There is promising evidence of yoga on improving cardio-metabolic health. Findings are limited by small trial sample sizes, heterogeneity, and moderate quality of RCTs.

Out of 1404 records, 37 RCTs were included in the systematic review and 32 in the meta-analysis. Compared to non-exercise controls, yoga showed significant improvement for body mass index (−0.77 kg/m 2 (95% confidence interval −1.09 to −0.44)), systolic blood pressure (−5.21 mmHg (−8.01 to −2.42)), low-density lipoprotein cholesterol (−12.14 mg/dl (−21.80 to −2.48)), and high-density lipoprotein cholesterol (3.20 mg/dl (1.86 to 4.54)). Significant changes were seen in body weight (−2.32 kg (−4.33 to −0.37)), diastolic blood pressure (−4.98 mmHg (−7.17 to −2.80)), total cholesterol (−18.48 mg/dl (−29.16 to −7.80)), triglycerides (−25.89 mg/dl (−36.19 to −15.60), and heart rate (−5.27 beats/min (−9.55 to −1.00)), but not fasting blood glucose (−5.91 mg/dl (−16.32 to 4.50)) nor glycosylated hemoglobin (−0.06% Hb (−0.24 to 0.11)). No significant difference was found between yoga and exercise. One study found an impact on smoking abstinence.

Electronic searches of MEDLINE, EMBASE, CINAHL, PsycINFO, and The Cochrane Central Register of Controlled Trials were performed for systematic reviews and RCTs through December 2013. Studies were included if they were English, peer-reviewed, focused on asana-based yoga in adults, and reported relevant outcomes. Two reviewers independently selected articles and assessed quality using Cochrane’s Risk of Bias tool.

This was a systematic review and random-effects meta-analysis of randomized controlled trials (RCTs).

Yoga, a popular mind-body practice, may produce changes in cardiovascular disease (CVD) and metabolic syndrome risk factors.

References

1. Go, AS, Mozaffarian, D, Roger, VL. Heart disease and stroke statistics–2014 update: A report from the American Heart Association . Circulation 2014 ; 129: e28 – e292 .

Google Scholar Crossref | Medline | ISI

2. World Health Organization . Global status report on noncommunicable diseases 2010, Geneva : World Health Organization , 2011 .

Google Scholar

3. National Heart, Lung, and Blood Institute. What is metabolic syndrome, http://www.nhlbi.nih.gov/health/health-topics/topics/ms/ (2011, accessed 7 March 2014).

Google Scholar

4. D'Agostino, RB, Vasan, RS, Pencina, MJ. General cardiovascular risk profile for use in primary care: The Framingham heart study . Circulation 2008 ; 117: 743 – 753 .

Google Scholar Crossref | Medline | ISI

5. World Health Organization. Global recommendations for physical activity for health, http://whqlibdoc.who.int/publications/2010/9789241599979_eng.pdf (2010, accessed 7 March 2014).

Google Scholar

6. Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC Guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014; 63: 2960–2984.

Google Scholar

7. Stone NJ, Robinson J, Lichtenstein AH, et al. 2013 ACC/AHA Guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2013.

Google Scholar

8. Perk, J, De Backer, G, Gohlke, H. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) . Eur Heart J 2012 ; 33: 1635 – 1701 .

Google Scholar Crossref | Medline | ISI

9. Younge JO, Gotink RA, Baena CP, et al. Mind-body practices for patients with cardiac disease: A systematic review and meta-analysis. Eur J Prev Cardiol. Epub ahead of print 16 September 2014. DOI: 10.1177/2047487314549927.

Google Scholar

10. Cramer H, Lauche R, Haller H, et al. A systematic review of yoga for heart disease. Eur J Prev Cardiol. Epub ahead of print 3 February 2014. DOI: 10.1177/2047487314523132.

Google Scholar

11. Jayasinghe, SR . Yoga in cardiac health (a review) . Eur J Cardiovasc Prev Rehabil 2004 ; 11: 369 – 375 .

Google Scholar SAGE Journals

12. Cusumano, JA, Robinson, SE. The short-term psychophysiological effects of Hatha yoga and progressive relaxation on female Japanese students . Appl Psychol 1993 ; 42: 77 – 90 .

