Effect of sudarshan-kriya yoga on determinants of cardiometabolic health: A systematic review

BACKGROUND: Sudarshan Kriya Yoga (SKY), a breath-based mind-body practice, is globally recognized for its physical and psychological benefits. Cardiovascular and metabolic disorders pose significant global health challenges. While SKY studies suggest benefits for cardiometabolic health, varied findings necessitate rigorous synthesis to confirm its efficacy. METHODS: SKY and cardiometabolic risk variables (blood pressure (BP), blood glucose, lipid profile, and anthropometric indicators of obesity) were searched in PubMed, Scopus, and the Cochrane Library until May '23. English papers with SKY interventions that monitored at least one cardiometabolic risk factor were eligible. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies assessed the quality and the certainty of evidence was evaluated using the GRADE framework. Due to heterogeneity across studies, findings were synthesized narratively. RESULTS: Twenty-one studies met the inclusion criteria: Nine RCTs, three CCTs, one double-arm pre-post study, one case-control study, and seven single-arm studies with 1716 participants aged 18-78. Intervention durations ranged from less than one to twenty-four weeks. Lipid improvements were reported in thirteen of fifteen, while reductions in BP were observed in several studies, particularly among hypertensive populations. Evidence for glycaemic and anthropometric outcomes was inconsistent. Seven studies were moderate quality and fourteen were weak. The certainty of evidence was graded as low for lipid and BP outcomes and very low for glycaemic and anthropometric outcomes. CONCLUSIONS: SKY may improve certain cardiometabolic risk factors, particularly lipid profile and BP, but the predominance of weak studies warrants caution. High-quality, sufficiently powered long-term RCTs are needed to validate these findings.