R L Bijlani

All India Institute of Medical Sciences, New Delhi, NCT, India

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Publications (51)33.98 Total impact

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    ABSTRACT: Amitriptyline (10-50mg) is the most common drug prescribed for the treatment of fibromyalgia. Amitriptyline influences the autonomic nervous system, as is well known; fibromyalgia is also associated with dysautonomia. The present preliminary study was designed to observe the effects of amitriptyline prescribed in a low dose (10mg) on the autonomic function tests and blood flow measurements in well-diagnosed patients with fibromyalgia. Amitriptyline (10mg) was prescribed for 3 months to 21 female patients with fibromyalgia. A standard battery of noninvasive autonomic function tests comprising of lying to standing test, hand grip test, cold pressor test, deep breathing test, and Valsalva maneuver was performed both before and after amitriptyline therapy to study the autonomic reactivity of the patients with fibromyalgia. Heart rate variability analysis was done to quantify autonomic tone (activity). Blood flow measurement around the knee joint was performed using impedance plethysmography technique. The patients were also assessed for 10 major clinical symptoms of primary fibromyalgia and state and trait anxiety (state and trait anxiety inventory) at both instances. No significant changes in autonomic activity (tone) and reactivity were observed after amitriptyline therapy. Clinical symptom score and anxiety scores (both state and trait) decreased significantly from the pretreatment values. Blood flow measurement showed significant improvement in blood flow index values at the affected sites after amitriptyline therapy. Amitriptyline therapy (10mg for 3 months) increases blood flow to the affected sites. It does not affect autonomic tone and reactivity in the patients with fibromyalgia.
    Pain Medicine 12/2011; 13(1):131-6. DOI:10.1111/j.1526-4637.2011.01286.x · 2.24 Impact Factor
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    ABSTRACT: The hypothesis of autonomic nervous system involvement in pathophysiology in the patients with fibromyalgia has been addressed and tested time and again but the existing reports are both contradictory and inconclusive. A complete knowledge of the degree of autonomic dysfunction in fibromyalgia patients would be more substantial. We conducted a comprehensive non-invasive study to investigate the complete autonomic profile of female patients with fibromyalgia. An autonomic function test using a standard battery and heart rate variability analysis in the 42 fibromyalgia patients as well as 42 age matched healthy controls was performed. Both autonomic activity (tone) and reactivity were measured. Autonomic tone (both time and frequency domain parameters) was measured using heart rate variability (HRV) analysis. Autonomic reactivity was measured using a standard battery of autonomic function tests. Resting blood pressure (both systolic and diastolic) was significantly higher in the fibromyalgia patients than controls. The time domain variables and HF% as recorded by HRV were significantly lower in the patients than the controls. The autonomic reactivity for sympathetic and parasympathetic nervous system was found to be within normal limits. The cardiac autonomic function is normal and the autonomic reflex arc seems to be intact in the patients with fibromyalgia.
    Clinical Autonomic Research 10/2011; 22(3):117-22. DOI:10.1007/s10286-011-0150-6 · 1.86 Impact Factor
  • Amit Mohan, Ratna Sharma, Ramesh L Bijlani
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    ABSTRACT: The objective of this study was to study the effects of meditation on stress-induced changes in cognitive functions. The study was conducted on 32 healthy adult male student volunteers who had never practiced meditation before the study. The study consisted of practicing 20 minutes of guided meditation and administration of psychologic stress to the subjects. The psychologic stress was administered to the subjects by asking them to play a (preselected) stressful computer game. The subjects were asked to meditate either before or after the administration of psychologic stress. For the control group measurements, the subjects were asked to wait quietly for an equivalent period of meditation time. The outcome measures were galvanic skin response (GSR), heart rate (HR), electromyography (EMG), sympathetic reactivity (QTc/QS2 ratio), cortisol, and acute psychologic stress scores. The central nervous system functions were assessed using Wechsler memory scale and visual-choice reaction time (VCRT). These parameters were measured both at the beginning and at the end of the intervention, using a pre-post experimental test design. Computer game stress was associated with a significant increase in physiologic (GSR, EMG, HR, QTc/QS2) and psychologic (acute stress questionnaire scores) markers of stress. Meditation was associated with relaxation (significant decrease in GSR, EMG, QTc/QS2, and acute stress questionnaire scores). Meditation, if practiced before the stressful event, reduced the adverse effects of stress. Memory quotient significantly increased, whereas cortisol level decreased after both stress and meditation. VCRT showed no significant change. Practice of meditation produced a relaxation response even in the young adult subjects who had never practiced meditation before. The practice of meditation reduced the physiologic stress responses without taking away the beneficial effect of stress, namely, improved memory scores.
