Institute for Health and Sport, Victoria University, Melbourne, Australia.
Ministry of Health, Kathmandu, Nepal.
BMC Public Health. 2021 Mar 20;21(1):550. doi: 10.1186/s12889-021-10528-y.
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.
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.
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.
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.
This trial was prospectively registered with the Clinical Trial Registry of India [ CTRI/2017/02/007822 ] on 10/02/2017.
高血压的控制仍然是一个全球性的主要挑战。最近的一项系统评价表明，瑜伽对降低血压有有益的影响。然而，瑜伽在初级卫生保健中管理高血压的作用尚未得到重视，也没有研究评估完全由医务人员提供的瑜伽方案对高血压的影响。因此，本研究评估了由卫生工作者主导的瑜伽干预对初级保健中高血压患者血压降低的影响。
这是一项多中心、双臂、随机试验，于 2017 年 3 月至 2018 年 6 月在尼泊尔的 7 个阿育吠陀健康中心进行，共纳入 121 名正在服用或未服用药物的高血压患者。采用分层块随机化方法，将 121 名参与者随机分为干预组（n=61）和候补对照组（n=60）。干预组接受为期 5 天的中心结构化瑜伽训练，然后在接下来的 90 天内每周 5 天在家进行瑜伽练习。干预组和对照组还参加了 2 小时的健康教育课程。本试验的主要结局是 90 天随访时的收缩压。采用线性混合效应回归模型进行意向治疗分析。
我们将所有 121 名研究参与者（干预/对照组分别为 61/60）纳入主要分析（52.1%为男性；平均±标准差年龄为 47.8±10.8 岁）。与对照组相比，干预组的收缩压差异为-7.66mmHg（95%CI：-10.4，-4.93）。对于舒张压，差异为-3.86mmHg（95%CI：-6.65，-1.06）。参与者未报告任何不良事件。
由 5 天的中心培训和 90 天的家庭练习组成的高血压患者瑜伽方案可有效降低血压。如果此类方案成为标准治疗实践的一部分，高血压患者可能会获得显著益处。
该试验于 2017 年 2 月 10 日在印度临床试验注册中心（CTRI）进行了前瞻性注册[CTRI/2017/02/007822]。
