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

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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.