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Research Article
Effect of Yoganidra on Blood Pressure, Hs-CRP, and Lipid
Profile of Hypertensive Subjects: A Pilot Study
J. P. Devraj ,
1
B. Santosh Kumar ,
2
M. Raja Sriswan ,
1
B. Jagdish,
3
B. S. Priya,
4
S. B. Neelu,
4
Vijayabhaskar Desai Rao,
5
Manoj Kumar,
6
J. J. Babu Geddam,
1
and R. Hemalatha
4
1
Division of Clinical Epidemiology, ICMR-National Institute of Nutrition, Hyderabad, Telangana-500 007, India
2
Clinical Division, ICMR-National Institute of Nutrition, Hyderabad, Telangana-500 007, India
3
Behavioral Science Unit, Extension & Training Division, (ICMR)-National Institute of Nutrition, Hyderabad,
Telangana-500 007, India
4
ICMR- National Institute of Nutrition, Hyderabad, Telangana-500 007, India
5
Department of Biostatistics, (ICMR)-National Institute of Nutrition, Hyderabad, Telangana-500 007, India
6
Department of Microbiology, ICMR-National Institute of Research in Environmental Health, Bhopal,
Madhya Pradesh-462030, India
Correspondence should be addressed to B. Santosh Kumar; drsantoshkumar999@gmail.com and M. Raja Sriswan;
srishwan@gmail.com
Received 7 July 2020; Revised 28 August 2021; Accepted 3 December 2021; Published 30 December 2021
Academic Editor: Robson Xavier Faria
Copyright ©2021 J. P. Devraj et al. is is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background.Yoganidra is a systematic method of promoting a state of complete physical, mental, and emotional relaxation. It is a
safe, inexpensive, and very effective method of management of hypertension when used along with standard pharmacological
therapy. is study aims to assess the effect of yoganidra on blood pressure (both systolic blood pressure (SBP) and diastolic blood
pressure (DBP)), Hs-CRP, and lipid profile of hypertensive subjects at the time of enrollment (subjects that are hypertensive at the
time of enrollment). Methods. Both treated and untreated subjects (n�74) with hypertension (blood pressure ≥140/90 mmHg) and
age between 35 and 70 years were included in this study after obtaining ICMR-NIN-IEC approval and written informed consent from
all subjects. Subjects with critical illness and/or psychological disturbances were excluded from this study. e subjects in the
experimental group (n�31) practiced yoganidra for 45 minutes daily for 12 weeks under strict supervision. ere was no intervention
in the control group (n�43). Weekly blood pressure was recorded in the experimental group, whereas it was performed at baseline
and at endpoint for control groups. Hs-CRP and lipid profile were estimated at baseline and endpoint for both the groups. Results. A
significant reduction in mean SBP from 142.9 mm Hg (SD ±16.46) to 118.68 mm Hg (SD ±9.21; pvalue 0.0001) and DBP from
89.84 mm Hg (SD ±10.42) to 77.03 mm Hg (SD ±6.47: pvalue 0.0001) was observed among the experimental group after 12 weeks of
yoganidra practice when compared with the control group. A significant reduction in mean Hs-CRP (2.21 ±1.49 to 1.06 ±0.82 mg/L,
p<0.001∗∗∗) was observed among the experimental group. ere were no significant differences between triglycerides and total
cholesterol levels, whereas LDL-C and HDL-C showed a trend of improvement in the experimental group after intervention.
Conclusions. In this pilot study, we observed a significant reduction in blood pressure and Hs-CRP in the yoganidra group compared
with the control group. ere were no significant side effects observed in the intervention group during the study period.
