGA INTERVENTION ON BLOOD PRESSURE OF HYPERTENSIVE PATIENTS: A RANDOMISED CONTROLLED MULTICENTRE TRIAL IN THE PRIMARY CARE SETTING. BACKGROUND: HYPERTENSION CONTROL REMAINS A MAJOR CHALLENGE GLOBALLY. A RECENT SYSTEMATIC REVIEW SUGGESTED THAT YOGA HAS BENEFICIAL EFFECTS ON REDUCING BLOOD PRESSURE. HOWEVER, THE ROLE OF YOGA IN HYPERTENSION MANAGEMENT IN PRIMARY HEALTH CARE HAS RECEIVED LITTLE ATTENTION, AND NO STUDIES HAVE EVALUATED THE IMPACT OF A YOGA PROGRAM FULLY DELIVERED BY HEALTH CARE STAFF ON HYPERTENSION. THIS STUDY, THEREFORE, ASSESSED THE EFFECTS OF A HEALTH WORKER-LED YOGA INTERVENTION ON BLOOD PRESSURE REDUCTION AMONG HYPERTENSIVES PATIENTS IN THE PRIMARY CARE SETTING. METHODS: THIS WAS A MULTICENTRIC, TWO-ARM, RANDOMISED TRIAL CONDUCTED AMONG HYPERTENSIVE PATIENTS IN SEVEN AYURVEDA HEALTH CENTRES IN NEPAL BETWEEN MARCH 2017 AND JUNE 2018. ONE HUNDRED AND TWENTY-ONE PARTICIPANTS WHO WERE ON OR WITHOUT MEDICATIONS WERE RANDOMISED TO INTERVENTION (N = 61) AND WAIT-LIST CONTROL (N = 60) GROUPS USING STRATIFIED BLOCK RANDOMISATION. PARTICIPANTS IN THE INTERVENTION ARM RECEIVED AN INTERVENTION CONSISTING OF AN INITIAL FIVE-DAY STRUCTURED YOGA TRAINING AT THE CENTRES AND THEN A FURTHER HOME-BASED PRACTICE OF YOGA FOR FIVE DAYS A WEEK FOR THE FOLLOWING 90 DAYS. BOTH INTERVENTION AND CONTROL GROUPS ALSO PARTICIPATED IN A 2-H HEALTH EDUCATION SESSION. THE PRIMARY OUTCOME OF THIS TRIAL WAS SYSTOLIC BLOOD PRESSURE AT 90-DAY FOLLOW-UP. DATA WERE ANALYSED ON AN INTENTION-TO-TREAT BASIS USING LINEAR MIXED-EFFECTS REGRESSION MODELS. RESULTS: WE INCLUDED ALL 121 STUDY PARTICIPANTS (INTERVENTION/CONTROL = 61/60) IN THE PRIMARY ANALYSIS (52.1% MALES; MEAN +/- SD AGE = 47.8 +/- 10.8 YEARS). THE DIFFERENCE IN SYSTOLIC BLOOD PRESSURE BETWEEN THE INTERVENTION GROUP AND THE CONTROL GROUP WAS - 7.66 MMHG (95% CI: - 10.4, - 4.93). FOR DIASTOLIC BLOOD PRESSURE, THE DIFFERENCE WAS - 3.86 MMHG (95% CI: - 6.65, - 1.06). NO ADVERSE EVENTS WERE REPORTED BY THE PARTICIPANTS. CONCLUSIONS: A YOGA PROGRAM FOR HYPERTENSIVE PATIENTS CONSISTING OF A FIVE-DAY TRAINING IN HEALTH CENTRES AND 90 DAYS OF PRACTICE AT HOME IS EFFECTIVE FOR REDUCING BLOOD PRESSURE. SIGNIFICANT BENEFITS FOR HYPERTENSIVE PATIENTS COULD BE EXPECTED IF SUCH PROGRAMMES WOULD BECOME A PART OF THE STANDARD TREATMENT PRACTICE. TRIAL REGISTRATION: THIS TRIAL WAS PROSPECTIVELY REGISTERED WITH THE CLINICAL TRIAL REGISTRY OF INDIA [ CTRI/2017/02/007822 ] ON 10/02/2017.	2021	

