Yoga for secondary prevention of coronary heart disease

Coronary heart disease (CHD) is a major cause of early cardiovascular-related illness and death in most developed countries. Secondary prevention is a term used to describe interventions that aim to prevent repeat cardiac events and death in people with established CHD. Individuals with CHD are at the highest risk of coronary events and death. Lifestyle modifications play an important role in secondary prevention. Yoga has been regarded as both a type of physical activity and a stress management strategy. The physical and psychological benefits of yoga are well accepted, yet inappropriate practice of yoga may lead to musculoskeletal injuries, such as muscle soreness and strain. The aim of this systematic review was to determine the effectiveness of yoga for secondary prevention in CHD in terms of cardiac events, death, and health-related quality of life. We found no randomised controlled trials which met the inclusion criteria for this review. Therefore, the effectiveness of yoga for secondary prevention in CHD remains uncertain. High-quality randomised controlled trials are needed.

This is an update of a review previously published in 2012.

Authors' conclusions: 

The effectiveness of yoga for secondary prevention in CHD remains uncertain. Large RCTs of high quality are needed.

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Background: 

Coronary heart disease (CHD) is the major cause of early morbidity and mortality in most developed countries. Secondary prevention aims to prevent repeat cardiac events and death in people with established CHD. Lifestyle modifications play an important role in secondary prevention. Yoga has been regarded as a type of physical activity as well as a stress management strategy. Growing evidence suggests the beneficial effects of yoga on various ailments.

Objectives: 

To determine the effectiveness of yoga for the secondary prevention of mortality and morbidity in, and on the health-related quality of life of, individuals with CHD.

Search strategy: 

This is an update of a review previously published in 2012. For this updated review, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 1 of 12, 2014), MEDLINE (1948 to February week 1 2014), EMBASE (1980 to 2014 week 6), Web of Science (Thomson Reuters, 1970 to 12 February 2014), China Journal Net (1994 to May 2014), WanFang Data (1990 to May 2014), and Index to Chinese Periodicals of Hong Kong (HKInChiP) (from 1980). Ongoing studies were identified in the metaRegister of Controlled Trials (May 2014) and the World Health Organization International Clinical Trials Registry Platform (May 2014). We applied no language restrictions.

Selection criteria: 

We planned to include randomised controlled trials (RCTs) investigating the influence of yoga practice on CHD outcomes in men and women (aged 18 years and over) with a diagnosis of acute or chronic CHD. Studies were eligible for inclusion if they had a follow-up duration of six months or more. We considered studies that compared one group practicing a type of yoga with a control group receiving either no intervention or interventions other than yoga.

Data collection and analysis: 

Two authors independently selected studies according to prespecified inclusion criteria. We resolved disagreements either by consensus or by discussion with a third author.

Main results: 

We found no eligible RCTs that met the inclusion criteria of the review and thus we were unable to perform a meta-analysis.

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