1. Introduction
Hypertension (HTN) is a significant public health problem,
which affects the cardiovascular health of most of the people
in India. According to the World Health Organization [1],
140/90 mm Hg or higher is considered hypertension. By
2025, there will be 1.56 billion adults who may become
hypertensive, as globally estimated. Nearly 8 million and 1.5
million people will die every year worldwide and in the
South-East Asia (SEA) region [1], respectively. e
Hindawi
Evidence-Based Complementary and Alternative Medicine
Volume 2021, Article ID 2858235, 9 pages
https://doi.org/10.1155/2021/2858235
prevalence of hypertension in India is seen to be increasing
day by day. One among the three adults is reported to be
hypertensive in a recently shown national-level survey. It
was conducted with a fixed one-day blood pressure mea-
surement of 180,335 participants through camps across
more than 20 states of India. A study reported that the
prevalence of hypertension was 30.7% [2]. A recent “Global
Burden of Disease” study reported that hypertension led to
India’s 1.63 million deaths in 2016 alone. It was the second
leading risk factor in terms of attributable disability-adjusted
life years (DALYs) in men (122.2 million DALYs) after
smoking and the leading risk factor in women (89.9 million
DALYs) [3]. Nevertheless, about 25.6% of subjects on
medication had their B.P. under normal levels. More than
50% of all stroke deaths and 24% of all coronary heart disease
deaths in India are due to raised blood pressure [4]. Long-
term high blood pressure leads to coronary artery disease,
stroke, heart failure, atrial fibrillation, peripheral vascular
disease, vision loss, chronic kidney disease, and dementia
[5, 6]. us, the burden of hypertension can be genuinely
considered as a pandemic. It has been found that dyslipi-
demia, inflammation, stress, high-risk behaviors, and sed-
entary and unhealthy lifestyles are significant causes of
hypertension. Dyslipidemia is recognized as a prominent
risk factor for CVD [7]. Altered lipid parameters, low HDL
levels, raised LDL-C, and triglycerides are associated with a
rise in cardiovascular diseases. Hs-CRP is an acute-phase
reactant synthesized by the liver and elevated in response to
acute infections, inflammatory conditions, and trauma [8].
Several studies have shown that serum Hs-CRP can be an
excellent diagnostic and a prognostic marker in diagnosing
prehypertensive subjects, and elevated levels have shown a
greater risk of stroke and cardiovascular disorders [9–11].
Antihypertensive medications are essential in the manage-
ment of hypertension. Major antihypertensive agents used
are ACE inhibitors, diuretics, β-blockers, angiotensin II
receptor blockers, calcium channel blockers, and vasodila-
tors. Due to the side effects of these medications, non-
adherence occurs in about 50% of newly treated
hypertensive patients within the first year of treatment
[12–15]. Long-term use of antihypertensive drugs has a
significant risk of developing type 2 diabetes, osteoporotic
fractures, atrial fibrillation, and breast cancer in women
[16–18]. Over the years, patients with hypertension may
experience mental health disorders such as anxiety, de-
pression, and stress, which again lead to increased blood
pressure [19]. Long-term use of medications leads to de-
creased quality of life [20]. All these constitute a significant
burden on the economy of the country. Several studies have
been conducted on diet and physical activity to reduce blood
pressure in hypertensive subjects [21, 22]. Although these
have been mainly beneficial, they tend to be effective as long
as a given regimen is followed. Often people find it chal-
lenging to incorporate specific lifestyle changes. It is ob-
served that yoganidra, when used along with standard
therapy, is a safe, inexpensive, and very effective method of
management of hypertension [23–26]. Yoganidra has been
used earlier as a therapeutic option with no documented side
effects. Previous studies have separately reported the effect of
yoganidra on hypertension, Hs-CRP, and lipid profile
[23–26]. In this study, we have assessed all the three pa-
rameters (reduction in blood pressure, Hs-CRP, and lipid
profile) in one study among hypertensive subjects on pilot
mode.
2. Methodology
2.1. Sample Size and Study Subjects. Since this study was
planned to be a pilot one, we have not calculated the sample
size for this study. e nonprobability convenient sampling
technique was adopted to select the subjects for this study.
Subject recruitment was performed based on the inclusion
and exclusion criteria listed below.
2.2. Inclusion and Exclusion Criteria. Subjects (on medica-
tion/without medication) aged between 35 and 70 years old
having blood pressure ≥140/90 mmHg were screened.
Subjects who were pregnant and lactating, those who were
with critical illness and hearing impairment, or those taking
any kind of sedatives or psychological treatments were
excluded from this study. Seventy-four eligible subjects with
HTN were recruited after obtaining NIN-IEC approval (IEC
no. 04/II/2016) and written informed consent. Data on
anthropometry such as height, weight, sociodemographic
details such as education, professional clinical history re-
garding the onset and duration of hypertension, family
history, and duration of drug therapy, type, and dosage of
drugs was obtained. e experimental (or test) group in-
cluded subjects who could comprehend the relaxation
techniques, showed interest in yoganidra, and could commit
to attending and regularly practicing yoganidra as per our
recommendation. Others were included in the control group
and were asked to continue with a regular diet, physical
activity, and medications prescribed by physicians. Blood
samples (5 ml) were collected for Hs-CRP and blood lipid
profile for all recruited subjects at baseline and endpoint
(after 12 weeks). In the intervention group, thirty-one hy-
pertensive subjects on medication (n�19) and no medi-
cation (n�12) were included to practice yoganidra daily
(45 min/d) for 12 weeks, at institute premises under the
guidance of a trained yoga instructor. During the study
duration, blood pressure was monitored weekly by the
physician before the yoganidra session—using both manual
and digital B.P. apparatus. e subjects were asked to relax
for 10 min before the start of yoganidra to decrease or
minimize the white-collar effect.