    Journal of alternative and complementary medicine (New York, N.Y.) 03/2011; 17(3):207-12. DOI:10.1089/acm.2010.0142 · 1.69 Impact Factor
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    ABSTRACT: Weight gain, feed efficiency and proliferation response of splenic lymphocytes were studied in mice fed either a yogurt or a milk-based diet. The yogurt contained live Lactobacillus bulgaricus and Streptococcus thermophilus. The feeding trial lasted for 10 months. Proliferation response of lymphocytes was measured by the uptake of tritiated thymidine into the cells when stimulated with the mitogens phytohaemagglutinin (PHA), concanavalin A (Con A) and Escherichia coli lipopolysaccharide (LPS). There was no significant difference between the average body weight of mice belonging to the two dietary groups. But yogurt diet showed a higher feed efficiency ratio when compared to the milk diet for the first 8 weeks of the study while the mice were growing. After the period of growth was over, yogurt-fed mice maintained a constant body weight like the milk-fed mice but on a lower energy intake. The proliferation of splenic lymphocytes, expressed as Stimulation Index, was significantly higher in response to the T-lymphocyte mitogens Con A and PHA. Results suggest that yogurt has better feed efficiency and its long term inclusion in diets primes the splenic T-lymphocytes for a higher mitogenic response.
    International Journal of Food Sciences and Nutrition 08/2009; 45(4):231-235. DOI:10.3109/09637489409166163 · 1.20 Impact Factor
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    ABSTRACT: There is a substantial body of evidence on the efficacy of yoga in the management of bronchial asthma. Many studies have reported, as the effects of yoga on bronchial asthma, significant improvements in pulmonary functions, quality of life and reduction in airway hyper-reactivity, frequency of attacks and medication use. In addition, a few studies have attempted to understand the effects of yoga on exercise-induced bronchoconstriction (EIB) or exercise tolerance capacity. However, none of these studies has investigated any immunological mechanisms by which yoga improves these variables in bronchial asthma. The present randomized controlled trial (RCT) was conducted on 57 adult subjects with mild or moderate bronchial asthma who were allocated randomly to either the yoga (intervention) group (n = 29) or the wait-listed control group (n = 28). The control group received only conventional care and the yoga group received an intervention based on yoga, in addition to the conventional care. The intervention consisted of 2-wk supervised training in lifestyle modification and stress management based on yoga followed by closely monitored continuation of the practices at home for 6-wk. The outcome measures were assessed in both the groups at 0 wk (baseline), 2, 4 and 8 wk by using Generalized Linear Model (GLM) repeated measures followed by post-hoc analysis. In the yoga group, there was a steady and progressive improvement in pulmonary function, the change being statistically significant in case of the first second of forced expiratory volume (FEV1) at 8 wk, and peak expiratory flow rate (PEFR) at 2, 4 and 8 wk as compared to the corresponding baseline values. There was a significant reduction in EIB in the yoga group. However, there was no corresponding reduction in the urinary prostaglandin D2 metabolite (11beta prostaglandin F2alpha) levels in response to the exercise challenge. There was also no significant change in serum eosinophilic cationic protein levels during the 8-wk study period in either group. There was a significant improvement in Asthma Quality of Life (AQOL) scores in both groups over the 8-wk study period. But the improvement was achieved earlier and was more complete in the yoga group. The number-needed-to-treat worked out to be 1.82 for the total AQOL score. An improvement in total AQOL score was greater than the minimal important difference and the same outcome was achieved for the sub-domains of the AQOL. The frequency of rescue medication use showed a significant decrease over the study period in both the groups. However, the decrease was achieved relatively earlier and was more marked in the yoga group than in the control group. The present RCT has demonstrated that adding the mind-body approach of yoga to the predominantly physical approach of conventional care results in measurable improvement in subjective as well as objective outcomes in bronchial asthma. The trial supports the efficacy of yoga in the management of bronchial asthma. However, the preliminary efforts made towards working out the mechanism of action of the intervention have not thrown much light on how yoga works in bronchial asthma. Current Controlled Trials ISRCTN00815962.
