Raja Ram Dhungana1, Zeljko Pedisic2, Suira Joshi3, Mahesh Kumar Khanal3, Om Prakash Kalauni3, Anu Shakya3, Vijay Bhurtel3, Savyata Panthi3, K C Ramesh Kumar3, Binod Ghimire4, Achyut Raj Pandey5, Bihungum Bista6, Shiva Ram Khatiwoda7, Craig Steven McLachlan8, Dinesh Neupane9,10, Maximilian de Courten2,11. 1. Institute for Health and Sport, Victoria University, Melbourne, Australia. raja.dhungana@live.vu.edu.au. 2. Institute for Health and Sport, Victoria University, Melbourne, Australia. 3. Ministry of Health, Kathmandu, Nepal. 4. Nepal Ayurveda Research and Training Center, Kathmandu, Nepal. 5. DFID/NHSP3/MEOR, Abt Associates, Kathmandu, Nepal. 6. Nepal Health Research Council, Kathmandu, Nepal. 7. Patanjali Ayurveda Medical College and Research Center, Dhulikhel, Nepal. 8. Health Faculty, Torrens University, Sydney, Australia. 9. Welch Center for Prevention, Epidemiology and Clinical Research, Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA. 10. Nepal Development Society, Bharatpur, Chitwan, Nepal. 11. Mitchell Institute for Education and Health Policy, Victoria University, Melbourne, Chitwan, Australia.
Abstract
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.
RCT Entities:
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 hypertensivespatients in the primary care setting. METHODS: This was a multicentric, two-arm, randomised trial conducted among hypertensivepatients 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 hypertensivepatients 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 hypertensivepatients 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.
Authors: Biraj M Karmacharya; Rajendra P Koju; James P LoGerfo; Kwun Chuen Gary Chan; Ali H Mokdad; Archana Shrestha; Nona Sotoodehnia; Annette L Fitzpatrick Journal: Heart Asia Date: 2017-01-04
Authors: Lg Saptharishi; Mb Soudarssanane; D Thiruselvakumar; D Navasakthi; S Mathanraj; M Karthigeyan; A Sahai Journal: Indian J Community Med Date: 2009-10
Authors: Hema Subramanian; M Bala Soudarssanane; R Jayalakshmy; D Thiruselvakumar; D Navasakthi; Ajit Sahai; Lg Saptharishi Journal: Indian J Community Med Date: 2011-07