Additional Improvement of Respiratory Technique on Vascular Function in Hypertensive Postmenopausal Women Following Yoga or Stretching Video Classes: The YOGINI Study

Abstract

Background: Hypertension remains highly prevalent in postmenopausal women, along with vascular dysfunction and increased oxidative stress. In such context, regular exercises, yoga practice, and slow breathing have been recommended to treat hypertension. However, the effects of the multiple components of yoga, including the respiratory techniques involved in the practice, on hypertension and on vascular and endothelial function have never been evaluated. Objective: This study aimed to investigate the additional effects of respiratory technique on vascular function and oxidative stress profile in hypertensive postmenopausal women (HPMWs) following yoga or stretching video classes. Study Design: Hypertensive postmenopausal women were recruited and randomized for 12 weeks, twice a week, of supervised yoga or stretching video classes of 75 min for 12 weeks associated or not with respiratory technique. Baseline and post-intervention measurements included pulse wave velocity (PWV), flow-mediated dilation (FMD), and oxidative stress parameters. Hypertensive postmenopausal women (59 ± 0.7 years) who ended the protocol were distributed into three groups: (1) control group (yoga or stretching, C, n = 14); (2) yoga + respiratory technique (Y+, n = 10); (3) stretching + respiratory technique (S+, n = 9). Results: Diastolic blood pressure and FMD [baseline: C: 6.94 ± 1.97%, Y+: 7.05 ± 1.65%, and S+: 3.54 ± 2.01% vs. post: C: 16.59 ± 3.46% ( p = 0.006), Y+: 13.72 ± 2.81% ( p = 0.005), and S+: 11.79 ± 0.99% ( p = 0.0001)] have significantly increased in all groups when baseline and post-practice values were compared. However, resting heart rate and PWV [baseline: Y+: 10.44 ± 3.69 and S+: 9.50 ± 0.53 m/s vs. post: Y+: 9.45 ± 0.39 ( p = 0.003) and S+: 8.02 ± 0.47 m/s ( p = 0.003)] decreased significantly only in the Y+ and S+ groups (baseline vs. post). Systemic antioxidant enzyme activities (superoxide dismutase and catalase) increased in all groups, and hydrogen peroxide and lipoperoxidation reduced in Y+ and S+ (baseline vs. post). Conclusions: Twelve weeks of yoga or stretching video classes promoted positive changes in several outcomes generally regarded as cardiovascular risk factors in HPMWs, and these changes were even more pronounced by the association with respiratory technique.

Content, Structure, and Delivery Characteristics of Yoga Interventions for Managing Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…In total, 5,083 people were invited and 3,125 participated in these studies. Twenty-one RCTs were conducted in India ( n = 1,694 participants), 4 in the USA ( n = 382) ( 45 , 47 , 53 , 59 ), 2 in Germany ( n = 415) ( 46 , 67 ), 2 in Nepal ( n = 135) ( 61 , 77 ) and 1 each in Sweden ( n = 191) ( 49 ), Thailand ( n = 61) ( 63 ), Spain ( n = 100) ( 64 ), Hong-Kong ( n = 97) ( 68 ) and Brazil ( n = 50) ( 72 ). Studies recruited participants who were between 18 and 70 years old.…”

“…Four RCTs recruited only male participants ( 50 , 54 , 67 , 70 ). Two recruited only female participants ( 72 , 74 ) and the sex of the participants was unclear in 3 RCTs ( 44 , 51 , 69 ). Nineteen out of 34 studies did not specify the stages of hypertension.…”

“…Ten studies did not provide information if participants were on antihypertensive medication. Additional health conditions of the participants included postmenopause ( n = 2) ( 72 , 74 ), type 2 diabetes mellitus (T2DM) ( n = 2) ( 58 , 71 ) and metabolic syndrome (MetS) ( n = 1) ( 68 ). Previous experience of yoga practice among participants varied across the RCTs and 17 studies recruited yoga-naïve participants whereas 2 studies recruited participants with experience of practicing yoga.…”

“…Pranayama was more effective in reducing DBP compared to no intervention (−5.38 mmHg; −8.03– −2.73) but not compared to non-pharmaceutical interventions (1.49 mmHg; −1.28–4.26) ( Figures 10 , 11 ). Interventions combining any two components of yoga could not be included in the meta-analysis as no two studies met the criteria to be pooled ( 46 , 49 , 58 , 64 , 67 , 72 ).…”

The impact of exercise training on endothelial function in postmenopausal women: a systematic review

“…The majority of the intervention studies utilized an aerobic training (Fetter et al, 2020) and exergaming in postmenopausal women with high CVD risk (Jo et al, 2020) both improved brachial artery FMD.…”