2.3. Blood Pressure and Data Collection. Our main aim was
to assess the impact of yoganidra on blood pressure in the
intervention group and evaluate its effect on a weekly basis.
We included the control group to compare their blood
pressure at two time points with the intervention group.
Blood pressure was measured in the sitting position before
starting yoganidra every week for 12 weeks for all subjects in
the experimental group using a digital blood pressure
monitor (oscillatory-OMRON) and mercury sphygmoma-
nometer (auscultatory). Each subject was asked to relax in a
2Evidence-Based Complementary and Alternative Medicine
sitting posture for 5 min. ree readings of digital blood
pressure monitor and one reading of mercury sphygmo-
manometer were taken to ensure accuracy. e first reading
of blood pressure was measured using a digital blood
pressure monitor. Two more readings were recorded by
maintaining an interval of 5 minutes. e fourth reading was
taken using a mercury sphygmomanometer. All readings
were duly recorded.
2.4. MAP. Mean arterial pressure (MAP) is the average
blood pressure in an individual during a single cardiac
cycle. It is calculated by using the following formula
MAP �SBP + 2DBP/3. MAP value of 70–100 is considered
to be normal. Any variations, which are high or low, are a
sign of the underlying medical disorder.
2.5. Control Group. Forty-two hypertensive subjects with or
without medication were included in a control group
without any lifestyle modification. One subject was excluded
due to noncompliance. Both male and female subjects were
included with disease duration ranging from 1 to 15 years.
2.6. Intervention Group. e yoganidra intervention was
conducted at the institute premises in a semidark room from
5:30 pm to 6:30 pm for 5 days in a week for 12 weeks. e
subjects were strictly monitored, and an attendance register
was maintained to check the regularity of the subjects. en,
subjects were asked to do warm-up exercises like body
rotation and joint rotation after a 2-3 min brisk walk to get
them ready for yoganidra intervention. ese warm-up steps
help subjects to be active, attentive, and energetic during the
intervention period. Otherwise, there is a possibility of
subjects going into deep sleep. en, subjects were asked to
lay in shavasana (relaxed lying down on the back) position
for yoganidra protocol (35 min) in the semidark room,
under the supervision of the yoga instructor and an in-
vestigator. e room was provided with an audio CD player
and speakers. Since darkness and light have an effect on the
brain, semidarkness is necessary to maintain a state of re-
laxed awareness to maintain a balance between introversion
and extroversion.
2.7. e Technique of Yoganidra. Yoganidra means sleeping
consciously, which systematically induces complete physical,
mental, and emotional relaxation [26]. Yoganidra has a
preventive, promotive, and curative value. It is a noninva-
sive, easy-to-practice, cost-effective intervention to prevent
stress [24]. Yoganidra is a meditation and relaxation tech-
nique that focuses more on the mind than on the physical
body. Its mode of principal action on the mind may bring
down sympathetic activity and reduce blood pressure [24].
2.8. Stages of Yoganidra. e practice of yoganidra was
performed in the following stages: in the preparatory stage,
body and mind were wholly relaxed by inducing the
awareness of stillness and comfort of the body by correcting
posture and position, speed of breath, and listening to the
external sounds. e subjects were educated to be aware of
the surroundings and asked them to be in the state of
witnessing the activity. In the second stage, subjects were
instructed to take sankalpa or a resolution according to their
wish after the body and mind were completely relaxed. ey
were told to keep it short, clear, and positive and were asked
to mentally repeat the selected sankalpa three times, with full
determination, conviction, and confidence. During the third
stage, consciousness or awareness was systematically
switched throughout the different parts of the body. Subjects
were instructed to remain aware, listen to the instructions,
and very rapidly move the mind according to the instruc-
tions without making any physical movements. A definite
sequence was followed to shift the awareness. In the next
stage, subjects were asked to become conscious of the natural
breath without changing the breath flow. Subjects were
aware of each inspiration and expiration by mentally
counting them. During the 5th stage, the physical or
emotional sensations were recalled, intensified, and fully
experienced. Pairs of contradictory feelings or sensations
were practiced by asking subjects to imagine the heat and
cold, heaviness and lightness, pain and pleasure, love and
hate, and so on. In the visualization stage, the subjects were
asked to visualize some objects, stories, or situations in the
chidakasha (“space of consciousness” or “inner space.”) At
this time once again, subjects were asked to mentally repeat
sankalpa three times, which was taken earlier in stage two,
with full dedication, faith, and optimism. In the final stage,
slowly, the awareness was externalized by asking the subjects
to become aware of the external sounds, objects, and per-
sons. ey were then asked to slowly move the body parts
and to stretch the body. We observed that initially, for 3–5
days, most of the subjects fell asleep for 5–10 min. It was
difficult for them to remain awakened during yoganidra.