15 2213  29 THE HYPOTENSIVE EFFECT OF YOGA'S BREATHING EXERCISES: A SYSTEMATIC REVIEW. THE AIM OF THIS REVIEW WAS TO EVALUATE THE EFFECT OF PRANAYAMA (YOGA'S BREATHING EXERCISES) ON BP AND ITS APPLICABILITY IN THE TREATMENT OF HYPERTENSION. THIRTEEN TRIALS, ASSESSING ACUTE (EIGHT STUDIES) AND CHRONIC (FIVE STUDIES) BP RESPONSE TO PRANAYAMA WERE INCLUDED. SIGNIFICANT BP REDUCTIONS AFTER PRANAYAMA WERE FOUND IN BOTH ACUTE (2-10 MMHG MEAN SBP REDUCTION, N = 5 STUDIES; 1 MMHG MEAN DBP REDUCTION, N = 1 STUDY) AND CHRONIC STUDIES (4-21 MMHG MEAN SBP REDUCTION, N = 3 STUDIES; 4-7 MMHG MEAN DBP REDUCTION, N = 2 STUDIES). THE PRANAYAMA'S EFFECT ON BP WERE NOT ROBUST AGAINST SELECTION BIAS DUE TO THE LOW QUALITY OF STUDIES. BUT, THE LOWERING BP EFFECT OF PRANAYAMA IS ENCOURAGING. THE PRANAYAMA WITH SLOWER RHYTHMS AND MANIPULATION OF THE NOSTRILS, MAINLY WITH BREATHS BY THE LEFT, PRESENT BETTER RESULTS WHEN COMPARED WITH THE OTHER TYPES AND SHOULD BE THE MAIN PRANAYAMA APPLIED WHEN THE GOAL IS TO REDUCE BLOOD PRESSURE ESPECIALLY IN HYPERTENSIVE PATIENTS.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
16  692  33 EFFECT OF COMMUNITY-BASED YOGA INTERVENTION ON OXIDATIVE STRESS AND GLYCEMIC PARAMETERS IN PREDIABETES: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: TO STUDY THE EFFECTIVENESS OF YOGA INTERVENTION ON OXIDATIVE STRESS, GLYCEMIC STATUS, BLOOD PRESSURE AND ANTHROPOMETRY IN PREDIABETES. DESIGN: RANDOMIZED-CONTROLLED TRIAL. PARTICIPANTS: TWENTY NINE PREDIABETES SUBJECTS AGED 30-75 YEARS. SETTING: YOGA WAS CONDUCTED AT 4 DIFFERENT COMMUNITY DIABETES CLINICS IN MANGALORE, INDIA. INTERVENTIONS: PARTICIPANTS WERE RANDOMIZED TO EITHER 3-MONTH YOGA OR WAIT-LIST CONTROL GROUPS. MAIN OUTCOME MEASURES: MALONDIALDEHYDE, GLUTATHIONE, VITAMIN C, VITAMIN E, SUPEROXIDE DISMUTASE, PLASMA GLUCOSE, GLYCATED HAEMOGLOBIN, BMI, WAIST CIRCUMFERENCE, WAIST-TO-HIP RATIO AND BLOOD PRESSURE. RESULTS: YOGA INTERVENTION RESULTED IN A SIGNIFICANT DECLINE IN MALONDIALDEHYDE (P<0.001), RELATIVE TO THE CONTROL GROUP. IN COMPARISON WITH THE CONTROL, THERE WAS A SIGNIFICANT IMPROVEMENT IN BMI, WAIST CIRCUMFERENCE, SYSTOLIC BLOOD PRESSURE AND FASTING GLUCOSE LEVELS AT FOLLOW-UP. NO SIGNIFICANT IMPROVEMENT IN GLYCATED HAEMOGLOBIN, WAIST-TO-HIP RATIO OR ANY OF THE ANTIOXIDANTS WAS OBSERVED. CONCLUSIONS: YOGA INTERVENTION MAY BE HELPFUL IN CONTROL OF OXIDATIVE STRESS IN PREDIABETES SUBJECTS. YOGA CAN ALSO BE BENEFICIAL IN REDUCTION IN BMI, WAIST CIRCUMFERENCE, SYSTOLIC BLOOD PRESSURE AND FASTING GLUCOSE. EFFECT OF YOGA ON ANTIOXIDANT PARAMETERS WAS NOT EVIDENT IN THIS STUDY. THE FINDINGS OF THIS STUDY NEED TO BE CONFIRMED IN LARGER TRIALS INVOLVING ACTIVE CONTROL GROUPS.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
