Positive outcomes for patients with heart failure who practice yoga

New findings reveal significant long-term improvements in cardiac health when yoga is added to standard medications as a treatment option.

Author: Denise Doherty

Practising yoga is associated with symptom improvement and better cardiac outcomes in patients with heart failure, according to a recent study. The new findings documented significant improvements in a range of outcomes among those who practised yoga – focusing on breathing, meditation, and relaxation – as well as taking standard medication compared with those who took medication alone. While previous studies have shown the short-term benefits of yoga in patients with heart failure, this study provides new information about the long-term effects.

“Patients who practised yoga on top of taking their medications felt better, were able to do more, and had stronger hearts than those who only took drugs for their heart failure,” said study author Dr Ajit Singh of the Indian Council of Medical Research, Manipal Academy of Higher Education, India. “The findings suggest that yoga can be a beneficial complementary therapy in patients with heart failure.”

Heart failure carries significant morbidity and mortality, and can have devastating impacts on quality-of-life for the large number of those diagnosed, with the disease affecting more than 64 million people globally. In Ireland, heart failure is more common than most cancers and represents a major public health and economic burden. There are currently more than 90,000 people across the country living with heart failure and over 10,000 new cases are diagnosed annually. Approximately 2 per cent of people in Ireland have symptomatic disease, and this prevalence rises to 10 per cent among adults over the age of 75 years. A further 2 per cent are estimated to have asymptomatic left ventricular systolic dysfunction. Individually, these patients attend general practice around 14 times a year.

The study included 85 patients with heart failure aged between 30 and 70, 82 per cent of whom were male, from the cardiology outpatient department of Kasturba Hospital in Manipal, India. All participants had undergone a cardiac procedure within the past six months to one year and were taking guideline-recommended heart failure medications. The average age of participants was 49 years. The study enrolled patients with New York Heart Association (NYHA) Classification III or less. Those with class IV were excluded.

In a non-randomised fashion, 40 patients were assigned to the yoga group and 45 patients were allocated to a control group. All participants continued taking guideline-recommended heart failure medications throughout the study.

Experienced faculty in the hospital’s Department of Yoga demonstrated pranayama (yogic breathwork), meditation, and relaxation techniques to patients in the yoga group. Participants were supervised for one week and then advised to continue self-administered yoga at home once a week for 50 minutes. Patients spoke to an instructor after each home session to monitor their progress.

All participants in both groups were assessed at baseline, six months, and one year using echocardiography. The measurements included left ventricular ejection fraction and assessment of right ventricular function. The researchers also examined blood pressure, heart rate, body weight, and body mass index. Symptom burden and the ability to do ordinary activities such as walking and climbing stairs were assessed using the NYHA classification system.

Patients in the yoga group had greater improvement in all variables at both time points compared with the control group. The yoga group demonstrated significantly greater improvements in all measurements at six months and one year relative to baseline.

Dr Singh said: “Patients who did yoga had healthier hearts and were more able to carry out ordinary activities such as walking and climbing stairs than those who only took medications. Patients with heart failure should speak to their doctor before starting yoga and should then receive training from an experienced instructor. Prescribed medications should be continued as before. Yoga may be unsuitable for heart failure patients with severe symptoms, who were excluded from our study.”

The abstract ‘Impact of yoga therapy on long-term outcomes in heart failure patients using functional and echocardiographic parameters’ was presented during the session ‘Chronic heart failure – treatment 16’ at Heart Failure 2024, a scientific congress of the European Society of Cardiology, which took place 11-14 May at the Lisbon Congress Centre, Portugal, and online.