Hypertension, Postmenopausal Symptoms
Conditions
Keywords
Yoga, Hypertension, Post-Menopausal Women, Heart Rate Variability
Brief summary
Autonomic and endothelial imbalance in post menopause women raise the need to manage cardiovascular risk. Yoga poses and breathing control present controversial results on prevention and treatment of hypertension.. The aim of this study is to compare the effect of 12 week intervention based on yoga poses and their muscle contractions known as bandhas (pelvic floor, core and throat/neck) and ujjayi pranayama (victorious breath) on autonomic modulation, endothelial function, arterial stiffness, aerobic capacity and cognitive function of hypertensive post-menopausal women.
Detailed description
Abstract: Increased hypertension prevalence in post-menopausal women, along with cardiovascular damages such as autonomic and endothelial imbalance raise the need to include non-pharmacological interventions, such as yoga in the management of cardiovascular risk. Yoga practices are composed by several variations of techniques including physical postures (yoga poses and specific muscles contractions), breathing control (pranayamas), relaxation and meditation, beside others.The effects of each of these compounds has not been elucidated up to date and can be considered confounding effects for commonly named yoga programs. Existing yoga based data are controversial about its effect on prevention and treatment of hypertension and point to poor methodological standards of most studies. Considering the effects of comparable interventions such as slow breathing on improving autonomic modulation, resistive and isometric exercise on endothelial function, and associations of flexibility with arterial stiffness, it´s licit to search for specific effects of yoga compounds. Thus, the aim of this study is to compare the effect of 12 week intervention based on yoga poses including their muscle contractions known as bandhas (pelvic floor, core and throat/neck), ujjayi pranayama (victorious breath) and stretching/ flexibility on autonomic modulation, endothelial function, arterial stiffness, aerobic capacity and cognitive function of hypertensive post-menopausal women.
Interventions
OTHERStretching exercises
Stretching exercises routine based on dynamic and static exercises excluding those similar to yoga poses. This routine works on great range of motion of all body joints and main muscles groups/ chains.
OTHERYoga Poses
Yoga poses routine including specific muscles contractions known as bandhas (pelvic floor, core and throat/neck contraction) within each pose, which are advised to be done with steadiness and comfort.
OTHERBreath Control
Ujjayi pranayama (Victorious breath) Inhalation and exhalation are both done through the nose. The ocean sound is created by moving the glottis as air passes in and out. As the throat passage is narrowed so, too, is the airway, the passage of air through which creates a rushing sound. The length and speed of the breath is controlled by the diaphragm, the Strengthening of which is, in part, the purpose of ujjayi. The inhalations and exhalations are equal in duration.
Sponsors
Instituto de Cardiologia do Rio Grande do Sul
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
All participants will be told they are attending to a yoga protocol. All outcomes assessments will be taken by blind investigators to the interventions.
Eligibility
Sex/Gender
FEMALE
Age
45 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* FSH\>35mui/ml * minimum 12 months amenorrhea * sedentary life style (less than 150 minutes per week of exercise) * never been in yoga -practicing (self declaration) * Blood pressure \> 140/90 or in continuous use of medication (diuretics,Ca+ channel inhibitors, ACE inhibitors)
Exclusion criteria
* Use of Betablockers * recent cardiovascular events or surgery * renal alterations * respiratory and/or motor pathologies * smoking * BMI\>34,9
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cardiovascular autonomic control by heart rate variability(HRV) and blood pressure variability (BPV) in frequency domain acquired by Finometer | 30 minutes | Sympathovagal balance HRV (ratio of low frequency (LF in ms2) and high frequency (HF in ms2) components of HRV = LF/HF) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Maximal Oxygen Uptake by Cardiopulmonary Exercise Test | 45 minutes | Increase Maximal Oxygen Uptake (VO2max ml/kg/min) |
| Ambulatory Arterial Pressure Monitoring | 24 hours | Decrease Ambulatory Arterial Pressure Monitoring (mmHg) |
| Respiratory rate and movements of rib cage and abdomen by Pneumotrace respiratory belt | 30 minutes along with Finometer | Reduction of respiratory rate (cycles per minute/ cpm) |
| Blood samples laboratorial analysis | 5 minutes | Improved blood sample analysis HDL cholesterol, glucose, creatinine, c-reactive protein (mg/dL) |
| Flow mediated dilation (FMD) of brachial artery by ultrasound | 20 minutes | Increase Flow Mediated Dilation (FMD) (%) |
| Fat percentage by Bioimpedance | 5 minutes | Reduction of fat percentage and increase of lean mass (% ) |
| Carotid -femoral pulse wave velocity (Complior) | 10 minutes | Reduction of carotid -femoral pulse wave velocity (m/s) |
| Diaphragm Thickness by ultrasound | 5 minutes | Increase diaphragm thickness (mm) |
| Intima Media Thickness of carotid artery by ultrasound | 5 minutes | Decrease of intima media thickness (IMT) (mm) |
| Blood sample analysis of oxidative stress markers (Spectrophotometry) | 5 minutes along for all blood samples | Levels of Superoxide Dismutase (SOD) (un/SOD/mg protein) |
| Blood levels of sample analysis of Inflammatory markers (ELISA) | 5 minutes along for all blood samples | Levels of Interleukin(IL) IL 1, IL 6, IL 10 (pg/ml)Tumor Necrosis Factor (TNF) alpha (pg/ml) |
| Assessment of center of pressure (COP) and balance by baropodometry platform | 5 minutes | Decreased area of COP (cm2) |
| Sit and reach flexibility test | 5 minutes | Increase flexibility levels (cm) |
| Cognitive function | 40 minutes | Changes in scores of Mini Mental State Examination (0 to 30) |
Countries
Brazil
Outcome results
None listed