17  944  43 EFFECTS OF A 12-WEEK HATHA YOGA INTERVENTION ON METABOLIC RISK AND QUALITY OF LIFE IN HONG KONG CHINESE ADULTS WITH AND WITHOUT METABOLIC SYNDROME. OBJECTIVE: TO DETERMINE THE EFFICACY OF A 12-WEEK HATHA YOGA INTERVENTION TO IMPROVE METABOLIC RISK PROFILES AND HEALTH-RELATED QUALITY OF LIFE (HRQOL) IN CHINESE ADULTS WITH AND WITHOUT METABOLIC SYNDROME (METS). METHODS: WE CONDUCTED A CONTROLLED TRIAL WITHIN AN UNIVERSITY-AFFILIATED HOSPITAL. 173 CHINESE MEN AND WOMEN AGED 18 OR ABOVE WERE ASSIGNED TO EITHER THE YOGA INTERVENTION GROUP (N = 87) OR THE CONTROL GROUP (N = 86). PRIMARY OUTCOMES INCLUDED 12-WEEK CHANGE IN METABOLIC RISK FACTORS AND METS Z SCORE. SECONDARY OUTCOME WAS HRQOL (MEDICAL OUTCOMES SHORT FORM SURVEY AT 12 WEEKS). RESULTS: THE MEAN AGE OF PARTICIPANTS WAS 52.0 (SD 7.4, RANGE 31-71) YEARS. ANALYSIS INVOLVING THE ENTIRE STUDY POPULATION REVEALED THAT THE YOGA GROUP ACHIEVED GREATER DECLINE IN WAIST CIRCUMFERENCE (P<0.001), FASTING GLUCOSE (P<0.01), TRIGLYCERIDES (P<0.05), AND METS Z SCORE (P<0.01). YOGA TRAINING ALSO IMPROVED GENERAL HEALTH PERCEPTIONS (P<0.01), PHYSICAL COMPONENT SCORE (P<0.01), AND SOCIAL FUNCTIONING (P<0.01) DOMAINS SCORE OF HRQOL. HOWEVER, NO SIGNIFICANT DIFFERENCES BETWEEN GROUPS WERE OBSERVED IN THE MEAN CHANGE OF SYSTOLIC/DIASTOLIC BLOOD PRESSURES OR HIGH-DENSITY LIPID PROTEIN CHOLESTEROL (ALL P>0.05). THERE WERE NO SIGNIFICANT DIFFERENCES IN THE INTERVENTION EFFECTS ON WAIST CIRCUMFERENCE AND METS Z SCORE BETWEEN THE METS SUBGROUPS (BOTH P>0.05). CONCLUSION: A 12-WEEK HATHA YOGA INTERVENTION IMPROVES METABOLIC RISK PROFILES AND HRQOL IN CHINESE ADULTS WITH AND WITHOUT METS. TRIAL REGISTRATION: AUSTRALIAN NEW ZEALAND CLINICAL TRIALS REGISTRY ACTRN12613000816752.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
18 1368  46 IMPACT OF A SHORT HOME-BASED YOGA PROGRAMME ON BLOOD PRESSURE IN PATIENTS WITH HYPERTENSION: A RANDOMIZED CONTROLLED TRIAL IN PRIMARY CARE. THE PRESENT STUDY WAS DESIGNED TO EVALUATE YOGA'S IMPACT ON BLOOD PRESSURE (BP) AND QUALITY OF LIFE (QOL) AND ON STRESS, DEPRESSION AND ANXIETY IN PATIENTS WITH HYPERTENSION IN A PRIMARY CARE SETTING. WE CONDUCTED A MULTI-CENTRE RANDOMIZED CONTROLLED TRIAL WITH FOLLOW-UP AFTER 