A study to compare and correlate the effect of a yogic lifestyle on Framingham, Q RISK 3, and WHO risk scores among high-risk cardiovascular subjects
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Keywords
Dietary intervention, Framingham, High-risk subjects, QRISK3 Score, WHO CVD risk chart,, yoga
Abstract
Background: Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels. Yoga is a low-cost, easily accessible lifestyle modification program that holds as an approach to decreasing cardiometabolic risk factors and increasing exercise self-efficacy among high-risk subjects. This study aimed to assess the impact of the yogic lifestyle (including diet) on cardiovascular risk scores by using the Framingham (FRS), QRISK3 score, and World Health Organization (WHO) CVD risk prediction charts at baseline, three months, and six months. The present study compares and correlates FRS, QRISK3, and WHO cardiovascular risk scores.
Methodology: The experimental interventional study was conducted among the high-risk population at RUHS College of Medical Sciences and Associated Group of Hospitals, Jaipur. Framingham risk Score, QRISK3 score, and WHO CVD risk prediction charts were used as a method of measurement for the outcome of interest at baseline, three months, and six months in the study and control group. Randomization and allocation in yoga and control groups were performed using computer-generated random numbers. The statistical analysis was done using advanced SPSS-22 software at significant level tests as p≤0.05, ensuring the highest level of accuracy. Data were analyzed using a one-way variance ANOVA test analysis at baseline, three, and six months. Pearson correlation analysis was done to compare different risk scores.
Results: Participants had a mean age of 48.43 ± 6.4 years. Baseline values (mean±SD) of FRS, Qrisk3, WHO were
24.59±10.15,28.59±10.11,15.71±6.07. After six months of yogic lifestyle, these values decreased significantly to 15.1±7.05, 20.09±7.08, and 13.85±4.96. The decrease in cardiovascular scores was statistically significant (p<0.0001), providing strong evidence for the effectiveness of the yogic lifestyle. Pearson correlation analysis results depict that FRS and Q risk 3 (r=0.840, p<0.0001), FRS and WHO risk chart (r=0.768, p<0.0001), Q risk3 and WHO risk chart (r=0.778, p<0.0001) have a statistically significant strong positive correlation.
Conclusion: This study's findings suggest that a 24-week yogic lifestyle intervention (including diet) significantly decreased FRS, Q RISK 3, and WHO CVD risk scores among high-risk subjects compared to the control group.
References
2. Srinath Reddy K, Shah B, Varghese C, Ramadoss A. Responding to the threat of chronic diseases in India. Lancet. 2005 ;366(9498):1744-49.
3. Joshi P, Islam S, Pais P, Reddy S, Dorairaj P, Kazmi K,et al. Risk factors for early myocardial infarction in South Asians compared with individuals in other countries. JAMA. 2007; 297: 286–94.
4. Xavier D, Pais P, Devereaux PJ, Xie C, Prabhakaran D, Reddy KS, et al. CREATE registry investigators. Treatment and outcomes of acute coronary syndromes in India (CREATE): A prospective analysis of registry data. Lancet. 2008; 371: 1435–42. emerging therapies.
5. World Health Organization. Obesity- Preventing and managing the global epidemic. WHO technical report series 894. Geneva: WHO; 1999.
6. Yadav RK, Magan D, Mehta N, Sharma R, Mahapatra SC. Efficacy of a short-term yoga-based lifestyle intervention in reducing stress and inflammation: preliminary results. J Altern Complement Med. 2012 Jul;18(7):662-7. doi: 10.1089/acm.2011.0265.
7. Ornish D, Brown SE, Scherwitz LW, Billings JH, Armstrong WT, Ports TA, McLanahan SM, Kirkeeide RL, Brand RJ, Gould KL. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet. 1990 Jul 21;336(8708):129-33. doi: 10.1016/0140-6736(90)91656-u.
8. Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: A systematic review. J Am Board Fam Pract Am Board Fam Pract 2005; 18:491–51
9. Yadav RK, Magan D, Mehta N, Sharma R, Mahapatra SC. Preliminary results include the efficacy of a short-term yoga-based lifestyle intervention in reducing stress and inflammation. J Altern Complement Med. 2012 Jul;18(7):662-7. doi: 10.1089/acm.2011.0265.
10. Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998 May 12;97(18):1837-47. doi: 10.1161/01.cir.97.18.1837.
11. The WHO CVD Risk Chart Working Group. World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions. Lancet Glob Health 2019; published online WHO Revised Risk Chart
12. Hippisley-Cox J, Coupland C, Brindle P. Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: Prospective cohort study. BMJ. 2017;357: 1-21.
13. Joint British Societies' consensus recommendations for the prevention of cardiovascular disease (jbs3). Heart. 2014;100(suppl 2):ii1eii67.
14. Kariuki JK, Yamnia CI, Imes CC, Weiss PM, Engberg SJ. Impact of lifestyle modification on absolute cardiovascular disease risk: A systematic review protocol. JBI Database System Rev Implement Rep. 2019;17(10):2106-2114. doi: 10.11124/JBISRIR-2017-003847.