    BMC Pulmonary Medicine 08/2009; 9:37. DOI:10.1186/1471-2466-9-37 · 2.49 Impact Factor
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    ABSTRACT: The study was conducted to evaluate the acute postprandial and long-term metabolic response to a traditional mixture of barley (Hordeum vulgare), Bengal gram (Cicer arietinum) and wheat (Triticum aestivum). The acute study was performed on eight healthy subjects (five male, three female) and six subjects with non-insulin dependent diabetes mellitus (NIDDM) (four male, two female). Each subject underwent two 50g carbohydrate meal tolerance tests (MTT), one with white bread (reference meal) and another with chapaties made from the cereal-pulse mixture (CP). The postprandial glycaemic and insulinaemic responses to CP were attenuated compared to those to white bread, the glycaemic index being 68.6 and 64.9 in healthy and NIDDM subjects, respectively, and the insulinaemic index being 88.1 and 66.0 in healthy and NIDDM subjects, respectively.
    International Journal of Food Sciences and Nutrition 07/2009; 44(4):243-251. DOI:10.3109/09637489309017444 · 1.20 Impact Factor
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    ABSTRACT: Metabolic responses to barley (Hordeum vulgare) were studied in six healthy human subjects (five male, one female). The trial comprised two dietary periods, control and experimental, of four weeks each, separated by a washout period of one week. The control diet was one to which the subject was normally accustomed. In the experimental diet, part of the daily cereal intake was replaced by 100 g of whole barley flour. The control and experimental dietary periods were random in sequence and a cross-over design was used. A meal tolerance test using a 50g carbohydrate portion of white bread was performed at the beginning and end of each dietary period. Fasting blood samples were collected for estimation of glycosylated haemoglobin, total cholesterol and triglycerides at the beginning and end of each dietary period. No measured variable changed significantly during the control period. At the end of the experimental period, the MTT incremental area under the 3h glucose curve decreased from 107.9 ± 54.8 to 91.5 ± 30.8 (mean ± s.d., mg/dl/3h; P < 0.05) and HDL cholesterol increased from 50.7 ± 9.2 to 65.5 ± 15.4 (mean ± s.d., mg/dl; P < 0.05). The observed changes are possibly mediated by the water soluble β-glucan fraction of barley dietary fibre and are favourable in relation to prevention and treatment of diabetes mellitus and atherosclerosis.
    International Journal of Food Sciences and Nutrition 07/2009; 43(1):41-46. DOI:10.3109/09637489209027531 · 1.20 Impact Factor
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    ABSTRACT: The objective of the study was to study the short-term impact of a brief lifestyle intervention based on yoga on some of the biochemical indicators of risk for cardiovascular disease and diabetes mellitus. The variables of interest were measured at the beginning (day 1) and end (day 10) of the intervention using a pre-post design. The study is the result of operational research carried out in our Integral Health Clinic (IHC). The IHC is an outpatient facility which conducts 8-day lifestyle modification programs based on yoga for prevention and management of chronic disease. A new course begins every alternate week of the year. The study is based on data collected on 98 subjects (67 male, 31 female), ages 20-74 years, who attended one of our programs. The subjects were a heterogeneous group of patients with hypertension, coronary artery disease, diabetes mellitus, and a variety of other illnesses. The intervention consisted of asanas (postures), pranayama (breathing exercises), relaxation techniques, group support, individualized advice, lectures and films on the philosophy of yoga and the place of yoga in daily life, meditation, stress management, nutrition, and knowledge about the illness. The outcome measures were fasting plasma glucose and serum lipoprotein profile. These variables were determined in fasting blood samples, taken on the first and last day of the course. Fasting plasma glucose, serum total cholesterol, low-density lipoprotein (LDL) cholesterol, very- LDL cholesterol, the ratio of total cholesterol to high density lipoprotein (HDL) cholesterol, and total triglycerides were significantly lower, and HDL cholesterol significantly higher, on the last day of the course compared to the first day of the course. The changes were more marked in subjects with hyperglycemia or hypercholesterolemia. The observations suggest that a short lifestyle modification and stress management education program leads to favorable metabolic effects within a period of 9 days.