12-WEEK INTERVENTION COMPLETION. ADULT PRIMARY CARE PATIENTS DIAGNOSED WITH HYPERTENSION WERE RANDOMLY ALLOCATED TO YOGA OR USUAL CARE. THE INTERVENTION GROUP PERFORMED A SHORT HOME-BASED KUNDALINI YOGA PROGRAMME 15 MIN TWICE-DAILY DURING THE 12-WEEK INTERVENTION PERIOD. AT BASELINE AND FOLLOW-UP, THE PARTICIPANTS UNDERWENT STANDARDIZED BP MEASUREMENTS AND COMPLETED QUESTIONNAIRES ON QOL, STRESS, ANXIETY AND DEPRESSION. DATA OBTAINED FROM 191 PATIENTS (MEAN AGE 64.7 YEARS, S.D. 8.4) ALLOCATED TO YOGA INTERVENTION (N=96) AND CONTROL GROUP (N=95), WITH A TOTAL PROPORTION OF 52% WOMEN, SHOWED A SIGNIFICANT REDUCTION IN SYSTOLIC AND DIASTOLIC BP FOR BOTH GROUPS (-3.8/-1.7 MM HG FOR YOGA AND -4.5/-3.0 MM HG FOR CONTROL GROUPS, RESPECTIVELY). HOWEVER, THE BP REDUCTION FOR THE YOGA GROUP WAS NOT SIGNIFICANTLY DIFFERENT FROM CONTROL. THERE WERE SMALL BUT SIGNIFICANT IMPROVEMENTS FOR THE YOGA GROUP IN SOME OF THE QOL AND DEPRESSION MEASURES (P<0.05, HOSPITAL ANXIETY AND DEPRESSION SCALE, HADS-D) COMPARED WITH CONTROL. THE FINDINGS OF OUR STUDY, WHICH IS THE LARGEST STUDY FROM AN OECD COUNTRY (ORGANIZATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT) TO DATE, DO NOT SUPPORT THE SUGGESTION FROM PREVIOUS SMALLER STUDIES THAT YOGA LOWERS THE BP. FURTHER CLINICAL TRIALS ARE NEEDED TO CONFIRM THESE FINDINGS. HOWEVER, THE YOGA PATIENTS HAD OTHER HEALTH BENEFITS.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
19 1898  34 RESTORATIVE YOGA AND METABOLIC RISK FACTORS: THE PRACTICING RESTORATIVE YOGA VS. STRETCHING FOR THE METABOLIC SYNDROME (PRYSMS) RANDOMIZED TRIAL. AIMS: INTENSIVE LIFESTYLE CHANGE PREVENTS TYPE 2 DIABETES BUT IS DIFFICULT TO SUSTAIN. PRELIMINARY EVIDENCE SUGGESTS THAT YOGA MAY IMPROVE METABOLIC FACTORS. WE TESTED A RESTORATIVE YOGA INTERVENTION VS. ACTIVE STRETCHING FOR METABOLIC OUTCOMES. METHODS: IN 2009-2012, WE CONDUCTED A 48-WEEK RANDOMIZED TRIAL COMPARING RESTORATIVE YOGA VS. STRETCHING AMONG UNDERACTIVE ADULTS WITH THE METABOLIC SYNDROME AT THE UNIVERSITIES OF CALIFORNIA, SAN FRANCISCO AND SAN DIEGO. WE PROVIDED LIFESTYLE COUNSELING AND A TAPERING SERIES OF 90-MIN GROUP CLASSES IN THE 24-WEEK INTERVENTION PERIOD AND 24-WEEK MAINTENANCE PERIOD. FASTING AND 2-H GLUCOSE, HBA1C, TRIGLYCERIDES, HDL-CHOLESTEROL, INSULIN, SYSTOLIC BLOOD PRESSURE, VISCERAL FAT, AND QUALITY OF LIFE WERE ASSESSED AT BASELINE, 6- AND 12-MONTHS. RESULTS: 180 PARTICIPANTS WERE RANDOMIZED AND 135 (75%) COMPLETED THE TRIAL. AT 12 MONTHS, FASTING