Many studies report the benefits of using relaxation techniques, such as yoga, to work away anxiety, stress, and even depression and pain.
However, few researchers also have looked for improvements in overall well-being or for changes in physiological markers for a specific disease. Until now.
Cleveland Clinic's Joan Fox, PhD, and Thomas Morledge, MD, recently joined forces to do just that. Together, they have delved further into the subject of mind over matter to better understand whether and how yoga and a practice called mindfulness positively affect cardiovascular health.
“Studies show that 70 to 80 percent of all chronic disease, such as cardiovascular disease, is caused by lifestyle. Thus, the potential for improving health and decreasing health-care costs is enormous,” says Dr. Fox, who is with the Department of Molecular Cardiology, the Robert and Suzanne Tomsich Department of Cardiovascular Medicine, and Center for Integrative Medicine. Her co-investigator, Dr. Morledge, is with the Wellness Institute’s Center for Integrative Medicine.
The duo set out to study the effectiveness of regularly practicing yoga or mindfulness in decreasing negative emotions and increasing positive emotions — unique to their research — and in modulating some of the physiological pathways that may lead to the development of cardiovascular disease.
Sixty-two individuals with moderate cardiovascular risk were enrolled in the study. They were randomly assigned to one of three groups: One that practiced yoga postures, meditation and breathing exercises; a second that used mindfulness — a central teaching of Buddhist meditation described as a calm awareness of one’s body functions, feelings, consciousness, etc. — including discussion of concepts of the practice, various mindfulness meditations, relaxation practices and some yoga; and a control group, whose sessions were based on those of a typical conventional stress-reduction program, such as muscle relaxation exercises, lectures on health and wellness, and stretching exercises as recommended by the American Heart Association.
All groups were asked to practice at home daily for 24 weeks, as well as meeting weekly for the first 12 weeks. About 75 percent completed the 12 weeks and 60 percent the 24 weeks. Negative emotions such as anxiety, depression and psychological stress were assessed using validated questionnaires. Questionnaires also were used to assess changes in emotional and spiritual well-being. Sympathetic nervous system activity was assessed by blood pressure, heart rate and heart rate variability recordings.
Another unique feature of the study involved collecting blood and urine samples to measure the concentration of inflammatory markers, or molecules produced by immune cells that are thought to contribute to the damage to the vessel wall that ends up in atherosclerotic lesions.
“Our preliminary analyses suggests that all three groups received benefits in terms of decreased scores on questionnaires that assess negative emotions such as stress, anxiety and depression and also increased scores on well-being questionnaires,” Dr. Fox says. “Although the control group showed improvements in these scores, the improvements in the yoga and mindfulness groups were significantly greater than those for the control group.”
Most of the physiological outcome data has yet to be analyzed, although preliminary data for one of the inflammatory markers shows a significantly greater decrease in the mindfulness group compared to the control group.
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