Yoga, Mindfulness
and Cardiovascular Disease

Background

Heart disease is the leading cause of mortality in the United States, accounting for more than one-third of all deaths, according to the latest data from the American Heart Association. Recent studies have lead to the recognition that negative emotions such as anxiety and depression are playing a substantive role in the development and progression of cardiovascular disease. Imbalance of the autonomic nervous system (ANS) tone and stress-related hormones, with resulting dysregulation of endothelial, platelet and immune cell function, have been proposed as molecular pathways through which psychological distress and coronary artery disease development and progression might be linked. However, direct evidence for any of these proposed pathways is still lacking. Identification of key pathways would be greatly facilitated if approaches for decreasing the harmful components of psychological distress and improving overall wellbeing were available. Practices such as Tai Chi, Yoga and Mindfulness Meditation, are becoming increasingly popular as ways of not only releasing stress but also improving emotional and spiritual well-being. For some of these practices, there is preliminary evidence for beneficial modulation of (i) psychological state, (ii) levels of stress-related hormones, and (iii) activity of the ANS. However, detailed information on the benefits of these practices in improving overall wellbeing is lacking and rigorous studies examining effects on downstream pathways involved in the development of cardiovascular disease have not been performed.

Study Description

This study funded by the Bakken Heart-Brain Institute will evaluate the efficacy and mechanisms of action of two practices, Mindfulness Meditation and Yoga, chosen because of their emphasis on both emotional and spiritual wellbeing. 105 otherwise healthy individuals who have moderate cardiovascular risk factors, including elevated blood pressure and mild to moderate anxiety will be randomized to one of three groups: Mindfulness, Yoga, or an education-based stress-reduction program.

Our Primary objectives are to evaluate the effectiveness of these practices in (1) decreasing stress and anxiety and improving emotional and spiritual wellbeing, as assessed by validated inventories and stress-related hormones, (2) decreasing blood pressure, and (3) modulating pathways potentially involved in development of cardiovascular disease, including: (a) ANS activity, as assessed by heart rate variability and catecholamine levels (b) inflammatory mediators of cardiovascular disease, (c) and platelet activity.

A secondary objective is to determine whether there is an association between any aspect of improved mood or physiological marker of psychological stress and beneficial changes in any cardiovascular risk factors or proposed brain/cardiovascular system linkage pathways.

We anticipate that the study will provide information on the efficacy of the Mindfulness and Yoga interventions in improving various aspects of psychological wellbeing, their effects on cardiovascular risk factors, and potential pathways mediating the brain/cardiovascular system connections. The study will also provide the data needed to design a future study that will rigorously address these questions in a larger, randomized trial of Mindfulness practice and Yoga in patients with cardiovascular risk factors.

For additional information
or to find out if you are eligible to participate in this research study
please call 216/445-3874 or toll free at 800/223-2273, ext. 53874