In a systematic review of 37 randomised controlled trials which included 2,768 subjects, investigators from the Netherlands and US found "promising evidence" that yoga is beneficial in managing and improving the risk factors associated with cardiovascular disease and is a "potentially effective therapy" for cardiovascular health.
Yoga may provide the same benefits in risk factor reduction as such traditional physical activities as biking or brisk walking, researchers said.
"This finding is significant as individuals who cannot or prefer not to perform traditional aerobic exercise might still achieve similar benefits in [cardiovascular] risk reduction," they said.
Yoga incorporates physical, mental, and spiritual elements and has been shown in several studies to be effective in improving cardiovascular risk factors, with reduction in the risk of heart attacks and strokes.
This meta-analysis was performed to appraise the evidence and provide a realistic pooled estimate of yoga's effectiveness when measured against exercise and no exercise, researchers said.
Results showed first that risk factors for cardiovascular disease improved more in those doing yoga than in those doing no exercise, and second, that yoga had an effect on these risks comparable to exercise.
When compared to no exercise, yoga was associated with significant improvement in each of the primary outcome risk factors measured: body mass index was reduced by 0.77 kg/m2, systolic blood pressure reduced by 5.21 mm Hg, low-density (bad) lipoprotein cholesterol reduced by 12.14 mg/dl, and high-density (good) lipoprotein cholesterol increased by 3.20 mg/dl.
There were also significant changes seen in secondary endpoints - body weight fell by 2.32 kg, diastolic blood pressure by 4.9 mm Hg, total cholesterol by 18.48 mg/dl, and heart rate by 5.27 beats/min.

However, no improvements were found in parameters of diabetes (fasting blood glucose and glycosylated hemoglobin). Risk factor improvements (in BMI, blood pressure, lipid levels) were significant when yoga was used in addition to medication.
Among patients with existing coronary heart disease, yoga provided a statistically significant benefit in lowering LDL cholesterol when added to medication (statins and lipid-lowering drugs).
In comparisons with exercise itself, yoga was found to have comparable effects on risk factors as aerobic exercise. The investigators noted that this might be because of yoga's impact on stress reduction, "leading to positive impacts on neuroendocrine status, metabolic and cardio-vagal function".
The study is published in the European Journal of Preventive Cardiology.

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