Preliminary results of the largest ever multi-centre randomised trial on cardiac rehabilitation and of health benefits of yoga have shown that it is safe and offers “similar” benefits as cardiac care typically prescribed after surgery. The study was conducted in 24 centres across India and recruited close to 4,000 patients immediately after discharge following a heart attack. The patients were randomised to undergo a structured ‘Yoga-CaRe’ programme that comprised meditation, breathing exercises and selected heart-friendly yoga poses in addition to lifestyle advice. The control group received conventional lifestyle advice. Target group Cardiac rehabilitation is prescribed for patients after a heart attack and cardiac surgery to get patients back to normal activities. The study in question, which lasted for five years and ended in September 2018, was funded by the Indian Council for Medical Research (ICMR) and the Medical Research Council – U.K. The results were presented at a meeting of the American Heart Association in Chicago, U.S., last month. Professor D. Prabhakaran, Vice President, Public Health Foundation of India (PHFI) and principal investigator of the study, explained that the prevalence of ischemic heart disease in India has increased by over 50%, and in terms of absolute numbers, from 10 million in 1990 to 24 million in 2016. “This trial is the largest so far on yoga as well as cardiac rehabilitation (CR) and has shown the potential of yoga to be an alternative to conventional CR programmes. It addresses the unmet needs of cardiac rehabilitation for patients in low- and middle-income countries,” he says. The benefits applied to those patients who attended at least 75% of the sessions. The results show that yoga is safe, relatively inexpensive, does not need an elaborate infrastructure, is culturally acceptable and improves quality of life, notes a release issued by the authors. Independent doctors say that there is now scientific evidence to recommend yoga as equivalent to conventional CR. ‘Evidence-based’ “Modern medicine demands evidence of benefit for interventions for its wider acceptance, especially among the medical research community. This study is a step in that direction. We hope that it spurs several such large rigorously performed trials in other diseases where yoga can be potentially beneficial,” says Dr. Ambuj Roy, Professor of Cardiology at the All India Institute of Medical Sciences. “It gives me a lot of confidence now in sending my patient on a yoga-based cardiac rehabilitation [programme] as we realise that the benefits are similar to conventional CR programmes… This trial transcends yoga from belief to science-based intervention.” Focus on quality of life Professor Sanjay Kinra, Head, Epidemiology, London School of Hygiene and Tropical Medicine, and co-principal investigator of the study, says that improvements in cardiac care mean that most people nowadays survive a heart attack. “The focus has therefore shifted to improving the quality of life of survivors of heart attacks so that they can readjust better after such a catastrophic event and contribute maximally to their families and society.” According to him, this is particularly true in India where heart attacks tend to occur at a very young age. Yoga has gained immense popularity nationally and internationally as a tool for health promotion, especially after the United Nations declared June 21 as International Yoga Day.