Manjunatha Aithala

Effect of yoga on arterial stiffness in elderly subjects with increased pulse pressure: A randomized controlled study

OBJECTIVE We aimed to determine the effect of yoga on arterial function in elderly with increased pulse pressure (PP). DESIGN Randomized controlled study with two parallel groups. PARTICIPANTS Elderly subjects with PP≥60 mmHg (n=60). INTERVENTIONS Yoga group (n=30) was assigned for yoga training and brisk-walking (BW) group (n=30) for brisk-walk with stretching exercise for 1h in the morning for 6 days in a week for 12 weeks. MAIN OUTCOME MEASURES Arterial stiffness measures: Brachial-ankle pulse wave velocity (baPWV), Carotid-femoral pulse wave velocity (c-f PWV), aortic augmentation index (AIx@75), arterial stiffness index at brachial (bASI) and tibial arteries (aASI). Total serum nitric oxide concentration (NOx) as an index of endothelial function. Heart rate variability (HRV) measures: Low frequency and high frequency in normalized units (LFnu, HFnu) and LF/HF ratio. RESULTS The mean between-group change (with 95% CI) in arterial stiffness: c-f PWV(m/s) [1.25(0.59-1.89); p<0.001], baPWV(m/s) [1.96(0.76-3.16), p<0.01], AIx@75 [3.07(0.24-5.89), p=0.066], aASI [8.3(4.06-12.53), p<0.001]; endothelial function index: NO(μmol/L) [-9.03(-14.57 to -3.47), p<0.001]; SBP(mmHg) [14.23(12.03-16.44), p<0.001], DBP(mmHg) [0.1(-1.95-2.15), p=0.38], PP(mmHg) [14.07(11.2-16.92), p<0.001], MAP(mmHg) [4.7(3.08-6.32), p<0.001]; and cardiac autonomic function: LF(nu) [4.81(1.54-8.08), p<0.01], HF(nu) [-4.13(-7.57 to -0.69), p<0.01], LF/HF ratio [0.84(0.3-1.37), p<0.001], indicate significant difference in effects of two intervention on arterial stiffness, endothelial function, BP and cardiac autonomic activity. There was significant change within-yoga group in vascular function, BP and autonomic function, while no significant change within-BW group was observed. CONCLUSION Our findings suggest that yoga program offered was more effective than brisk-walk in reducing arterial stiffness along with BP in elderly individuals with increased PP. Yoga can also significantly reduce sympathetic activity and improve endothelial function with enhancement in bioavailability of NO.

Effect of Yoga on Oxidative Stress in Elderly with Grade-I Hypertension: A Randomized Controlled Study

BACKGROUND AND OBJECTIVES Hypertension, especially in elderly is a strong risk factor for cardiovascular mortality and morbidity. Oxidative stress has been implicated as one of the underlying cause of hypertension. Yoga has been found to control hypertension in the elderly, but the underlying benefits of mechanism in relation to oxidative stress regulation remains unclear. The purpose of the study was to investigate the effect of yoga on oxidative stress in elderly with Grade-I hypertension. METHODS An open parallel-arm randomised controlled study was conducted at BLDE Universitys Shri B.M.Patil Medical College, Hospital and Research Centre, India on elderly male individuals with Grade-I hypertension (n=57, age 60-80 years). Study (Yoga) group was assigned for yoga intervention and control group for walking for one hour in the morning for six days in a week for three months under the supervision of yoga instructor and physical training instructor respectively. Serum malondialdehyde (MDA) as an indicator of oxidative stress and antioxidants such as serum superoxide dismutase (SOD), reduced glutathione (GSH) and vitamin C levels were estimated. RESULTS Yoga practice for three months has significantly reduced serum MDA level (p<0.001), and enhanced antioxidants level such as SOD activity (p=0.007), serum GSH (p=0.002) and vitamin C (p=0.002). In the control group, we observed a significant increase in serum MDA level (p=0.04) and reduction in serum vitamin C level (p=0.015) with no significant difference in the SOD activity and GSH level. CONCLUSION These findings suggest that yoga is an effective means to reduce oxidative stress and to improve antioxidant defense in elderly hypertensive individuals.