    The Journal of Alternative and Complementary Medicine 05/2005; 11(2):267-74. DOI:10.1089/acm.2005.11.267 · 1.52 Impact Factor
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    ABSTRACT: Ghee (clarified butter) has generally been assumed to be hypercholesterolaemic on the basis of its composition but there is hardly any study to support or refute the assumption. The present study was conducted on sixty-three healthy, young, physically active adult volunteers (52 male, 11 female). The study design was that of a randomized controlled trial with a parallel design. After a lead-in period of 2 wk, the subjects were randomly divided into two groups, Group A (n = 30; 25 male, 5 female) and Group B (n = 33; 27 male, 6 female). Group A (experimental) consumed for 8 wk a diet in which ghee provided 10% of the energy intake. The only other visible fat in the diet was mustard oil, and total energy from fats was 25% of the energy intake. Group B (control) consumed for 8 wk a similar diet except that all visible fat came from mustard oil. The serum total cholesterol level showed a significant rise in the experimental group at 4 wk; the rise persisted at 8 wk. A similar rise was also seen in HDL cholesterol. Hence the total cholesterol/HDL cholesterol ratio did not show any significant change. In the control group, there was a trend towards a fall in LDL cholesterol but the change was not significant. The study does not indicate any adverse effect of ghee on lipoprotein profile. However, more studies are needed on older subjects, hyperlipidaemic subjects, and on subjects following less healthy lifestyles before the results of this study can be extrapolated to the general population.
    Indian journal of physiology and pharmacology 02/2005; 49(1):49-56.
  • Allergy & Clinical Immunology International - Journal of the World Allergy Organization 01/2005; · 0.62 Impact Factor
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    ABSTRACT: Oxidative stress contributes to the process of aging as well as a variety of chronic degenerative diseases. There are indications that psychological stress increases oxidative stress whereas relaxation decreases it. We have measured the concentration of thiobarbituric acid reactive substances (TBARS) in blood as an indicator of oxidative stress at the beginning and at the end of a comprehensive yoga-based lifestyle modification program (YLMP). The data was collected from 104 subjects (59 male, 45 female), 19-71 years of age (mean +/- SD, 41.2 +/- 14.6 years). The YLMP consisted of a nine-day educational out-patient course on the theory and practice of yoga and included, besides a daily one-hour practice of physical postures (asanas) and breathing exercises (pranayama), lecture and films on yoga, stress management and nutrition, practice of meditation and shavasana (a relaxation technique), and individual counseling. Venous blood samples were collected on the first and last day of the course. The serum concentration of TBARS decreased significantly from 1.72 +/- 0.72 nmoles/ml on day 1 to 1.57 +/- 0.72 nmoles/ml on day 10 (P<0.05). The study suggests that a brief low cost lifestyle intervention based on yoga reduces oxidative stress.
    Indian journal of physiology and pharmacology 01/2005; 49(3):358-62.
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    ABSTRACT: Thirty four healthy young volunteers (22 men, 12 women; age 25.7 +/- 5.8 years; BMI 20.8 +/- 2.3 kg/m2) participated in a randomized controlled cross-over trial on the effect of consuming one boiled egg every day for 8 wk on the serum lipid profile. The only significant change after 8 wk of egg consumption was an elevation of the total cholesterol/HDL cholesterol ratio. However, scrutiny of individual responses revealed that twelve of the subjects (10 men, 2 women) had a greater than 15% rise in the LDL cholesterol level after 8 wk of egg consumption. These subjects, considered hyperresponders, showed significant increases (P < 0.025) at both 4 wk and 8 wk after egg consumption in total cholesterol and LDL cholesterol levels, and at 8 wk in total cholesterol/HDL cholesterol ratio. The remaining 22 hyporesponders showed no change in any of the variables measured at 4 wk or 8 wk after egg consumption. In view of the high nutritional value of eggs, a blanket ban on eggs is not justified. However, since up to one-third of the population may be hyperresponders, knowing the response of an individual is important before making the egg a regular item of the diet.
