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The most recent version of this article was published on 2014-08-13
  1. Holger Cramer1,
  2. Heidemarie Haller1,
  3. Romy Lauche1,
  4. Nico Steckhan2,3,
  5. Andreas Michalsen2,3 and
  6. Gustav Dobos1
  1. 1 Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany;
  2. 2 Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Berlin, Germany;
  3. 3 Charité - Universitätsmedizin Berlin, Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Berlin, Germany.
  1. Correspondence: Holger Cramer (h.cramer{at}kliniken-essen-mitte.de).
  • Received January 16, 2014.
  • Revision received February 7, 2014.
  • Accepted March 27, 2014.

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 (120–139/80–89mm Hg) or hypertension (≥140/≥90mm 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) = −9.65mm 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 = −7.22mm Hg, 95% CI = −12.83 to −1.62, P = 0.01; heterogeneity: I 2 = 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.

Keywords:
  • © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email:
  1. Am J Hypertens (2014) doi: 10.1093/ajh/hpu078 First published online: May 2, 2014

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Источник: http://ajh.oxfordjournals.org/content/early/2014/0...

Запостил:MrWolf | 08.10.2014 | 9885

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