ORIGINAL ARTICLE

The effectiveness of yoga exercise toward blood pressure and endothelial-derived hyperpolarizing factor (EDHF) level in hypertensive diabetic population

Nila Wahyuni , Agung Wiwiek Indrayani, Indira Vidiari Juhanna

Nila Wahyuni
Department of Physiology, Faculty of Medicine, Universitas Udayana, Denpasar, Bali, Indonesia. Email: [email protected]

Agung Wiwiek Indrayani
Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Udayana, Denpasar, Bali, Indonesia

Indira Vidiari Juhanna
Department of Physiology, Faculty of Medicine, Universitas Udayana, Denpasar, Bali, Indonesia
Online First: December 01, 2020 | Cite this Article
Wahyuni, N., Indrayani, A., Juhanna, I. 2020. The effectiveness of yoga exercise toward blood pressure and endothelial-derived hyperpolarizing factor (EDHF) level in hypertensive diabetic population. Bali Medical Journal 9(3): 940-946. DOI:10.15562/bmj.v9i3.2028


Introduction: Diabetes and its complications are the leading causes of premature death worldwide. Diabetes causes complications such as hypertension and an increased risk of cardiovascular diseases. Endothelial dysfunction is the primary pathophysiology that underlies complications of diabetes mellitus. EDHF (Endothelial-Derived Hyperpolarizing Factor) is a relaxing factor that targets current therapy in vascular dysfunction and insulin resistance in obesity and diabetes mellitus. Yoga training is a physical activity that has been shown to play a role in decrease blood pressure, but to our knowledge, there are no studies that prove the effectiveness of yoga in increasing EDHF levels. Therefore, this study aimed to determine the efficacy of yoga to decrease blood pressure and increase EDHF levels in type II diabetes mellitus patients with hypertension.

Methods: This research was a randomized control trial that involved 39 hypertensive diabetic respondents and was conducted in Denpasar, Bali, Indonesia. Yoga exercise was carried out two times a week for eight weeks, with a duration of 60 minutes per session. EDHF levels were examined using the ELISA technique.

Results: There was a significant difference in systolic, diastolic and EDHF levels after the intervention between the yoga and control groups and large effect size.

Conclusion: In conclusion, yoga training effectively reduced blood pressure and prevented endothelial dysfunction by increasing the blood vessel relaxing factor, namely EDHF.

References

Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol. 2018;14(2):88-98. doi:10.1038/nrendo.2017.151

Leon BM. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes. 2015;6(13):1246. doi:10.4239/wjd.v6.i13.1246

Hu L, Huang X, You C, et al. Prevalence of overweight, obesity, abdominal obesity and obesity-related risk factors in southern China. PLoS One. 2017;12(9):1-14. doi:10.1371/journal.pone.0183934

Akalu Y, Belsti Y. Hypertension and its associated factors among type 2 diabetes mellitus patients at Debre Tabor general hospital, northwest Ethiopia. Diabetes, Metab Syndr Obes Targets Ther. 2020;13:1621-1631. doi:10.2147/DMSO.S254537

Sousa AC, Jardim TV, Costa TO, et al. Hypertensive diabetic patients: Incidence of cardiovascular and renal outcomes in a historical cohort over 11 years. Diabetol Metab Syndr. 2017;9(1):1-9. doi:10.1186/s13098-017-0296-z

Jia G, Durante W, Sowers JR. Endothelium-derived hyperpolarizing factors: A potential therapeutic target for vascular dysfunction in obesity and insulin resistance. Diabetes. 2016;65(8):2118-2120. doi:10.2337/dbi16-0026

Jia G, Sowers JR. Endothelial dysfunction potentially interacts with impaired glucose metabolism to increase cardiovascular risk. Hypertension. 2014;64(6):1192-1193. doi:10.1161/HYPERTENSIONAHA.114.04348

Huang J, Zhang H, Tan X, Hu M, Shen B. Exercise restores impaired endothelium-derived hyperpolarizing factor-mediated vasodilation in aged rat aortic arteries via the TRPV4-KCa2.3 signaling complex. Clin Interv Aging. 2019;14:1579-1587. doi:10.2147/CIA.S220283

Wu Y, Johnson BT, Acabchuk RL, et al. Yoga as Antihypertensive Lifestyle Therapy: A Systematic Review and Meta-analysis. Mayo Clin Proc. 2019;94(3):432-446. doi:10.1016/j.mayocp.2018.09.023

Olin BR, Pharm D. Hypertension : The Silent Killer : Updated JNC-8 Guideline Recommendations.; 2018.