After five days, they got used to the practice of yoganidra.
2.9. Quality Control. As the first step, midupper arm cir-
cumference was measured to use an accurate cuff bladder
size to obtain accurate blood pressure. Quality control for
measuring blood pressure was ensured, which includes two
parts, the checking of equipment and performance moni-
toring of the blood pressure recorders. Before checking the
first blood pressure measurement, we checked to ensure that
the sphygmomanometer’s mercury column was at zero and
the mercury column smoothly falls when the cuff was de-
flated. We also checked whether the column properly latches
into the vertical position. e results were recorded in a
book. e following precautions were taken for the correct
measurement of blood pressure: an average of three readings
was taken at intervals of 5 min. e subjects were allowed to
sit for at least 10 min in a quiet room before taking blood
pressure measurement.
Blood pressure measurement was performed in a
standard sitting position. e subject’s arm was fully bared
and supported at the level of the heart. e blood pressure
recordings were taken as mentioned in the intervention
group. ese readings were taken as pretrial blood pressure
Evidence-Based Complementary and Alternative Medicine 3
measurements. e controls were selected from our insti-
tute’s clinic, and 62 subjects were screened, out of which, 43
subjects were selected based on inclusion and exclusion
criteria. In this group, 30 men and 13 women were included
with hypertension duration ranging from 1 to 20 years with a
mean of 5.02 years. irty-four were on antihypertensive
drugs, and the remaining subjects were newly diagnosed,
who are on diet and lifestyle modification. All the recruited
subjects were asked not to change their drug and dosage
during the study period. None practiced yoganidra earlier,
both among the intervention and the control group.
2.10. Biochemical Parameters. Five ml blood samples were
collected (twice) from all recruited subjects in the morning
after an overnight fast of 12 hours to assess the effect of
yoganidra on Hs-CRP and blood lipid profile.
2.11. Hs-CRP. Hs-CRP was measured by immunoturbidim-
etry. It was classified according to the recommendation of the
American Heart Association and Center for Disease Control,
defining Hs-CRP <1 mg/L as low risk, between 1 and 3 mg/L
as moderate risk, and >3 mg/L as high risk [27].
2.12. Lipid Profile. Total cholesterol and triglyceride con-
centrations were determined by enzymatic methods. HDL-C
was determined following the deletion of triglyceride-rich
lipoprotein and low-density lipoprotein (LDL-C) using the
HDL direct liquid select TM kit. LDL cholesterol was cal-
culated using Friedewald’s formula: LDL-C �TC-HDL
minus (TG/5) [28].
2.13. Statistical Analysis. Descriptive statistics was per-
formed employing the SPSS-20 version for variables with a
normal distribution.
Descriptive values were expressed as means and standard
deviations. In this study, p<0.05 was considered to be the level
of significance. e proportions of responders and nonre-
sponders to yoganidra were compared among treated/on
medication and untreated/no medication groups by percentage.
3. Results
Both treated and untreated subjects (74) with hypertension
were recruited and were grouped into the experimental
(n�31) and control group (n�43). Anthropometry and
sociodemographic details are as shown in Table 1. Male
subjects were more among both the groups (77% in the
experimental and 70% in the control group). e mean age
of study subjects in the experimental group was 54.61 years
(SD ±9.95) and the control group was 49.64 years
(SD ±7.67). More than 95% of subjects were aged more than
45 years in the experiment, whereas it was 80% among the
control group. About 90% of subjects were literate up to
intermediate level and above among both the groups. Less
than 10% had a temporary job, and 10% were unemployed.
e remaining subjects were either government employees
or were engaged in business among the experimental group,
whereas 14% were unemployed and 21% had temporary jobs
among the control group. Comparisons of BMI, SBP, DBP,
PR, MAP, Hs-CRP, and lipid profile are shown in Table 2.