Google Scholar Crossref | ISI

13. Innes, KE, Bourguignon, C, Taylor, AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: A systematic review . J Am Board Fam Pract 2005 ; 18: 491 – 519 .

Google Scholar Crossref | Medline

14. Innes, KE, Vincent, HK. The influence of yoga-based programs on risk profiles in adults with type 2 diabetes mellitus: A systematic review . Evid Based Complement Alternat Med 2007 ; 4: 469 – 486 .

Google Scholar Crossref | Medline | ISI

15. Barnes PM, Bloom B and Nahim RL. Complementary and alternative medicine use among adults and children: United States, 2007. National health statistics reports; no 12. Hyattsville, MD: National Center for Health Statistics, 2008.

Google Scholar

16. Saper, RB, Eisenberg, DM, Davis, RB. Prevalence and patterns of adult yoga use in the United States: Results of a national survey . Altern Ther Health Med 2004 ; 10: 44 – 49 .

Google Scholar Medline | ISI

17. Lau, HLK, Yeung, JS, Chau, F. Yoga for secondary prevention of coronary heart disease . Cochrane Database Syst Rev 2012 ; 12: CD009506 – CD009506 .

Google Scholar Medline

18. Bussing, A, Michalsen, A, Khalsa, SB. Effects of yoga on mental and physical health: a short summary of reviews . Evid Based Complement Alternat Med 2012 ; 13: 2 – 10 .

Google Scholar

19. Hagins, M, States, R, Selfe, T. Effectiveness of yoga for hypertension: Systematic review and meta-analysis . Evid Based Complement Alternat Med 2013 ; 2013: 649836. DOI: 10.1155/2013/649836 – 649836. DOI: 10.1155/2013/649836 .

Google Scholar Crossref | ISI

20. Raub, JA . Psychophysiologic effects of Hatha Yoga on musculoskeletal and cardiopulmonary function: A literature review . J Altern Complement Med 2002 ; 8: 797 – 812 .

Google Scholar Crossref | Medline | ISI

21. Hutchinson, SC . Yoga therapy for coronary heart disease: A systematic review . Focus Altern Complement Ther 2003 ; 8: 144 – 144 .

Google Scholar Crossref

22. Ross, AT . The health benefits of yoga and exercise: A review of comparison studies . J Altern Complement Med 2010 ; 16: 3 – 12 .

Google Scholar Crossref | Medline | ISI

23. Higgins JPT, ALterman DG and Sterne JAC (eds). Assessing risk of bias in included studies. In: Huggins JPT, Green S (eds). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 updated March 2011. The Cochrane Collaborations, 2011.

Google Scholar

24. Higgins, JP, Thompson, SG, Deeks, JJ. Measuring inconsistency in meta-analyses . Br Med J 2003 ; 327: 557 – 560 .

Google Scholar Crossref | Medline

25. DerSimonian, R, Laird, N. Meta-analysis in clinical trials . Control Clin Trials 1986 ; 7: 177 – 188 .

Google Scholar Crossref | Medline

26. The Cochrane Collaboration. Review Manager (RevMan) (program). 5.2 version. Copenhagen: The Nordic Cochrane Centre, 2012.

Google Scholar

27. Blumenthal, JA, Emery, CF, Madden, DJ. Cardiovascular and behavioral effects of aerobic exercise training in healthy older men and women . J Gerontol 1989 ; 44: M147 – M157 .

Google Scholar Crossref | Medline

28. Chen, KM, Chen, MH, Hong, SM. Physical fitness of older adults in senior activity centres after 24-week silver yoga exercises . J Clin Nurs 2008 ; 17: 2634 – 2646 .

Google Scholar Crossref | Medline | ISI

29. Vogler J, O'Hara L, Gregg J, et al. The impact of a short-term Iyengar yoga program on the health and well-being of physically inactive older adults. Int J Yoga Therap 2011: 61–72.

