A systematic review on physiological role of yoga and pranayama in management of orthostatic hypotension and vasovagal syncope

Background: OH and VVS are increasingly recognized as important causes of impairment of quality of life and potentially of poor prognosis. Existing management therapies have modest effect. Recently few studies have emerged and have demonstrated the efficacy of yoga and pranayama in disorders having autonomic imbalance, suggesting its possible efficacy in OH and VVS.

Objective: This review aims to determine the effectiveness of yogic practices in patients with orthostatic hypotension (OH) and recurrent vasovagal syncope (VVS).

Materials and Methods: A Medline search was done in Google chrome to review relevant articles in English literature considering the eligibility criteria that the article should focus on yoga and pranayama and its physiological effects on OH and VVS. The main outcome expected was attenuation of OH and frequency of attacks of syncope and presyncope.

Results and Conclusions: Out of the total 86 articles searched, 7 articles (3 RCTs, 3 observational/interventional, 1 review) full filled the eligibility criteria and depicted that yogic practices can have positive impact in attenuation of orthostatic hypotension and reduce the frequency of attacks of syncope and presyncope, among patients with recurrent VVS. However, we recommend higher-quality RCTs in future to confirm our results.