Significant reduction in mean SBP from 142.9 mm Hg
(SD ±16.46) to 118.68 mm Hg (SD ±9.21) (pvalue 0.0001)
was observed among the experimental group after 12 weeks
of yoganidra intervention when compared with the control
group (from baseline: 134.29 mm Hg (SD ±14.17) to end-
point: 130.71 mm Hg (SD ±16.21: pvalue 0.114)). A sig-
nificant reduction in DBP was observed among the
experimental group from 89.84 mm Hg (SD ±10.42) to
77.03 mm Hg (SD ±6.47: pvalue 0.0001) after 12 weeks of
yoganidra practice when compared with the controls
(baseline: 86.84 mm Hg (SD ±14.17) to endpoint 84.16 mm
Hg (SD ±9.82: pvalue 0.121)). e mean difference and
median of SBP were 24.22 and 23.00, whereas the mean
difference and median of DBP were 12.8 and 14.0 after 12
weeks of the intervention of yoganidra among the experi-
mental group. Since SBP and DBP were not matched at
baseline, after adjusting for them, a highly significant re-
duction in SBP (mean 16 mm/Hg) and DBP (mean 8.6mm/
Hg) was observed among the experimental group
(p<0.001∗∗). Weekly blood pressure was recorded for ex-
perimental group subjects, and the mean and SD of both SBP
and DBP were as shown in Figures 1(a) and 1(b). A gradual
reduction in both SBP and DBP was observed among the
intervention group. Furthermore, when the effect of yoga-
nidra was compared among treated/on medication and
untreated/no hypertensive medication subjects (Table 3),
there were 19 subjects on standard pharmacological treat-
ment, whereas 12 were newly diagnosed untreated cases in
the experimental group. e mean difference of SBP among
treated and untreated groups was 23.47 and 27.03 mm Hg
and DBP was 11.52 and 15.57 mm Hg, respectively. It was
observed that the mean difference between SBP and DBP
was more among the untreated group. Any intervention that
reduces blood pressure by 10 mm Hg SBP and 5 mm Hg
DBP has good clinical significance [29]. We grouped among
responders (SBP >10 mm hg and DBP >5 mm hg) and
Table 1: Comparision of demographic details among both groups.
Experimental (n�31) Control (n�43)
Male (n+ %) 24 (77.4) 30 (69.8)
Female (n+ %) 7 (22.6) 13 (30.2)
Age (mean ±SD) 54.61 ±9.95 49.645 ±7.67
35–44 (n+ %) 1 (3.2) 9 (20.93)
45–54 (n+ %) 7 (22.6) 21(48.83)
55–65 (n+ %) 10 (32.3) 11 (25.58)
>65 (n+ %) 13 (41.9) 2(4.65)
Illiterate (n+ %) 1 (3.2) 4 (9.3)
Up to inter (n+ %) 7 (22.6) 21 (48.8)
Up to graduate (n+ %) 10 (32.3) 9 (20.9)
PG and above (n+ %) 13 (41.9) 9 (20.9)
Govt job 12 (38.7) 18 (41.9)
Pvt/temporary job 3 (9.7) 9 (20.9)
Business 5 (16.1) 9 (20.9)
Not earning 3 (9.7) 6 (14.0)
Retired personnel 8 (25.8) 1 (2.3)
HTN-T 19 (61.29) 34 (79.06)
HTN-U 12 (38.7) 9 (20.93)
4Evidence-Based Complementary and Alternative Medicine
nonresponders. When the proportions of responders and
nonresponders were compared (Table 4), which showed that
SBP responders were 94.73% in the treated group and
83.33% responders were in an untreated group, whereas for
DBP nonresponders were 79% in treated and 100% in the
untreated group. MAP was compared from baseline to
endpoint among both groups. A significant reduction in
MAP (107.76 ±11.07 to 90.92 ±6.48: mean difference 16.69
pvalues 0.0001) was observed among the experimental
group, whereas reduction in MAP was not significant in the
control group (102.58 ±9.44 to 99.75 ±11.23). When Hs-
CRP was analyzed, a significant reduction in mean Hs-CRP
(2.21 ±1.49 to 1.06 ±0.82 mg/L; p<0.001) was observed
among the experimental group after 12 weeks of a regular
practice of yoganidra, whereas with a significantly increased
mean Hs-CRP was observed among the control group
(1.22 ±1.05 to 2.57 ±1.71 mg/L; p<0.001). When the lipid
profile was analyzed, it was found that there were no sig-
nificant differences in triglycerides and total cholesterol
levels among both groups, whereas HDL-C and LDL-C
showed a trend of improvement without statistical signifi-
cance in the experimental group after the intervention,
which may be due to the small sample size.
