Yoga can prolong life after a heart attack, results of a new study say. According to preliminary results of the “largest ever” multi-centre, randomised trial on Yoga-Care, a yoga-based cardiac rehabilitation programme, performing select heart-friendly asanas significantly improved the quality of life for patients and aided their return to daily activities that were similar to those before the attack. Among those who attended 10 or more of the 13 yoga training sessions in the trial, researchers found success in improving clinical outcomes by reducing death and lowering hospitalisations.
The prevalence of ischemic heart disease in India has increased over by 50 per cent; the numbers increased from 10 million in 1990 to 24 million in 2016, data shows. “This trial, the largest one on yoga and cardiac rehabilitation (CR), has shown the potential of yoga. Yoga-based programmes can serve as an alternative to the conventional CR programmes and address the unmet needs of patients in low-and middle-income countries,” said Professor D. Prabhakaran, principal investigator of the study. “It is safe, relatively inexpensive, does not need an elaborate infrastructure, culturally acceptable and improves quality of life,” added Prabhakaran, also, vice president, Public Health Foundation of India.
The study was conducted over five years, in 24 centres in India, with 4,000 patients, who were either discharged after treatment for a heart attack, or were about to be discharged. The patients were randomised to undergo a structured yoga care programme, comprising of medication, breathing exercises, selected heart-friendly yoga poses, and life-style advice. The control group received the usual lifestyle advice. The trial then compared the effectiveness of a yoga-based programme with standard care on clinical outcomes such as death, recurrent heart attacks, stroke, heart related emergency hospital admissions and quality of life. The results show that the programme is “safe, feasible and improved the quality of life for patients”. However, there were no changes in the tobacco cessation and compliance to medication.
The preliminary results were presented at the American Heart Association Scientific Session in Chicago last week. The programme was funded by the Indian Council for Medical Research (ICMR) and Medical Research Council (UK).
Professor Sanjay Kinra, head, epidemiology, London School of Hygiene and Tropical Medicine, co-principal investigator of the study, said that improvements in cardiac care have resulted in most people surviving a heart attack. Focus has shifted to improving quality of life for survivors of heart attacks so that they can re-adjust better after the catastrophic event. “This is particularly true in India where heart attacks tend to occur at very young ages. While we await formal peer review, the preliminary results of our trial suggest that a yoga-based cardiac rehabilitation programme could improve quality of life and promote earlier return to usual activities. This offers a low-cost and culturally-acceptable effective alternative to standard cardiac rehabilitation programmemes that are usually complex and expensive,” Kinra said in a press statement.
Kinra said that the trial highlights the potential of traditional practices playing a complementary role in medical care, particularly given the high costs of managing chronic conditions. “We hope that this study will encourage other researchers to carry out similar robust studies of other health benefits of traditional practices such as yoga,” he said.
Professor Ambuj Roy, Professor of Cardiology, All India Institute of Medical Sciences (AIIMS), said that this was a “landmark study” showing that the use of yoga as a CR tool helped improve quality of life and reduced cardiovascular events among those who completed at least 75 per cent of the sessions. “Yoga has gained immense popularity nationally and internationally as a tool for health promotion, especially after the UN declared 21st June as international Yoga Day. However, modern day medicine demands evidence of benefit for interventions for its wider acceptance especially among the medical research community. This study is a step in that direction. I hope that this study spurs several such large rigorously performed trials in other diseases where yoga can be potentially beneficial.”
Prabhakaran said that there was some indication that yoga has the potential to “reduce death” and other complications. “We will continue the study for another two years and by then, sufficient number of clinical outcomes will be accrued. This will also help us develop innovative tools in improving adherence to yoga. One limitation was the lower number of women in the study. Contrary to popular belief, women have a higher risk of dying in the years following a heart attack and therefore, we should device means of increasing their participation and facilitation of uptake of yoga”.
The study will help further the idea of application of yoga-based approaches in other cardiovascular conditions such as heart failure and other chronic diseases such as early dementia, mental health and cancer rehabilitation in improving disease specific outcomes and quality of life, he said.