Google Scholar

30. Tracy, BL, Hart, CE. Bikram yoga training and physical fitness in healthy young adults . J Strength Cond Res 2013 ; 27: 822 – 830 .

Google Scholar Crossref | Medline | ISI

31. Kerr, D, Gillam, E, Ryder, J. An Eastern art form for a Western disease: Randomised controlled trial of yoga in patients with poorly controlled insulin-treated diabetes . Practical Diabetes Int 2002 ; 19: 164 – 166 .

Google Scholar Crossref

32. Bock, BC, Fava, JL, Gaskins, R. Yoga as a complementary treatment for smoking cessation in women . J Womens Health (Larchmt) 2012 ; 21: 240 – 248 .

Google Scholar Crossref | Medline | ISI

33. Cohen, BE, Chang, AA, Grady, D. Restorative yoga in adults with metabolic syndrome: a randomized, controlled pilot trial . Metab Syndr Relat Disord 2008 ; 6: 223 – 229 .

Google Scholar Crossref | Medline

34. Fields, JZ, Walton, KG, Schneider, RH. Effect of a multimodality natural medicine program on carotid atherosclerosis in older subjects: a pilot trial of Maharishi Vedic Medicine . Am J Cardiol 2002 ; 89: 952 – 958 .

Google Scholar Crossref | Medline | ISI

35. Pal, A, Srivastava, N, Tiwari, S. Effect of yogic practices on lipid profile and body fat composition in patients of coronary artery disease . Complement Ther Med 2011 ; 19: 122 – 127 .

Google Scholar Crossref | Medline | ISI

36. Pal, A, Srivastava, N, Narain, VS. Effect of yogic intervention on the autonomic nervous system in the patients with coronary artery disease: A randomized controlled trial . East Mediterr Health J 2013 ; 19: 452 – 458 .

Google Scholar Medline | ISI

37. Skoro-Kondza, LT, Gadelrab, SS, Drincevic, R. Community based yoga classes for type 2 diabetes: An exploratory randomised controlled trial . BMC Health Serv Res 2009 ; 9: 33 – 33 .

Google Scholar Crossref | Medline | ISI

38. Vaishali, K, Kumar, KV, Adhikari, P. Effects of yoga-based program on glycosylated hemoglobin level serum lipid profile in community dwelling elderly subjects with chronic type 2 diabetes mellitus-a randomized controlled trial . Phys Occup Ther Geriatr 2012 ; 30: 22 – 30 .

Google Scholar Crossref

39. McCaffrey, R, Ruknui, P, Hatthakit, U. The effects of yoga on hypertensive persons in Thailand . Holistic Nurs Pract 2005 ; 19: 173 – 180 .

Google Scholar Crossref | Medline

40. Saptharishi, L, Soudarssanane, M, Thiruselvakumar, D. Community-based randomized controlled trial of non-pharmacological interventions in prevention and control of hypertension among young adults . Indian J Community Med 2009 ; 34: 329 – 334 .

Google Scholar Crossref | Medline

41. Ray, US, Sinha, B, Tomer, OS. Aerobic capacity & perceived exertion after practice of Hatha yogic exercises . Indian J Med Res 2001 ; 114: 215 – 221 .

Google Scholar Medline | ISI

42. Harinath, K, Malhotra, AS, Pal, K. Effects of Hatha yoga and Omkar meditation on cardiorespiratory performance, psychologic profile, and melatonin secretion . J Altern Complement Med 2004 ; 10: 261 – 268 .

Google Scholar Crossref | Medline | ISI

43. Ades, PA, Savage, PD, Brochu, M. Resistance training increases total daily energy expenditure in disabled older women with coronary heart disease . J Appl Physiol 2005 ; 98: 1280 – 1285 .

Google Scholar Crossref | Medline | ISI

44. Manchanda SC and Madan K. Yoga and meditation in cardiovascular disease. Clin Res Cardiol 2014: 1–6.

Google Scholar

45. Gordon, LA, Morrison, EY, McGrowder, DA. Effect of exercise therapy on lipid profile and oxidative stress indicators in patients with type 2 diabetes . BMC Complement Altern Med 2008 ; 8: 21 – 21 .

