Effectiveness of Yoga on Ambulatory Blood Pressure in Patients with Pre- and Stag

描述（由申请人提供）：高血压影响美国 5000 万人，是中风、心肌梗塞、心力衰竭和肾脏疾病的重要危险因素。多项研究普遍证据表明瑜伽课程可能有效降低血压。然而，这些研究大多数都是非随机和/或不受控制的，检查的是健康参与者而不是高血压参与者，并且许多研究使用多模式“基于瑜伽”的干预措施，其中不可能确定瑜伽的孤立效果。这些研究中的另一个实质性问题是，对于“瑜伽”干预措施的构成缺乏共识。因此，仍然需要明确定义代表常见瑜伽练习的瑜伽干预，并确定这种干预对血压控制的影响。在西方文化中，人们普遍认为最常见的瑜伽练习是由三个综合要素定义的：身体姿势、呼吸控制和冥想。瑜伽信徒认为，这些元素的整合所产生的健康结果比通过简单地添加这些元素的独立效果所预期的效果要好。然而，这一建议尚未得到研究。有证据表明瑜伽元素的呼吸控制和冥想对血压具有临床显着的独立影响，但没有证据表明瑜伽的身体姿势（体式）对血压具有独立影响。此应用程序的目标是定义综合瑜伽练习的标准化要素，并确定综合练习与单一练习要素（身体姿势）相比对动态血压 (ABP) 的影响。中心假设是，瑜伽元素（身体姿势/呼吸控制/冥想）的整合将比通过该练习的单个元素（身体姿势）产生的 ABP 产生更大的降低。我们计划通过对 90 名前期和 I 期高血压参与者进行为期 12 周的随机对照试验来测试我们的论文。我们还将检查与自主系统相关的各种次要社会心理和生理指标：心率、心率变异性、压力感受器敏感性、感知压力、应对、不确定性容忍度、控制感和体重指数，我们预计这些指标与 ABP 的改善相关。该研究还将确定与干预措施相关的招募、保留、依从性、期望、接受度和感知有效性。本研究中获得的信息将产生积极影响，提供关键的初步和可行性数据，以支持更大规模的多种族随机对照试验，研究瑜伽对 I 期高血压患者的影响。

DESCRIPTION (provided by applicant): Hypertension affects 50 million people in the US and is a significant risk factor for stroke, cardiac infarction, heart failure, and kidney disease. There is general evidence across multiple studies that yoga programs may be effective in the reduction of blood pressure. However, most of these studies are non-randomized and/or uncontrolled, examine healthy rather than hypertensive participants, and many use multi-modal "yoga-based" interventions in which it is impossible to determine the isolated effects of yoga. An additional substantive problem across these studies is the lack of agreement regarding what constitutes the intervention labeled "yoga." Consequently, there remains a need to clearly define a yoga intervention that represents common yoga practice and to determine the effects of such an intervention on blood pressure control. In western cultures, there is reasonable agreement that the most common yoga practice is defined by three integrated elements: physical postures, breath control, and meditation. Yoga adherents suggest that the integration of these elements produces greater health outcomes than would be expected through the simple addition of the independent effects of these elements. However, this suggestion has received no study. There is evidence that the yoga elements of breath control and meditation have clinically significant independent effects on blood pressure, while there is no evidence demonstrating that the physical postures (asana) of yoga have independent effects on blood pressure. The objectives of this application are to define standardized elements of an integrated yoga practice and determine the effects of the integrated practice compared to a single element of the practice (physical postures) on ambulatory blood pressure (ABP). The central hypothesis is that the integration of the elements of yoga (physical postures/breath control/meditation) will produce greater reductions in ABP than are produced through a single element of that practice (physical postures). We plan to test our thesis by performing a 12 week, RCT of 90 pre- and Stage I hypertensive participants. We will also examine a variety of secondary psychosocial and physiological measures related to the autonomic system: heart rate, heart rate variability, baroreceptor sensitivity, perceived stress, coping, tolerance of uncertainty, sense of control, and body mass index, which we expect to be correlated to improvements in ABP. The study will also determine the recruitment, retention, compliance, expectations, acceptance, and perceived effectiveness relative to the interventions. The information gained in this study will have a positive impact by providing critical preliminary and feasibility data to support a larger multi-ethnic RCT on the effects of yoga on individuals with Stage I hypertension.