4. Discussion
Hypertension is an important and common risk factor for
cardiovascular diseases, stroke, diabetes, etc., which leads to
considerable morbidity and mortality in developed and
developing countries and is a pandemic problem. Hyper-
tension and its ancillary complications globally are a leading
cause of death in modern societies. e medications used in
the management of hypertension not only decrease blood
pressure but also cause some side effects [20] that lead to
poor compliance. Prolonged usage of medications may cause
the onset of chronic noncommunicable diseases, decreased
quality of life, and work output, thus adding a major burden
on the country’s economy. Hypertension is a multifactorial
disease, and its pathogenesis is not fully understood. In
subjects with hypertension, arterial pressure is persistently
high without any identifiable cause. It is mainly dependent
on cardiac output and total peripheral resistance. e
possible mechanisms are believed to be sympathetic nervous
system overactivity and consequent increase in peripheral
vascular resistance. Besides this, the sympathetic nervous
system’s direct pressure effect and catecholamine released
from the adrenal medulla may also play a role. Hypertrophy
of systemic arterioles could represent an adaptive response
to chronically elevated blood pressure and perpetuate sys-
temic hypertension. Inappropriately high sympathetic ner-
vous outflow from the central nervous system is also believed
to be an important component in the pathophysiology of
acute and chronic essential hypertension, increasing cardiac
output, and peripheral resistance [30].
Yoganidra centrally acts upon the brain to induce
complete relaxation throughout the nervous system, and it
improves the resistance levels of the physiological and
physical systems of an individual. It controls the autonomic
nervous system, influencing the brain’s electrical rhythms,
heart rate, and systolic and diastolic blood pressures. It
maintains altered levels of circulating “stress hormones”
including adrenaline and cortisol from the adrenal glands
and decreased sympathetic nervous activity as reflected in
increased galvanic skin resistance. In this pilot study, we
used yoganidra as adjuvant therapy along with the standard
medications. A significant reduction in SBP and DBP was
observed after 12 weeks of supervised yoganidra practice in
hypertensive subjects. Our observations are in line with
earlier studies [23–25, 31–35]. Even though there was a
gradual reduction in both SBP and DBP from baseline to
endpoint. During the 4th week to the 5th week, there was a
slight increase in both SBP and DBP, which was shown in
Figures 1(a) and 1(b), which may be due to the fact that the
subjects reduced their dose of antihypertensive drugs by
50%. A significant reduction in SBP and DBP and a high
response rate among the untreated (Tables 3 and 4) com-
pared with the treated group suggests that yoganidra is very
effective among untreated or newly diagnosed subjects with
HTN. To confirm our observations and recommend yoga-
nidra to hypertensive subjects, multicentric randomized
controlled trials need to be planned. A significant reduction
in MAP was observed among the yoganidra group compared
with the control group, which is reported for the first time. It
was normalized in our study subjects after 12 weeks of
Table 2: Effect of yoganidra on blood pressure, Hs-CRP, and lipid profile among experimental and control group subjects.