Google Scholar Crossref | Medline | ISI

46. Bowman, AJ, Clayton, RH, Murray, A. Effects of aerobic exercise training and yoga on the baroreflex in healthy elderly persons . Eur J Clin Invest 1997 ; 27: 443 – 449 .

Google Scholar Crossref | Medline | ISI

47. Stachenfeld, NS, Mack, GW, DiPietro, L. Regulation of blood volume during training in post-menopausal women . Med Sci Sports Exerc 1998 ; 30: 92 – 98 .

Google Scholar Crossref | Medline | ISI

48. Subramanian, H, Soudarssanane, MB, Jayalakshmy, R. Non-pharmacological interventions in hypertension: A community-based cross-over randomized controlled trial . Indian J Community Med 2011 ; 36: 191 – 196 .

Google Scholar Crossref | Medline

49. Manchanda, SC, Narang, R, Reddy, KS. Retardation of coronary atherosclerosis with yoga lifestyle intervention . J Assoc Physicians India 2000 ; 48: 687 – 694 .

Google Scholar Medline

50. Field, T . Yoga clinical research review . Complement Ther Clin Pract 2011 ; 17: 1 – 8 .

Google Scholar Crossref | Medline

51. Shantakumari, N, Sequeira, S, El Deeb, R. Effects of a yoga intervention on lipid profiles of diabetes patients with dyslipidemia . Indian Heart J 2013 ; 65: 127 – 131 .

Google Scholar Crossref | Medline

52. Monroe, R, Power, J, Coumar, A. Yoga therapy for NIDDM: A controlled trial . Complement Med Res 1992 ; 6: 66 – 68 .

Google Scholar

53. Murugesan, R, Govindarajulu, N, Bera, TK. Effect of selected yogic practices on the management of hypertension . Indian J Physiol Pharmacol 2000 ; 44: 207 – 210 .

Google Scholar Medline

54. Mahajan, AS, Reddy, KS, Sachdeva, U. Lipid profile of coronary risk subjects following yogic lifestyle intervention . Indian Heart J 1999 ; 51: 37 – 40 .

Google Scholar Medline

55. Jatuporn, S, Sangwatanaroj, S, Saengsiri, AO. Short-term effects of an intensive lifestyle modification program on lipid peroxidation and antioxidant systems in patients with coronary artery disease . Clin Hemorheol Microcirc 2003 ; 29: 429 – 436 .

Google Scholar Medline | ISI

56. Ray, US, Mukhopadhyaya, S, Purkayastha, SS. Effect of yogic exercises on physical and mental health of young fellowship course trainees . Indian J Physiol Pharmacol 2001 ; 45: 37 – 53 .

Google Scholar Medline

57. Anderson JG and Taylor AG. The metabolic syndrome and mind-body therapies: A systematic review. J Nutr Metab 2011; 276419: 1–8.

Google Scholar

58. Cramer, H, Lauche, R, Haller, H. Effects of yoga on cardiovascular disease risk factors: A systematic review and meta-analysis . Int J Cardiol 2014 ; 173: 170 – 183 .

Google Scholar Crossref | Medline | ISI

59. Hartley, L, Dyakova, M, Holmes, J. Yoga for the primary prevention of cardiovascular disease . Cochrane Database Syst Rev 2014 ; 5: CD010072 – CD010072 .

Google Scholar

60. Patel, NK, Newstead, AH, Ferrer, RL. The effects of yoga on physical functioning and health related quality of life in older adults: A systematic review and meta-analysis . J Altern Complement Med 2012 ; 18: 902 – 917 .

Google Scholar Crossref | Medline | ISI

61. Roland, KP, Jakobi, JM, Jones, GR. Does yoga engender fitness in older adults? A critical review . J Aging Phys Act 2011 ; 19: 62 – 79 .

