Yoga-CaRe study boosts heart failure patient quality of life

Study involves 3,500 patients across 16 Indian hospitals

The trial recruited nearly 3,500 patients with heart failure with reduced ejection fraction from 16 hospitals across India. These participants were randomly assigned to either enhanced standard care or a yoga-based cardiac rehabilitation program.

The study showed clinically and statistically significant improvements in walking distance and quality of life that lasted for 24 months. Yoga as exercise involves postures, breathing exercises, flowing sequences, and meditation or relaxation.

Yoga-CaRe program combines education, behavior change, and practice

The Yoga-CaRe program includes a health education booklet, guided behavior change, and a set of yoga practices. These practices include asana, or postures, pranayama, or breathing exercises, and meditation tailored to patient capacity. A single trained professional delivers the entire program.

Patients received 20 training sessions over three months from a board-certified Yoga and Naturopathy practitioner.

They practiced at home for approximately 35 to 40 minutes per day, five days a week. These details were reported by The Tribune, established in 1881 and managed by a five-member trust. The trust includes Shri N N Vohra, Justice S S Sodhi, Shri Gurbachan Jagat, Lt Gen. Shamsher Singh Mehta, and Shri Paramjit Singh Patwalia. The publication also produces the Punjabi Tribune and Dainik Tribune.

Significant improvements in physical function and daily life

Patients showed a tangible improvement in their daily lives after the program. Three months after enrollment, participants showed an 8.1 unit improvement in the Minnesota Living with Heart Failure Questionnaire. They also achieved a 25.5-meter increase in six-minute walk distance and a 0.05 increase in quality-adjusted utility values.

These improvements in quality of life, functional capacity, and utility values persisted through 24 months.

The study also found improvements in patient frailty and tobacco cessation. Caregivers of these patients experienced an improved quality of life and a reduction in depression.

No statistically significant reduction in clinical events

The research did not find a reduction in death, stroke, or hospitalization rates over a 15-month duration. While clinical events in the yoga group fell by 10%, these differences were not statistically significant.

However, this result did not reach statistical significance.

Experts label yoga a lifestyle polypill for cardiac care

SC Manchanda, a Senior Consultant Cardiologist at Sir Ganga Ram Hospital, said, “For me, yoga is a lifestyle polypill with much relevance for all cardiac patients”. He said the program helped patients improve their physical activity, diet, and avoidance of tobacco and alcohol.

Manchanda, the former AIIMS Cardiology Head, also described yoga as a "lifestyle polypill" for cardiac patients. He cited its benefits for diet, physical activity, and the reduction of tobacco and alcohol consumption.

Ambuj Roy of the All India Institute of Medical Sciences, a co-lead of the study, said the trial addresses the limited penetration of cardiac rehabilitation benefits. He said the study demonstrates that traditional practices like yoga can be validated through rigorous modern scientific methods.

Addressing 1.8 million annual heart failure cases in India

The Indian Council of Medical Research provided funding for the Yoga-CaRe study. The study focused on heart failure patients with reduced ejection fraction.

Dorairaj Prabhakaran, the Executive Director of the Centre for Chronic Disease Control and President-Elect of the World Heart Federation, led the research. He noted that India sees approximately 1.8 million new heart failure cases every year.

Prabhakaran said very few patients receive cardiac rehabilitation. He said the Yoga-CaRe program offers an alternative to conventional multidisciplinary cardiac rehabilitation for resource-constrained settings.

Prabhakaran noted that yoga is culturally suitable for nations like India. He characterized the project as one of the largest cardiac rehabilitation studies for heart failure patients.

Cost-effectiveness analysis remains pending

A formal cost-effectiveness analysis of the program has not been completed, according to techtimes.com.