Lee PG, Halter JB. The pathophysiology of hyperglycemia in older adults: Clinical considerations. Diabetes Care. 2017;40(4):444-452. doi:10.2337/dc16-1732

Gunasekaran U, Gannon M. Type 2 diabetes and the aging pancreatic beta cell. Aging (Albany NY). 2011;3(6):565-575. doi:10.18632/aging.100350

Asiimwe D, Mauti GO, Kiconco R. Prevalence and Risk Factors Associated with Type 2 Diabetes in Elderly Patients Aged 45-80 Years at Kanungu District. J Diabetes Res. 2020;2020. doi:10.1155/2020/5152146

Power C, Pinto Pereira SM, Law C, Ki M. Obesity and risk factors for cardiovascular disease and type 2 diabetes: Investigating the role of physical activity and sedentary behaviour in mid-life in the 1958 British cohort. Atherosclerosis. 2014;233(2):363-369. doi:10.1016/j.atherosclerosis.2014.01.032

Daniel MJ. Lipid management in patients with type 2 diabetes. Am Heal Drug Benefits. 2011;4(5):312-322.

Thapa SD, K.C SR, Gautam S, Gyawali D. Dyslipidemia in Type 2 Diabetes mellitus. J Pathol Nepal. 2017;7(2):1149-1154. doi:10.3126/jpn.v7i2.17978

Paranjape S, Jain A. Prevalence of type 2 diabetes mellitus in elderly in a primary care facility: An ideal facility. Indian J Endocrinol Metab. 2013;17(7):318. doi:10.4103/2230-8210.119647

Murray A, Wilson K. Journal of Yoga & Physical Therapy Yoga and Hypertension : A Systematic Review. J Yoga Phys Ther. 2018;8(2):1-9. doi:10.4172/2157-7595.

Singh S, Malhotra V, Singh KP, Madhu S V., Tandon OP. Role of Yoga in modifying certain cardiovascular functions in type 2 diabetic patients. J Assoc Physicians India. 2004;52(MAR):203-206.

Shantakumari N, Sequeira S, Eldeeb R. Effect of a yoga intervention on hypertensive diabetic patients. J Adv Intern Med. 2012;1(2):60-63. doi:10.3126/jaim.v1i2.6526

Nivethitha L, Mooventhan A, Manjunath N. Effects of various Prāṇāyāma on cardiovascular and autonomic variables. Anc Sci Life. Published online 2016. doi:10.4103/asl.asl_178_16

Pedralli ML, Waclawovsky G, Camacho A, Markoski MM, Castro I, Lehnen AM. Study of endothelial function response to exercise training in hypertensive individuals (SEFRET): Study protocol for a randomized controlled trial. Trials. 2016;17(1):1-9. doi:10.1186/s13063-016-1210-y

Govindaraj R, Karmani S, Varambally S, Gangadhar BN. Yoga and physical exercise – a review and comparison. Int Rev Psychiatry. 2016;28(3):242-253. doi:10.3109/09540261.2016.1160878

Hunter SD, Laosiripisan J, Elmenshawy A, Tanaka H. Effects of yoga interventions practised in heated and thermoneutral conditions on endothelium-dependent vasodilatation: The Bikram yoga heart study. Exp Physiol. 2018;103(3):391-396. doi:10.1113/EP086725


No Supplementary Material available for this article.
Article Views      : 0
PDF Downloads : 0