Sl. no. Parameters Experimental group (n�31) Control group (n�43)
Pre (mean ±SD) Post (mean ±SD) Mean diff pvalue Pre (mean ±SD) Post (mean ±SD) Mean diff pvalue
1 BMI 28.68 ±3.91 28.29 ±3.62 0.389 0.009∗27.61 ±4.77 27.58 ±4.95 0.03 0.872
2 SBP 142.9 ±16.46 118.68 ±9.21 24.22 0.0001∗∗ 134.29 ±14.17 130.71 ±16.21 3.58 0.114
3 DBP 89.84 ±10.42 77.03 ±6.47 12.8 0.0001∗∗ 86.84 ±10.13 84.16 ±9.82 2.68 0.121
4 PR 80.61 ±11.49 78.94 ±9.05 1.677 0.247 84.16 ±9.82 81.19 ±11.73 −0.52 0.85
5 MAP 107.61 ±11.07 90.92 ±6.48 16.69 0.0001∗∗ 102.58 ±9.44 99.75 ±11.23 2.83 0.072
6 Hs-CRP 2.21 ±1.49 1.06 ±0.82 −1.15 0.0001∗∗ 1.22 ±1.05 2.57 ±1.71 1.35 0.0001∗
7 Trig 155.84 ±195.56 158.71 ±140.73 −2.87 0.858 131.24 ±74.28 130.84 ±54.63 0.4 0.971
8 Tot. Chol 184.94 ±32.19 186.00 ±33.65 −1.0645 0.806 175.04 ±37.46 181.0 ±34.86 −5.96 0.147
9 HDL 51.0 ±11.93 53.97 ±14.04 −2.968 0.359 52.64 ±9.57 51.73 ±12.50 0.91 0.77
10 LDL 95.83 ±29.64 89.63 ±28.40 6.2 0.297 92.76 ±28.96 88.0 ±31.90 4.76 0.384
11 VLDL 31.17 ±39.11 31.74 ±28.15 −0.574 0.858 26.25 ±14.±86 26.17 ±10.93 0.08 0.971
SD, standard deviation. ∗Significant and ∗∗highly significant (pvalue <0.005).
Evidence-Based Complementary and Alternative Medicine 5
123456789101112
Weeks
Weekly Mean and SD of SBP
142.9
135.8
132.83
130.32
131.9
128.61
126.96
125.51
125.35
126.45
125.12
118.68
16.46
12.86
14.74
13.67
12.32
16.2
16.11
15.58
15.63
15.75
15.49
9.21
0
10
20
30
40
50
60
70
80
90
100
110
120
130
140
150
160
Blood Pressure
Mean
SD
(a)
Mean
SD
123456789101112
Weeks
Weekly Mean and SD of DBP
90.28
85.9
83.74
82.38
83.7
82.9
80.48
80.96
79.7
81.38
80.61
77.03
10.42
8.62
8.56
7.17
8.55
8.26
8.36
8.47
8.6
8.42
8.32
10.42
0
10
20
30
40
50
60
70
80
90
100
Blood Pressure
(b)
Figure 1: (a) Weekly mean and SD of SBP among the yoganidra-treated group and (b) weekly mean and SD of DBP among the
yoganidra-treated group.
Table 3: Effect of yoganidra on blood pressure among untreated and treated cases.
Sl. no. Group Parameters Time points N+ Mean (±SD) Mean diff Two-tailed pvalue
1 Treated SBP Pre 19 141.52 (14.99) 23.47 <0.001∗∗
Post 19 118.05 (9.46)
2 Untreated SBP Pre 13 146.69 (19.12) 27.03 <0.001∗∗
Post 12 119.66 (9.09)
3 Treated DBP Pre 19 86.94 (11.11) 11.52 0.001∗∗
Post 19 75.42 (6.86)
4 Untreated DBP Pre 13 95.15 (7.67) 15.57 0.004∗∗
Post 12 79.58 (5.05)
SD, standard deviation. ∗∗Highly significant (pvalue <0.005).
6Evidence-Based Complementary and Alternative Medicine
yoganidra practice. Hs-CRP and erythrocyte sedimentation
rate (ESR) are known as inflammatory markers with clinical
significance among hypertensive subjects. In this study, a
significant reduction in Hs-CRP levels among the inter-
vention group was observed compared to the control group.
ere are no studies so far on the effect of yoganidra on Hs-
CRP among hypertensive subjects. In contrast, the earlier
study by Kumar and Pandya [35] suggested that yoganidra
has the potential to reduce ESR levels among normal sub-
jects, which proved that yoganidra may have a significant
role in controlling infection and inflammation and im-
proving immunity. In this study, we have observed a trend of
improvement of HDL and LDL levels, whereas no significant
changes were observed on triglycerides and total cholesterol
levels after yoganidra intervention. Less number of subjects
and a short duration may be the reason for the same. e
uniqueness of this pilot study is that no study in the recent
past had implemented a supervised yoganidra intervention
with a comparison between an experimental and a control
group, weekly blood pressure monitoring, and monitoring
the participants for Hs-CRP and lipid profile. Many subjects
showed definite symptomatic improvement after 12 weeks of
yoganidra with no side effects. We conclude that this therapy
opens a new avenue in the management of hypertension. We
suggest that yoganidra may be used as a stand-alone therapy
for untreated/asymptomatic for early or newly diagnosed
hypertensive or prehypertensive subjects that may not re-
quire any medications to manage hypertension. ere are
separate reports, which show that the yoganidra impacts
psychological well-being, quality of life, blood sugar levels,
mental health (stress, concentration, and behavior), and
sleep disorders [31–35]. Overall, yoganidra can be consid-
ered as an add-on option for the prevention and control of
chronic noncommunicable diseases in all age-groups, which
can be regularly practiced at home, at the office, and
community centers, without much financial burden.
