Cardiovascular disease (CVD) remains the leading cause of death in women. CVD risk rises sharply with menopause, likely due to the coincident rise in insulin resistance and related atherogenic changes that together comprise the insulin resistance syndrome (IRS), a cluster of metabolic and hemodynamic abnormalities strongly implicated in the pathogenesis and progression of CVD. There is growing evidence that the practice of yoga may offer a safe and cost-effective strategy for reducing IRS-related risk factors for CVD. However, rigorous studies in Western populations are few and the effects of yoga on CVD risk profiles in healthy postmenopausal women have not been studied. This GCRC-approved randomized controlled trial will investigate the effects of an 8 week intensive lyengar yoga program on IRS-related indices of CVD risk in this population. Participants will be 60 healthy, sedentary postmenopausal women aged 50-75 years who are overweight and/or have a first degree relative with type 2 diabetes mellitus or essential hypertension. African American women will be oversampled. Our primary aim is to evaluate the effects of lyengar yoga on change in insulin sensitivity as estimated by the QUICKI, a measure that combines excellent reliability and validity with minimal subject burden. Our secondary aims are: 1) to assess the effects of yoga on other markers of insulin resistance (fasting glucose, insulin, glycated hemoglobin), and related indices of CVD risk, including measures of sympathetic activation, dyslipidemia, endothelial function, inflammation, coagulopathy, visceral adiposity, insulin-like growth factor bioavailability, heart rate variability, psychological morbidity, and sleep disturbance; and 2) to evaluate and optimize the overall protocol design, including recruitment, and retention rates, protocol adherence, and instrument burden in both minority and non-minority participants. The intervention will comprise 8 weeks of structured lyengar yoga training, including two 90 minute classes/week in addition to daily directed yoga practice at home. The control group will complete an 8 week standardized educational film program designed to be easily replicable and to assure comparability of time, staff attention, and social interaction. Both groups will also receive standard American Heart Association materials regarding menopause, aging, and heart disease in women. Before and after the 8 week treatment period, fasting blood samples will be collected, and specific markers of insulin resistance and related physiological, anthropometric, and psychological indices of CVD risk will be measured. This pilot study will yield important information on the potential utility of yoga in reducing CVD risk in postmenopausal women, a population at increased risk for CVD and related chronic disorders. Findings of this study will also provide critical preliminary and feasibility data to support a larger, 3-arm, multi-ethnic RCT investigating the influence of yoga practice on IRS-related indices of CVD risk in women post-menopause. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Center for Complementary & Alternative Medicine (NCCAM)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21AT002982-01A1
Application #
7149798
Study Section
Special Emphasis Panel (ZAT1-JH (15))
Program Officer
Stoney, Catherine
Project Start
2006-09-30
Project End
2008-08-31
Budget Start
2006-09-30
Budget End
2007-08-31
Support Year
1
Fiscal Year
2006
Total Cost
$303,000
Indirect Cost
Name
University of Virginia
Department
Type
DUNS #
065391526
City
Charlottesville
State
VA
Country
United States
Zip Code
22904
Alexander, Gina K; Innes, Kim E; Selfe, Terry K et al. (2013) ""More than I expected"": perceived benefits of yoga practice among older adults at risk for cardiovascular disease. Complement Ther Med 21:14-28
Alexander, Gina; Innes, Kim E; Bourguignon, Cheryl et al. (2012) Patterns of yoga practice and physical activity following a yoga intervention for adults with or at risk for type 2 diabetes. J Phys Act Health 9:53-61
Innes, Kim E; Selfe, Terry Kit; Agarwal, Parul (2012) Restless legs syndrome and conditions associated with metabolic dysregulation, sympathoadrenal dysfunction, and cardiovascular disease risk: a systematic review. Sleep Med Rev 16:309-39
Innes, Kim E; Selfe, Terry Kit (2012) The Effects of a Gentle Yoga Program on Sleep, Mood, and Blood Pressure in Older Women with Restless Legs Syndrome (RLS): A Preliminary Randomized Controlled Trial. Evid Based Complement Alternat Med 2012:294058
Innes, Kim E; Selfe, Terry Kit; Agarwal, Parul (2011) Prevalence of restless legs syndrome in North American and Western European populations: a systematic review. Sleep Med 12:623-34
Innes, Kim E; Selfe, Terry Kit; Vishnu, Abhishek (2011) Association of fructosamine to indices of dyslipidemia in older adults with type 2 diabetes. Diabetes Metab Syndr 5:179-82
Innes, Kim E; Selfe, Terry Kit; Alexander, Gina K et al. (2011) A new educational film control for use in studies of active mind-body therapies: acceptability and feasibility. J Altern Complement Med 17:453-8
Alexander, Gina K; Innes, Kim E; Brown, Cynthia J et al. (2010) ""I could move mountains"": adults with or at risk for type 2 diabetes reflect on their experiences with yoga practice. Diabetes Educ 36:965-75
Innes, Kim E; Selfe, Terry Kit; Vishnu, Abhishek (2010) Mind-body therapies for menopausal symptoms: a systematic review. Maturitas 66:135-49
Selfe, Terry Kit; Innes, Kim E (2009) Mind-Body Therapies and Osteoarthritis of the Knee. Curr Rheumatol Rev 5:204-211

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