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. 2018 Jul 5;18(1):207.
doi: 10.1186/s12906-018-2275-9.

Impact of a Structured Yoga Program on Blood Pressure Reduction Among Hypertensive Patients: Study Protocol for a Pragmatic Randomized Multicenter Trial in Primary Health Care Settings in Nepal

Free PMC article

Impact of a Structured Yoga Program on Blood Pressure Reduction Among Hypertensive Patients: Study Protocol for a Pragmatic Randomized Multicenter Trial in Primary Health Care Settings in Nepal

Raja Ram Dhungana et al. BMC Complement Altern Med. .
Free PMC article


Background: Hypertension control remains a major global challenge. The behavioral approaches recommended for blood pressure reduction are stress reduction, increased exercise and healthy dietary habits. Some study findings suggest that yoga has a beneficial effect in reducing blood pressure. However, the role of yoga on blood pressure has received little attention in existing health care practices in developing countries. This study will be conducted in primary health care facilities in Nepal to assess the effectiveness of a pragmatic yoga intervention to complement standard practice in further reducing blood pressure.

Methods: This will be multicentric, two arms, randomized, nonblinded, pragmatic trial. It will be conducted in seven District Ayurveda Health Centers (DAHCs) in Nepal between July 2017 and June 2018. The study participants will consist of hypertensive patients with or without antihypertensive medication attending to the outpatient department (OPD). One hundred and forty participants will be randomized to treatment or control groups by using a stratified block randomization. At the study site, the treatment arm participants will receive an intervention consisting of five days of structured yoga training and practice of the same package at home with a recommendation of five days a week for the following 90 days. Both the intervention and control groups will receive two hours of health education on lifestyle modifications. The primary outcome of this trial will be the change in systolic blood pressure and it will be assessed after 90 days of the intervention.

Discussion: This study will establish the extent to which a yoga intervention package can help reduce blood pressure in hypertensive patients. If proven effective, study findings may be used to recommend the governing bodies and other stakeholders for the integration of yoga in the national healthcare system for the treatment and control of hypertension.

Trial registration: Clinical Trial Registry- India (CTRI); CTRI Reg. No- CTRI/2017/02/007822 . Registered on 10/02/2017.

Keywords: Hypertension; Nepal; Obesity; Primary health care; Yoga.

Conflict of interest statement

Ethics approval and consent to participate

The study protocol has been reviewed and approved by the Ethical Review Board of the Nepal Health Research Council Nepal (Ref No: 1185, 06 January 2017).

A team of co-investigator will involve in taking written consent from the participants. First, we will distribute the study brochure to the participant one week before commencing their consents. The brochure will contain information on purpose, objective, interventions, benefit, risk and outcome of the study. Besides, we will clearly explain the purpose of the study during signing of the consent form. They will be well informed about their rights to withdraw from the study at any time.

Participants will also be assured that all personal details will be confidential. Data will be stored in locked file cabinets in areas with limited access.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.


Fig. 1
Fig. 1
Location of study sites. Seven Ayurveda Health Centers are selected from Ramechhap, Dhading, Nuwakot, Kaski, Rupandehi, Surkhet and Rolpa Districts
Fig. 2
Fig. 2
Flow chart of phases of study. Total 140 study participants from seven study sites (20 per site) will be enrolled in the study. Both arms (treatment and control) will contain equal numbers of participants (10 in each arm) at each center (through stratified block randomization)

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