Yoganidra can be incorporated with the “Fit India” move-
ment along with other physical exercises. Most of our
population working in government and private organiza-
tions are seen to be suffering from type 2 diabetes, hyper-
tension, dyslipidemia, depression, and stress, which affect
their work efficiency, leading to financial losses not only to
the individual but also to the county as well. Yoganidra can
be regularly practiced after office hours, which can prevent
and manage hypertension, cardiovascular events, and im-
prove mental health status without medications. Addi-
tionally, no side effects were observed in practicing
yoganidra, and this could be effectively incorporated as an
indigenous novel intervention for newly diagnosed hyper-
tensive and psychosomatics under the National Health
Scheme.
5. Conclusions
In this pilot study, we observed a significant reduction in
SBP, DBP, and MAP among the yoganidra intervention
group as compared with the control group. Yoganidra, one
of the components of yoga, should become an integral part
of human life. e good health of people always impacts the
country’s economy in a positive way.
6. Recommendations
Keeping in view the significant findings of this study and
the potential beneficial impact of yoganidra on managing
HTN and related health issues, it is highly recommended to
carry out multicentric randomized controlled trials with a
larger sample size categorized by pharmacological groups.
Other sympathetic parameters may be evaluated for a
better understanding of the pathophysiology involved in
reducing hypertension. us, the data may help us bring
policy reform to address the burden of hypertension in the
country.
7. Limitations
e small sample size is a significant limitation of this study.
However, this pilot study provides significant impetus to
initiate major trials to evaluate the positive effect of yoga-
nidra on hypertension and other NCD markers.
Data Availability
e datasets for the current study are available from the
corresponding author upon request.
Ethical Approval
is study was approved by the Institutional Ethical
Committee, Indian Council of Medical Research—National
Institute of Nutrition, Hyderabad (IEC no. 04/II/2016).
Principle investigator followed the ethical principles of the
Declaration of Helsinki.
Consent
Written informed consent was obtained from all the study
participants.
Conflicts of Interest
e authors declare that they have no conflicts of interest.
Table 4: Comparison of responders to yoganidra (SBP ≥10 mm hg and DBP≥5 mm hg) among treated and untreated cases.
Sl. no. Parameters Treated group Untreated group
1 SBP responders (≥10mmhg) 18/19 (94.73%) 10/12 (83.33)
2 SBP nonresponders (<10 mm hg) 1/19 (5.26%) 2/12 (16.66)
3 DBP responders (≥5 mm hg) 15/19 (78.94%) 12/12 (100)
4 DBP nonresponders (<5 mm hg) 4/19 (21.05%) 0
Evidence-Based Complementary and Alternative Medicine 7
Authors’ Contributions
Devraj JP contributed to study design, obtaining approvals,
subject recruitment, analyzing results, and manuscript
writing. Santosh Kumar B contributed to clinical evaluation,
execution, follow-up, and manuscript corrections. Raja
Sriswan M contributed to screening subjects, clinical eval-
uation, execution, analyzing results, and manuscript cor-
rections. Jagdish B contributed to study design, performed
execution, and followed up the study. Priya B. S contributed
to subject recruitment, data collection and checking, follow-
up, and result interpretation. Neelu S B contributed to
subject recruitment, data collection and checking, follow-up,
and result interpretation. Vijayabhaskar Desai Rao con-
tributed to the design and statistical analysis. Manoj Kumar
contributed to subject recruitment, laboratory investiga-
tions, result interpretation, and manuscript corrections.
J J Babu Geddam contributed to overall supervision.
R. Hemalatha contributed to study design, critical inputs
during trial, interpretation, and manuscript correction.
Acknowledgments
e authors thank the team of “Rishi Chaitanya Ashram,”
NH-1 Ganaur District Sonipat, Haryana, India-131101, for
logistics and financial support.
Supplementary Materials
Weekly blood pressure was recorded for experimental group
subjects, and the mean and SD of both SBP and DBP are as
shown in Supplementary Table S1. A gradual reduction in
both SBP and DBP was observed among the intervention
group. (Supplementary Materials)
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