    Indian journal of physiology and pharmacology 07/2004; 48(3):286-92.
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    ABSTRACT: This study reports the results of 15 days of exercise training in 25 adult males on cardiovascular autonomic response amplitude and latencies. A standard battery of autonomic function tests including both activity (tone) and reactivity was used. Parasympathetic activity as evaluated from Heart rate variability (HRV) showed no statistically significant change in both time and frequency domain measures, similarly Sympathetic activity as measured by QT/QS2 ratio showed no statistically significant change, but there was a trend of a decrease in sympathetic activity and an increase in parasympathetic activity. There were no changes in the parameters measuring parasympathetic reactivity. Sympathetic reactivity as evaluated by diastolic blood pressure responses to hand grip test (HGT) and cold pressor test (CPT) showed significant decreases. Time domain assessment of autonomic responses was done by measuring tachycardia and bradycardia latencies during Valsalva maneuver (VM) and lying to standing test (LST). Physical training resulted in a decrease in tachycardia latency during LST and a decrease in bradycardia latency during VM. We conclude from the present study that 15 days of physical training is not enough to alter autonomic activity and PNS reactivity but can result in changes in SNS reactivity and latency parameters. We hypothesize that a decrease in bradycardia latency during VM signifies a faster recovery of heart rate during VM and a decrease in tachycardia latency during LST denotes a delayed activation of the system both of which are favorable cardiovascular responses.
    Indian journal of physiology and pharmacology 05/2004; 48(2):165-73.
  • Indian journal of physiology and pharmacology 01/2004; 48(5 (Suppl)):167.
  • R P Vempati, S Manjunatha, RL Bijlani
    Indian journal of physiology and pharmacology 01/2004; 48(5 (Suppl)):242-243.
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    ABSTRACT: This short communication is devoted to the problem of the effect of the regular treadmill training on the restoration of motor function after spinal cord interruption. Experiments were carried out on the full spinalized rats. One group of the operated rats (n = 5) received regular treadmill training and another group (n = 5) did not receive any training. Motor behavior and activity were investigated weekly up to week 9 after spinalization. It was observed that trained rats restarted motor behavior earlier and demonstrated locomotor hindlimbs movements, and were more active than untrained rats.
    Indian journal of physiology and pharmacology 11/2002; 46(4):499-503.
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    ABSTRACT: Egg is a major source of dietary cholesterol. Previous studies on the effect of egg on serum lipid profile have given conflicting results. Further, the serum lipid response to egg shows marked individual variation. Since the variation is at least partly genetically determined, and the response depends partly on the overall diet, studies on different ethnic groups are important. There is hardly any study on the subject available on Indians. In the present investigation, eighteen healthy young volunteers (7 male, 11 female) on a lacto-vegetarian diet were given one boiled egg per day for 8 wk in a randomized controlled cross-over study. Compared to the values obtained after 8 wk of egg-free period, the mean serum total cholesterol, LDL cholesterol, HDL cholesterol, total cholesterol/HDL ratio, VLDL cholesterol and triglycerides were not significantly different after 8 wk of egg consumption. However, the serum total cholesterol after 4 wk of egg consumption was significantly higher than the control values. Further, seven subjects out of 18 had an appreciable elevation of serum total cholesterol or LDL cholesterol, or both, after 8 wk of egg consumption. The study suggests that in young healthy Indian subjects on a vegetarian diet, consuming one egg per day raises serum cholesterol levels at 4 wk but in the majority baseline values are restored by 8 wk. However, some hyper-responders continue to have elevated serum cholesterol even at 8 wk. Knowing the response of an individual may be important before making egg consumption a regular habit.
    Indian journal of physiology and pharmacology 11/2002; 46(4):492-8.
