Academic journal article International Journal of Yoga

Effect of 6 Months of Meditation on Blood Sugar, Glycosylated Hemoglobin, and Insulin Levels in Patients of Coronary Artery Disease

Academic journal article International Journal of Yoga

Effect of 6 Months of Meditation on Blood Sugar, Glycosylated Hemoglobin, and Insulin Levels in Patients of Coronary Artery Disease

Article excerpt

Byline: Shashank. Sinha, Ajay. Jain, Sanjay. Tyagi, S. Gupta, Aarti. Mahajan

Background and Objectives: Coronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide. It has been recognized that stress, diabetes, and hypertension are important in etiology and progression of CAD. This study is to evaluate the role of meditation in improving biochemical parameters such as blood glucose, glycosylated hemoglobin, and serum insulin levels in known CAD patients. Material and Methods: Sixty CAD patients are divided into two groups of which one group did meditation and other did not. Blood glucose, glycosylated hemoglobin, and fasting serum insulin levels were measured before and at the end of 6 months of study in both the groups. Results: At the end of the study, significant decrease was seen in patients who practiced meditation as compared to other group. Conclusion: Meditation may modulate the physiological response to stress through neurohumoral activation, which may be a novel therapeutic target for the treatment of CAD.

Introduction

Coronary artery disease (CAD) is the leading cause of death worldwide, accounting for 22.9% of total deaths, and is projected to increase to 26.3% by 2030.[1] The factors that lead to increase the risk of developing atherosclerotic CAD were demonstrated in Framingham in the mid- twentieth century [2] and have subsequently been shown to be pervasive across ethnicities and regions of the world.[3] These risk factors are smoking, dyslipidemia, obesity, and diabetes; hypertension has been gradually escalating [4] and is thought to be the driving influence behind the epidemic of heart disease faced today.

Of the risk factors, diabetes, and its predominant form, type 2 diabetes mellitus (T2DM), has a distinctive association with CAD. Those with diabetes have two- to four-fold higher risk of developing coronary disease than people without diabetes.[5] More significantly, however, the age- and sex-adjusted mortality risk in diabetic patients without preexisting CAD was found to be equal to that of nondiabetic individuals with prior myocardial infarction (MI).[6] Compared to cardiovascular disease in nondiabetics, diabetic patients have a greater overall coronary plaque burden and a higher rate of multivessel disease. The proportion of stenotic segments is directly proportional to the duration of disease.[7] In combination, these factors place diabetic patients at greater risk for MI. In fact, diabetics without a prior MI are at equal risk for MI as nondiabetics with a prior MI. After MI, complications and death are higher in DM. The increased risk also extends to those undergoing cardiac procedures. After percutaneous coronary intervention, diabetic patients are at both higher risk for death and need for reintervention.[8] Diabetic patients who undergo coronary artery bypass grafting are at higher risk for both complications and death, particularly in those with insulin-dependent T2DM, with no benefit seen in those who have had tight postoperative glycemic control.[9],[10]

These remarkable findings regarding higher risk of mortality [11],[12],[13] have led to suspicion that common precursors predispose to diabetes and CAD,[14],[15] with subsequent implications that insulin resistance, visceral adiposity, and excess inflammation [16],[17],[18] underlie the pathophysiology of thrombogenesis. In addition, a complex mix of mechanistic processes such as oxidative stress, enhanced atherogenicity of cholesterol particles, abnormal vascular reactivity, augmented hemostatic activation, and renal dysfunction have been proposed as features characteristic of T2DM that may confer excess risk of CAD.[19]

Ornish et al .[20] were the first to document the beneficial effects of lifestyle changes in reversing the CAD. Manchanda et al .[21] in their study similarly showed encouraging results with their yoga lifestyle intervention. However, both these studies included only a small number of patients. …

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