Effect of yoga on blood pressure in hypertensive older adults: a randomised multicentre study with control group – study protocol

Background Hypertension is highly prevalent among older adults and remains a leading contributor to cardiovascular morbidity and mortality. Age-related arterial stiffness and endothelial dysfunction contribute to residual cardiovascular risk despite adequate brachial blood pressure control. Yoga is a mind–body intervention integrating physical postures, breathing techniques and meditation that has demonstrated modest blood pressure-lowering effects in adults; however, evidence in older hypertensive populations remains limited. Methods This prospective, randomised, controlled, multicentre study will include ninety (n=90) community-dwelling adults aged 65 years or older with treated hypertension, randomised in a 2:1 ratio to a 12-week structured, senior-adapted yoga programme plus usual care (n=60) or to usual care with attention-control health education sessions (n=30). The primary outcome is the between-group difference in change in brachial systolic blood pressure at 12 weeks. Secondary exploratory outcomes include ambulatory and central blood pressure, arterial stiffness, endothelial function, functional capacity, sleep parameters, quality of life, mood status and feasibility metrics. Ethics and dissemination All participants will provide written informed consent prior to enrolment. The study has been approved by the Comitê de Ética em Pesquisa do Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (CEP HC-FMUSP; approval number 8.068.380). The study will be conducted in accordance with the Declaration of Helsinki (World Medical Association, 2013). It was registered in the Brazilian Registry of Clinical Trials (ReBEC) on 19 February 2026 as ‘Yoga in Elderly Hypertensive Patients’, identifier RBR-23vmpsx (https://ensaiosclinicos.gov.br/rg/RBR-23vmpsx). Recruitment began in June 2026 and is expected to be completed by April 2027. Funding is provided by the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP; process 2024/23879-2). The sponsor, Instituto do Coração (InCor), will oversee study monitoring, with annual audits planned.