title: The effectiveness of yoga in modifying risk factors for cardiovascular disease and metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Yoga, a popular mind-body practice, may produce changes in cardiovascular disease (CVD) and metabolic syndrome risk factors.
  
  
  METHODS
  This was a systematic review and random-effects meta-analysis of randomized controlled trials (RCTs).
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Health Policy, Harvard University, MA, USA Center for Health Decision Science, Harvard School of Public Health, MA, USA.
authors.forename: Paula
authors.initials: P
authors.lastname: Chu
authors.affiliation: Department of Epidemiology, Erasmus MC, the Netherlands Department of Radiology, Erasmus MC, the Netherlands.
authors.forename: Rinske A
authors.initials: RA
authors.lastname: Gotink
authors.affiliation: Division of General Medicine and Primary Care, Harvard Medical School, MA, USA.
authors.forename: Gloria Y
authors.initials: GY
authors.lastname: Yeh
authors.affiliation: Center for Health Decision Science, Harvard School of Public Health, MA, USA Department of Health Policy and Management, Harvard School of Public Health, MA, USA.
authors.forename: Sue J
authors.initials: SJ
authors.lastname: Goldie
authors.affiliation: Center for Health Decision Science, Harvard School of Public Health, MA, USA Department of Epidemiology, Erasmus MC, the Netherlands Department of Radiology, Erasmus MC, the Netherlands Department of Health Policy and Management, Harvard School of Public Health, MA, USA m.hunink@erasmusmc.nl.
authors.forename: M G Myriam
authors.initials: MG
authors.lastname: Hunink
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D016009:Chi-Square Distribution; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D008875:Middle Aged; D065840:Protective Factors; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D015013:Yoga
keywords: Yoga; cardiovascular disease; meta-analysis; metabolic syndrome; systematic review