HRV is a significant predictor of cardiac mortality andmorbidity
[3]
.
Pharmacological interventions
,
exercisetraining
,
smoking
[9]
are known to affect HRV marked
唱
ly
.
The question now is whether the HRV can be in
唱
creased and whether the improved HRV will lead to abetter outcome in hypertensive patients
.
Yoga
,
as prescribed by the ancient Indian scripts
,
is understood to have influence on the autonomic con
唱
trol
.
There is a dearth of prospective studies in assess
唱
ing the effects of yoga and exercise on HRV in hyper
唱
tensive patients
.
The present study was taken up to de
唱
termine and compare the effects of supervised
,
integrat
唱
ed exercise and yoga on HRV in hypertensive patientsafter regular practice
.
METHODS
Forty seven hypertensive patients and
31
age
唱
matchedhealthy subjects who attended hypertension camp
,
dia
唱
betic camp and geriatric camp were selected
.
A detailed history of subjects was taken
.
Generalphysical examination including height
,
weight
,
bloodpressure
,
pulse rate and respiratory rate
,
and a completesystemic examination was done
.
An electrocardiogramwas also recorded
.
Untreated patients with systolic bloodpressure of
>140
mm Hg and
/
or diastolic blood pressureof
>90
mm Hg and all hypertensives on treatment re
唱
gardless of duration of ailment were included in thestudy
.
All the hypertensive patients with congestive car
唱
diac failure
,
acute myocardial infarction
,
cardiac arrhyth
唱
mias
,
serum creatinine
>1畅2
mg
%
and those who wereunable to undergo deep breathing test were excluded
.
All the
47
patients were requested to come to our center regularly for
5
days a week and practice dailyexercises or yoga
,
under the guidance of a physiothera
唱
pist and a yoga teacher
.
They were divided into threegroups viz
.
Group
Ⅰ[
n
=16],
Group
Ⅱ[
n
=16]
andGroup
Ⅲ [
n
=15].
Group I patients enrolled for exer
唱
cise program at our centre
,
and all of them practicedexercise for at least
4
days per week
(
for
9
months du
唱
ration
)
under the guidance of a physiotherapist
.
Group
Ⅱ
patients enrolled for
9
months of yoga asana practicefor at least
4
days a week under the guidance of a yogateacher
.
Group
Ⅲ
performed both yoga and exercise for nine months
.
An informed consent was taken from all these pa
唱
tients before enrolling them in the study
.
The clearancefrom the Institutional Ethics Committee was obtainedand all the experiments were carried out by strictly ad
唱
hering to the guidelines
,
by qualified doctor and yogatherapist and physiotherapist
.
Exercise Program
The types of exercises taught to the subjects under theguidance of a physiotherapist were as follows
:
Warmingup exercise for
5
minutes
,
followed by cycling or tread
唱
mill exercise
,
depending on exercising capacity of thepatients
,
for
30
minutes
.
Flowing the exercise
,
coolingdown exercise was done for
10
minutes
.
The entire du
唱
ration of the exercise was not more than
45
minutes
.
Yoga Program
The yoga was taught to the subjects by a yoga teacher
.
It included Meditation and Yoga asanas
.
The sessionbegan with the subjects sitting down on the floor in acomfortable position with their back straight
.
Chants of
‘
OM
’
were repeated for a few times
.
It was followedwith a prayer
.
The selected yoga asanas included Tadasana
,
Pa
唱
dahasthasana
,
Vrikshasana
,
Trikonasana
,
Viparitakari
唱
ni
,
Vajrasana
,
Sputa
唱
vajrasana
,
Vakrasana
,
Uthanapada
唱
sana
,
Pavanamukthasana
,
Bhujangasana
,
Shalabhasana
,
Dhanurasana and Makarasana
.
These yogic postures were followed by AnulomaPranayama and Viloma Pranayama
(
breathing tech
唱
niques
)
and Savasana
(
body relaxation by lying su
唱
pine
).
The entire duration of yoga practice was notmore than
60
minutes
.
Methods to test HRV
Before beginning the test
,
the subjects were instructedto breathe at a rate of
6
respiratory cycles per minute
;5
seconds for each cycle
(
inhalation and exhalation
).
ECG in lead II was then recorded at a speed of
25
mmper second for
60
seconds with the patient breathing asinstructed
.
Beginning of each inspiration and expirationwas noted down on the ECG
.
ECG was recorded on Day
1,
and at intervals of
3
months
(3
rd
month
,6
th
month and
9
th
month
).041
JOURNAL of CHINESE CLINICAL MEDICINE VOLUME
4|
NUMBER
3|
March
2009
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