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    ABSTRACT: A randomised controlled trial with a parallel design was conducted on 24 healthy young volunteers who were divided into two groups. After a lead-in period of 2 wk, the experimental group (n = 11; 9 male, 2 female) had for 8 wk a lactovegetarian diet providing about 25% of the energy intake in the form of fat, of which ghee provided 10 en% and the remaining fat energy came from mustard oil and invisible fat. The control group (n = 13; 8 male, 5 female) had a similar diet except that all visible fat was in the form of mustard oil. In neither group was there any significant change in the serum lipid profile at any point in time. At 8 wk, 2 volunteers in the experimental group, and 1 volunteer in the control group had more than 20% rise in serum total cholesterol as compared to their 0 wk values. There was also an appreciable increase in HDL cholesterol at 8 wk in the experimental group, but it was not statistically significant. Consuming ghee at the level of 10 en% in a vegetarian diet generally has no effect on the serum lipid profile of young, healthy, physically active individuals, but a few individuals may respond differently.
    Indian journal of physiology and pharmacology 08/2002; 46(3):355-60.
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    ABSTRACT: Chyawanprash is an ancient Indian dietary supplement containing vitamin C (34 mg/100 g) derived from amla (Emblica officinalis). In addition, Chyawanprash also contains several other herbal products. The present study was designed to compare the effects of vitamin C with those of Chyawanprash. Ten normal healthy adult male volunteers (age 20-32 years) participated in the 16-week study. They were placed randomly in either the Chyawanprash group (n = 5) or vitamin C group (n = 5). Those in the former received 15 g/d of Chyawanprash while those in the latter received 500 mg/d vitamin C during the first 8 weeks of the study. For the next 8 weeks, no supplement was given. For each individual, an oral glucose tolerance test was performed, and lipoprotein profile in peripheral serum samples was determined at 0 weeks, 4 weeks, 8 weeks, 12 weeks and 16 weeks. In the Chyawanprash group, the 8 weeks Vs 0 weeks value (mean +/- S.D.) respectively for various indices which were significantly different were fasting plasma glucose (100.2 +/- 5.58 mg/dl vs 116.2 +/- 11.6 mg/dl), area under 2-h plasma glucose curve (245.9 +/- 15.13 mg.dl-1.h vs 280.8 +/- 37.09 mg.dl-1.h), HDL cholesterol (53.2 +/- 4.56 mg/dl vs 42.7 +/- 7.17 mg/dl), LDL cholesterol (82.4 +/- 8.80 mg/dl vs 98.26 +/- 12.07 mg/dl), LDL/HDL ratio (1.56 +/- 0.28 vs 2.38 +/- 0.63). In the Vitamin C group, only the LDL/HDL ratio was significantly lower at 8 weeks than at 0 weeks (1.99 +/- 0.44 vs 2.29 +/- 0.43). All the variables that changed significantly were no longer significantly different from the 0 weeks value at 16 weeks. Chyawanprash reduces postprandial glycemia in the oral glucose tolerance test and reduces blood cholesterol level to a significantly greater extent than vitamin C.
    Indian journal of physiology and pharmacology 02/2001; 45(1):71-9.
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    ABSTRACT: Yoga has potential for benefit for patients with coronary artery disease though objective, angiographic studies are lacking. We evaluated possible role of lifestyle modification incorporating yoga, on retardation of coronary atherosclerotic disease. In this prospective, randomized, controlled trial, 42 men with angiographically proven coronary artery disease (CAD) were randomized to control (n = 21) and yoga intervention group (n = 21) and were followed for one year. The active group was treated with a user-friendly program consisting of yoga, control of risk factors, diet control and moderate aerobic exercise. The control group was managed by conventional methods i.e. risk factor control and American Heart Association step I diet. At one year, the yoga groups showed significant reduction in number of anginal episodes per week, improved exercise capacity and decrease in body weight. Serum total cholesterol, LDL cholesterol and triglyceride levels also showed greater reductions as compared with control group. Revascularisation procedures (coronary angioplasty or bypass surgery) were less frequently required in the yoga group (one versus eight patients; relative risk = 5.45; P = 0.01). Coronary angiography repeated at one year showed that significantly more lesions regressed (20% versus 2%) and less lesions progressed (5% versus 37%) in the yoga group (chi-square = 24.9; P < 0.0001). The compliance to the total program was excellent and no side effects were observed. Yoga lifestyle intervention retards progression and increases regression of coronary atherosclerosis in patients with severe coronary artery disease. It also improves symptomatic status, functional class and risk factor profile.
    The Journal of the Association of Physicians of India 08/2000; 48(7):687-94.