15. Hartley L, Dyakova M, Holmes J, Clarke A, Lee MS, Ernst E, et al. Yoga for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2014 13;2014(5): CD010072. doi: 10.1002/14651858.CD010072.pub2.
16. Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet. 2007;370:1929–38.
17. Mathers CD, Boerma T, Ma Fat D. Global and regional causes of death. Br Med Bull. 2009;92:7–32. doi: 10.1093/bmb/ldp028
18. Kuklina EV. Assessing and managing risk for cardiovascular disease: A worldwide perspective. N A J Med Sci. 2010; 3:94–103. doi: 10.7156/v3i1p094.
19. Trinder P. Determination of blood glucose using an oxidase-peroxidase system with a non-carcinogenic chromogen. Journal of clinical pathology.1989; 22(2); 158–161.
20. Metus P, Ruzzante N, Bonvicini P, Meneghetti M, Zaninotto M, Plebani M. Immunoturbidimetric assay of glycated hemoglobin. J Clin Lab Anal. 1999;13(1):5-8.
21. Allain CC, Poon LS, Chan CS, Richmond W, Fu PC. Enzymatic determination of total serum cholesterol. Clin Chem. 1974;20(4):470-5
22. Fossati P, Prencipe L. Serum triglycerides determined colorimetrically with an enzyme that produces hydrogen peroxide. Clin Chem. 1982;28(10):2077-80.
23. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972 ;18(6):499-502.
24. Icmr.nic.in/sites/default/files/guidelines/ICMR_Guidelines Type2 diabetes2018_0.pdf
25. Gopalan C, Rama Sastri BV, Balasubramanian SC. Nutritional value of Indian foods. Hyderabad, India: national institute of nutrition. ICMR;2012. https://www.nin.res.in/downloads/dietary Guidelines for NINwebsite.pdf
26. Pasricha S, Rebello LM. Some common Indian recipes and their nutritional value. Hyderabad, India: National Institute of Nutrition, ICMR.2011.
27. Pope SK, Kritchevsky SB, Morris MC, Block G, Tylavsky FA, Lee JS, et al. Cognitive ability is associated with suspected reporting errors on food frequency questionnaires. The Journal of nutrition, health & aging. 2007 ;11(1):55-58.
28. Rodgers JL, Jones J, Bolleddu SI, Vanthenapalli S, Rodgers LE, Shah K,et al . Cardiovascular Risks Associated with Gender and Aging. J Cardiovasc Dev Dis. 2019;6(2):19. doi: 10.3390/jcdd6020019.
29. Andersson C, Vasan RS. Epidemiology of cardiovascular disease in young individuals. Nat Rev Cardiol. 2018 ;15(4):230-240. doi: 10.1038/nrcardio.2017.154.
30. Cui J, Yan JH, Yan LM, Pan L, Le JJ, Guo YZ. Effects of yoga in adults with type 2 diabetes mellitus: A meta-analysis. Journal of diabetes investigation 2017;8(2): 201–209.
31. Kacker S, Saboo N, Sharma S, Sorout J. Quasi prospective comparative study on effect of yoga among prediabetics on progression of cardiovascular risk factors. Int J Yoga 2019;12:114-9.
32. Misra P, Sharma G, Tandon N, Kant S, Sangral M, Rai SK, et al. Effect of community-based structured yoga program on Hba1c level among type 2 diabetes mellitus patients: An Interventional Study. Int J Yoga. 2021;14(3):222-228.
33. Cramer H, Langhorst J, Dobos G, Lauche R. Yoga for metabolic syndrome: a systematic review and meta-analysis. Eur J Prev Cardiol.2016;23:1982–1993.
34. Pandey A, Pandey A, Pandey AS, Bonsignore A, Auclair A, Poirier P. Impact of Yoga on Global Cardiovascular Risk as an Add-On to a Regular Exercise Regimen in Patients with Hypertension. Can J Cardiol. 2023 ;39(1):57-62. doi: 10.1016/j.cjca.2022.09.019.
35. Innes KE, Selfe TK. Yoga for Adults with Type 2 Diabetes: A Systematic Review of Controlled Trials. J Diabetes Res. 2016; 2016:6979370. doi: 10.1155/2016/6979370. Epub 2015 Dec 14.
36. Rao A, Kacker S, Saboo N. The effects of yoga on cardiovascular risk factors. Mìžnarodnij endokrinologìčnij žurnal [Internet]. 2022 Nov. 26 [cited 2023 Nov. 16];18(7):396-403.
37. Raveendran AV, Deshpandae A, Joshi SR. Therapeutic Role of Yoga in Type 2 Diabetes. Endocrinol Metab (Seoul). 2018;33(3):307-317. doi: 10.3803/EnM.2018.33.3.307.
38. Saboo N, Kacker S. A Study to Assess and Correlate Metabolic Parameters with Carotid Intima-Media Thickness after Combined Approach of Yoga Therapy among Prediabetics. Adv Biomed Res. 2023 May 30; 12:145. doi: 10.4103/abr.abr_146_22.
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