A systematic review and meta-analysis of yoga for hypertension

Cramer, H; Haller, H; Lauche, R; Steckhan, N; Michalsen, A; Dobos, G

A systematic review and meta-analysis of yoga for hypertension

Cramer, H

Haller, H Lauche, R

Steckhan, N Michalsen, A Dobos, G

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Publication Type:: Journal Article
Citation:: American Journal of Hypertension, 2014, 27 (9), pp. 1146 - 1151
Issue Date:: 2014-01-01

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Field	Value	Language
dc.contributor.author	Cramer, H https://orcid.org/0000-0002-3640-8046	en_US
dc.contributor.author	Haller, H	en_US
dc.contributor.author	Lauche, R https://orcid.org/0000-0002-4171-7935	en_US
dc.contributor.author	Steckhan, N	en_US
dc.contributor.author	Michalsen, A	en_US
dc.contributor.author	Dobos, G	en_US
dc.date.issued	2014-01-01	en_US
dc.identifier.citation	American Journal of Hypertension, 2014, 27 (9), pp. 1146 - 1151	en_US
dc.identifier.issn	0895-7061	en_US
dc.identifier.uri	http://hdl.handle.net/10453/116056
dc.description.abstract	BACKGROUND: The aim of this systematic review and meta-analysis was to evaluate the quality of evidence and the strength of recommendation for yoga as a therapeutic means in the management of prehypertension and hypertension. METHODS: MEDLINE/Pubmed, Scopus, CENTRAL, and IndMED were screened through February 2014 for randomized controlled trials (RCTs) on the effects of yoga interventions (≥8 weeks) compared with usual care or any active control intervention on blood pressure in patients with prehypertension (120-139/80-89 mm Hg) or hypertension (≥140/≥90 mm Hg). Risk of bias was assessed using the Cochrane risk of bias tool; quality of evidence was assessed according to the GRADE recommendations. RESULTS: Seven RCTs with a total of 452 patients were included. Compared with usual care, very low-quality evidence was found for effects of yoga on systolic (6 RCTs, n = 278; mean difference (MD) = -9.65 mm Hg, 95% confidence interval (CI) = -17.23 to -2.06, P = 0.01; heterogeneity: I<sup>2</sup> = 90%, χ<sup>2</sup> = 48.21, P < 0.01) and diastolic blood pressure (6 RCTs, n = 278; MD = -7.22 mm Hg, 95% CI = -12.83 to -1.62, P = 0.01; heterogeneity: I<sup>2</sup> = 92%, χ<sup>2</sup> = 64.84, P < 0.01). Subgroup analyses revealed effects for RCTs that included hypertensive patients but not for RCTs that included both hypertensive and prehypertensive patients, as well as for RCTs that allowed antihypertensive comedication but not for those that did not. More adverse events occurred during yoga than during usual care. Compared with exercise, no evidence was found for effects of yoga on systolic or diastolic blood pressure. CONCLUSIONS: Larger studies are required to confirm the emerging but low-quality evidence that yoga may be a useful adjunct intervention in the management of hypertension. © American Journal of Hypertension, Ltd 2014. All rights reserved.	en_US
dc.relation.ispartof	American Journal of Hypertension	en_US
dc.relation.isbasedon	10.1093/ajh/hpu078	en_US
dc.subject.classification	Cardiovascular System & Hematology	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Hypertension	en_US
dc.subject.mesh	Antihypertensive Agents	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Combined Modality Therapy	en_US
dc.subject.mesh	Yoga	en_US
dc.subject.mesh	Chi-Square Distribution	en_US
dc.subject.mesh	Blood Pressure	en_US
dc.title	A systematic review and meta-analysis of yoga for hypertension	en_US
dc.type	Journal Article
utslib.citation.volume	9	en_US
utslib.citation.volume	27	en_US
utslib.for	1103 Clinical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	closed_access
pubs.issue	9	en_US
pubs.publication-status	Published	en_US
pubs.volume	27	en_US

Abstract:

BACKGROUND: The aim of this systematic review and meta-analysis was to evaluate the quality of evidence and the strength of recommendation for yoga as a therapeutic means in the management of prehypertension and hypertension. METHODS: MEDLINE/Pubmed, Scopus, CENTRAL, and IndMED were screened through February 2014 for randomized controlled trials (RCTs) on the effects of yoga interventions (≥8 weeks) compared with usual care or any active control intervention on blood pressure in patients with prehypertension (120-139/80-89 mm Hg) or hypertension (≥140/≥90 mm Hg). Risk of bias was assessed using the Cochrane risk of bias tool; quality of evidence was assessed according to the GRADE recommendations. RESULTS: Seven RCTs with a total of 452 patients were included. Compared with usual care, very low-quality evidence was found for effects of yoga on systolic (6 RCTs, n = 278; mean difference (MD) = -9.65 mm Hg, 95% confidence interval (CI) = -17.23 to -2.06, P = 0.01; heterogeneity: I² = 90%, χ² = 48.21, P < 0.01) and diastolic blood pressure (6 RCTs, n = 278; MD = -7.22 mm Hg, 95% CI = -12.83 to -1.62, P = 0.01; heterogeneity: I² = 92%, χ² = 64.84, P < 0.01). Subgroup analyses revealed effects for RCTs that included hypertensive patients but not for RCTs that included both hypertensive and prehypertensive patients, as well as for RCTs that allowed antihypertensive comedication but not for those that did not. More adverse events occurred during yoga than during usual care. Compared with exercise, no evidence was found for effects of yoga on systolic or diastolic blood pressure. CONCLUSIONS: Larger studies are required to confirm the emerging but low-quality evidence that yoga may be a useful adjunct intervention in the management of hypertension. © American Journal of Hypertension, Ltd 2014. All rights reserved.

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http://hdl.handle.net/10453/116056