Google Scholar Crossref | Medline | ISI

62. Yang, K . A review of yoga programs for four leading risk factors of chronic diseases . Evid Based Complement Alternat Med 2007 ; 4: 487 – 491 .

Google Scholar Crossref | Medline | ISI

63. Abel AN, Lloyd LK and Williams JS. The effects of regular yoga practice on pulmonary function in healthy individuals: A literature review. J Altern Complement Med 2013; 19: 185–190.

Google Scholar

64. Kanojia, S, Sharma, VK, Gandhi, A. Effect of yoga on autonomic functions and psychological status during both phases of menstrual cycle in young healthy females . J Clin Diagn Res 2013 ; 7: 2133 – 2139 .

Google Scholar Medline

65. Kim, S, Bemben, MG, Bemben, DA. Effects of an 8-month yoga intervention on arterial compliance and muscle strength in premenopausal women . J Sports Sci Med 2012 ; 11: 322 – 330 .

Google Scholar Medline | ISI

66. Wolever, RQ, Bobinet, KJ, McCabe, K. Effective and viable mind-body stress reduction in the workplace: A randomized controlled trial . J Occup Health Psychol 2012 ; 17: 246 – 258 .

Google Scholar Crossref | Medline | ISI

67. Van Montfrans, GA, Karemaker, JM, Wieling, W. Relaxation therapy and continuous ambulatory blood pressure in mild hypertension: A controlled study . Br Med J 1990 ; 300: 1368 – 1372 .

Google Scholar Crossref | Medline

68. Nicolson, DJD, Campbell, HO, Mason, F. Lifestyle interventions or drugs for patients with essential hypertension: A systematic review . J Hypertens 2004 ; 22: 2043 – 2048 .

Google Scholar Crossref | Medline | ISI

69. Wang, J, Xiong, X, Liu, W. Yoga for essential hypertension: A systematic review . PloS One 2013 ; 8: e76357 – e76357 .

Google Scholar Crossref | Medline | ISI

70. Rioux, JG, Ritenbaugh, C. Narrative review of yoga intervention clinical trials including weight-related outcomes . Altern Ther Health Med 2013 ; 19: 32 – 46 .

Google Scholar Medline | ISI

71. Cohen DL, Bloedon LT, Rothman RL, et al. Iyengar yoga versus enhanced usual care on blood pressure in patients with prehypertension to stage I hypertension: A randomized controlled trial. Evid Based Complement Alternat Med 2011; 2011: 546428. DOI: 10.1093/ecam/nep130.

Google Scholar

72. Carim-Todd, L, Mitchell, SH, Oken, BS. Mind–body practices: An alternative, drug-free treatment for smoking cessation? A systematic review of the literature . Drug Alcohol Depend 2013 ; 132: 399 – 410 .

Google Scholar Crossref | Medline | ISI

73. Lee, JA, Kim, JW, Kim, DY. Effects of yoga exercise on serum adiponectin and metabolic syndrome factors in obese postmenopausal women . Menopause 2012 ; 19: 296 – 301 .

Google Scholar Crossref | Medline | ISI

74. Aljasir, BB, Al-Shehri, M. Yoga practice for the management of type ii diabetes mellitus in adults: A systematic review . Evid Based Complement Alternat Med 2010 ; 7: 399 – 408 .

Google Scholar Crossref | Medline | ISI

75. Pilkington, KS, Kirkwood, E, Richardson, G. Diabetes and complementary therapies: Mapping the evidence . Pract Diab Int 2007 ; 24: 371 – 376 .

Google Scholar Crossref

76. Sharma, MK, Adam, P. Role of yoga in preventing and controlling type 2 diabetes mellitus . Evid Based Complement Alternat Med 2012 ; 17: 88 – 95 .

Google Scholar SAGE Journals

77. Yang K, Bernardo LM, Sereika SM, et al. Utilization of 3-month yoga program for adults at high risk for type 2 diabetes: A pilot study. Evid Based Complement Alternat Med 2011; 2011: 257891. DOI: 10.1093/ecam/nep117.

Google Scholar