GLUCOSE DECREASED MORE IN THE YOGA GROUP THAN IN THE STRETCHING GROUP (-0.35 MMOL/L VS. -0.03 MMOL/L; P=0.002); THERE WERE NO OTHER SIGNIFICANT DIFFERENCES BETWEEN GROUPS. AT 6 MONTHS FAVORABLE CHANGES WITHIN THE YOGA GROUP INCLUDED REDUCTIONS IN FASTING GLUCOSE, INSULIN, AND HBA1C AND AN INCREASE IN HDL-CHOLESTEROL THAT WERE NOT SUSTAINED AT 1 YEAR EXCEPT CHANGES IN FASTING GLUCOSE. THE STRETCHING GROUP HAD A SIGNIFICANT REDUCTION IN TRIGLYCERIDES AT 6 MONTHS WHICH WAS NOT SUSTAINED AT 1 YEAR BUT HAD IMPROVED QUALITY OF LIFE AT BOTH TIME-POINTS. CONCLUSIONS: RESTORATIVE YOGA WAS MARGINALLY BETTER THAN STRETCHING FOR IMPROVING FASTING GLUCOSE BUT NOT OTHER METABOLIC FACTORS.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
20  938  44 EFFECTS OF 1-YEAR YOGA ON CARDIOVASCULAR RISK FACTORS IN MIDDLE-AGED AND OLDER ADULTS WITH METABOLIC SYNDROME: A RANDOMIZED TRIAL. BACKGROUND: METABOLIC SYNDROME (METS) IS A CLUSTERING OF CARDIOVASCULAR RISK FACTORS, WHICH IS ASSOCIATED WITH DIABETES MELLITUS AND CARDIOVASCULAR DISEASE. LIFESTYLE INTERVENTIONS APPLIED TO PEOPLE WITH METS HAS CONSIDERABLE BENEFICIAL EFFECTS ON DISEASE PREVENTIVE OUTCOMES. THIS STUDY AIMED TO EXAMINE THE EFFECTS OF 1-YEAR OF YOGA EXERCISE ON THE CARDIOVASCULAR RISK FACTORS INCLUDING CENTRAL OBESITY, HYPERTENSION, DYSLIPIDEMIA AND HYPERGLYCEMIA IN MIDDLE-AGED AND OLDER HONG KONG CHINESE ADULTS WITH METS. METHODS: ADULTS DIAGNOSED WITH METS USING NATIONAL CHOLESTEROL EDUCATION PROGRAM CRITERIA (N = 182; MEAN +/- SD AGE = 56 +/- 9.1) WERE RANDOMLY ASSIGNED TO A 1-YEAR YOGA INTERVENTION GROUP OR CONTROL GROUP. SYSTOLIC AND DIASTOLIC BLOOD PRESSURE, WAIST CIRCUMFERENCE, FASTING PLASMA GLUCOSE, TRIGLYCERIDES, AND HIGH-DENSITY LIPOPROTEIN CHOLESTEROL WERE EXAMINED AT BASELINE, MIDWAY, AND ON COMPLETION OF THE STUDY. PHYSICAL ACTIVITY LEVEL AND CALORIC INTAKE WERE ASSESSED AND INCLUDED IN THE COVARIATE ANALYSES. RESULTS: A REDUCTION OF THE NUMBER OF DIAGNOSTIC COMPONENTS FOR METS WAS FOUND TO BE ASSOCIATED WITH THE YOGA INTERVENTION. WAIST CIRCUMFERENCE WAS SIGNIFICANTLY IMPROVED AFTER THE 1-YEAR YOGA INTERVENTION. A TREND TOWARDS A DECREASE IN SYSTOLIC BLOOD PRESSURE WAS OBSERVED FOLLOWING YOGA INTERVENTION. CONCLUSION: THESE RESULTS SUGGEST THAT YOGA EXERCISE IMPROVES THE CARDIOVASCULAR RISK FACTORS INCLUDING CENTRAL OBESITY AND BLOOD PRESSURE IN MIDDLE-AGED AND OLDER ADULTS WITH METS. THESE FINDINGS SUPPORT THE COMPLEMENTARY BENEFICIAL ROLE OF YOGA IN MANAGING METS.	2015