Effect of Occupational Exposure on Blood Cell Counts, Electrocardiogram and Blood Pressure in Rice Mill Workers

INTRODUCTION Under normal conditions, parasympathetic and sympathetic nervous systems interact to regulate the heart rate of about 70 beats per minute. Activation of sympathetic nervous system by emotional or physical stress increases heart rate and the force of heart beat. There are many factors which alter the heart rate. The chemical and mechanical stimulation of receptors can also cause change in blood pressure through autonomic nervous system. Exposure to dust also causes alteration in blood cell counts. This can be due to allergic reactions and inflammation which in turn evoked by dust entering the lungs. OBJECTIVES Aim of the study was to evaluate the effect of occupational exposure on haematological and cardiovascular parameters of rice mill workers by analysing Blood Cell Counts, ECG and Blood Pressure. MATERIALS AND METHODS This cross-sectional study was carried on 134 rice mill workers and an equal number of age and sex matched healthy individual. The blood cell counts were determined by automated cell counter machine, ECG was recorded by using ECG machine and Blood Pressure was measured by using mercurial sphygmomanometer. RESULTS Neurtrophil, Eosinophil and Lymphocyte count among haematological parameters were significantly increased in exposed individuals. Marked variation was seen in ECG and Blood pressure among cardiovascular parameters of exposed individuals compared with control group. CONCLUSION The findings of our study clearly indicate that the rice mill workers are under high level of dust exposure which has deleterious effects on their blood and tissues. It is due to high oxidative stress. There are abnormalities seen in cardiovascular system.

Comparison of yoga and walking-exercise on cardiac time intervals as a measure of cardiac function in elderly with increased pulse pressure

Objective Arterial aging along with increased blood pressure(BP) has become the major cardiovascular(CV) risk in elderly. The aim of the study was to compare the effects of yoga program and walking-exercise on cardiac function in elderly with increased pulse pressure (PP). Methods An open label, parallel-group randomized controlled study design was adopted. Elderly individuals aged ≥60 years with PP ≥ 60 mmHg were recruited for the study. Yoga (study) group (n = 30) was assigned for yoga training and walking (exercise) group (n = 30) for walking with loosening practices for one hour in the morning for 6 days in a week for 3 months. The outcome measures were cardiac time intervals derived from pulse wave analysis and ECG: resting heart rate (RHR), diastolic time(DT), ventricular ejection time(LVET), upstroke time(UT), ejection duration index (ED%), pre-ejection period (PEP), rate pressure product (RPP) and percentage of mean arterial pressure (%MAP). Results The mean within-yoga group change in RHR(bpm) was 4.41 (p = 0.031), PD(ms): −50.29 (p = 0.042), DT(ms): −49.04 (p = 0.017), ED%: 2.107 (p = 0.001), ES(mmHg/ms): 14.62 (p = 0.118), ET(ms): −0.66 (p = 0.903), UT(ms): −2.54 (p = 0.676), PEP(ms): −1.25 (p = 0.11) and %MAP: 2.08 (p = 0.04). The mean within-control group change in HR (bpm) was 0.35 (p = 0.887), PD (ms): 11.15(p = 0.717), DT (ms): 11.3 (p = 0.706), ED%: −0.101 (p = 0.936), ES (mmHg/ms): 0.75 (p = 0.926), ET(ms): 2.2 (p = 0.721), UT(ms):4.7(p = 455), PEP (ms): 2.1(p = 0.11), %MAP: 0.65 (p = 0.451). A significant difference between-group was found in RHR (p = 0.036), PD (p = 0.02), ED% (p = 0.049), LVET (p = 0.048), DT (p = 0.02) and RPP (p = 0.001). Conclusions Yoga practice for 3 months showed a significant improvement in diastolic function with a minimal change in systolic function. Yoga is more effective than walking in improving cardiac function in elderly with high PP.