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

•Yoga can have a significant beneficial effect on age-associated arterial stiffness in elderly with mild hypertension.•Yoga can induce significant beneficial modulation in cardiac autonomic nervous system, enhance bioavailability of NO and reduce BP in elderly individuals.•The yoga program offered was better than a brisk walking program in inducing beneficial modulation in arterial stiffness, endothelial function and sympathovagal balance.

ObjectiveWe aimed to determine the effect of yoga on arterial function in elderly with increased pulse pressure (PP).DesignRandomized controlled study with two parallel groups.ParticipantsElderly subjects with PP ≥ 60 mmHg (n = 60).InterventionsYoga group (n = 30) was assigned for yoga training and brisk-walking (BW) group (n = 30) for brisk-walk with stretching exercise for 1 h in the morning for 6 days in a week for 12 weeks.Main outcome measuresArterial 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.ResultsThe 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.ConclusionOur 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.