Impact of Yoga Therapy on D-dimer Level in Asymptomatic Varicose Vein Disease – a Randomized Controlled Trial
DOI:
https://doi.org/10.15391/prrht.2024-9(4).02Keywords:
Varicose veins, D-dimer, Yoga therapy, Middle-aged men, Randomized controlled trial.Abstract
Abstract
Background: Varicose veins (VV) affect a significant portion of the population, particularly middle-aged men, causing discomfort and potential complications. Elevated D-dimer levels may indicate thrombotic risk in VV patients. Yoga therapy (YT) has emerged as a complementary approach for managing vascular disorders, but its impact on biomarkers like D-dimer remains unclear, especially in middle-aged men with VV.
Material and Methods: This randomized controlled trial recruited 80 middle-aged men diagnosed with VV. Participants were equally and randomly assigned to a yoga therapy group (YTG) or a control group (CG). The YTG received tailored YT sessions three days a week for 12 weeks, focusing on specific asanas, pranayama techniques, and meditation. The CG continued with their usual activities. Outcome assessments included Systolic blood pressure (SBP), Diastolic blood pressure, Heart rate (HR), high-sensitivity C-reactive protein (hs-CRP), and D-dimer levels. Assessments were conducted before and after the intervention period for both groups.
Results: Following the yoga intervention in varicose vein patients, significant improvements were observed compared to the CG. SBP decreased from 140 mmHg to 128 mmHg in the YTG, whereas in the CG, it decreased from 142 mmHg to 138 mmHg. Similarly, DBP decreased from 90 mmHg to 85 mmHg in the YTG, while in the CG, it decreased from 92 mmHg to 90 mmHg. Heart rate also showed improvement in both groups, with a decrease from 80 bpm to 70 bpm in the YTG and from 82 bpm to 78 bpm in the CG. Furthermore, levels of hs-CRP decreased from 3.5 mg/L to 2.8 mg/L following the intervention in the YTG, whereas in the CG, there was a slight increase from 3.6 mg/L to 3.7 mg/L. Moreover, D-dimer levels, indicative of thrombotic risk, decreased from 1.6 mg/L to 1.4 mg/L after the YT, whereas in the CG, they remained relatively stable at 1.7 mg/L before and after the intervention.
Conclusion: This study highlights the potential of YT as a non-invasive intervention for managing VV and reducing thrombotic risk in middle-aged men. Further research is warranted to validate these findings and explore the mechanisms underlying the observed effects of yoga on biomarkers like D-dimer.
References
Vanitha, A., Pandiaraja, M., Maheshkumar, K., & Venkateswaran, S. T. (2018). Effect of yoga nidra on resting cardiovascular parameters in polycystic ovarian syndrome women. National Journal of Physiology, Pharmacy and Pharmacology, 8(11), 1505-1508. https://doi.org/10.5455/njppp.2018.8.0411112082018
Badri, K., & Subbulakshmi, V. (2023). Impact Of Yoga Therapy On 6 Minute Walk Test Among Middle Aged Men Diagnosed with Varicose Veins. Rivista Italiana di Filosofia Analitica Junior, 14(2), 1481-1486. https://rifanalitica.it/index.php/journal/article/view/420
Chauhan, S., & Patra, S. (2021). Yoga and its adjuvant therapies for the management of varicose vein disease: A narrative review. Yoga Mimamsa, 53(2), 134. https://doi.org/10.4103/ym.ym_108_21
Chauhan, S., Patra, S., Singh, S. P., & Lakhani, J. D. (2023). Combined effect of yoga and naturopathy in uncomplicated varicose vein disease – a prospective randomized controlled trial. Journal of Ayurveda and Integrative Medicine, 14(3), 100718. https://doi.org/10.1016/j.jaim.2023.100718
Cornuz, J., Ghali, W. A., Hayoz, D., Stoianov, R., Depairon, M., & Yersin, B. (2002). Clinical prediction of deep venous thrombosis using two risk assessment methods in combination with rapid quantitative D-dimer testing. The American Journal of Medicine, 112(3), 198–203. https://doi.org/10.1016/S0002-9343(01)01110-X
Das, M., Pundir, M., & Patra, S. (2023). Effectiveness of CAM (Complementary and Alternative Medicine) on Varicose Vein Complications. International Journal of Endovascular Treatment and Innovative Techniques, 4(1), 11–18. https://doi.org/10.61797/ijetit.v4i1.263
Gawas, M., Bains, A., Janghu, S., Kamat, P., & Chawla, P. (2022). A Comprehensive Review on Varicose Veins: Preventive Measures and Different Treatments. Journal of the American Nutrition Association, 41(5), 499–510. https://doi.org/10.1080/07315724.2021.1909510
Haapaniemi, E., & Tatlisumak, T. (2009). Is D-dimer helpful in evaluating stroke patients? A systematic review. Acta Neurologica Scandinavica, 119(3), 141–150. https://doi.org/10.1111/j.1600-0404.2008.01081.x
Lurie, F., Passman, M., Meisner, M., Dalsing, M., Masuda, E., Welch, H., Bush, R. L., Blebea, J., Carpentier, P. H., De Maeseneer, M., Gasparis, A., Labropoulos, N., Marston, W. A., Rafetto, J., Santiago, F., Shortell, C., Uhl, J. F., Urbanek, T., Van Rij, A., … Wakefield, T. (2020). The 2020 update of the CEAP classification system and reporting standards. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 8(3), 342–352. https://doi.org/10.1016/j.jvsv.2019.12.075
Mahajan, Dr. R. (2021). Preventing Varicose Veins: Role of Exercise, Diet and Physiotherapy. International Journal of Medical Science and Health Research, 05(05). https://doi.org/10.51505/IJMSHR.2021.5511
Maheshkumar, K., Dilara, K., Ravishankar, P., Julius, A., Padmavathi, R., Poonguzhali, S., & Venugopal, V. (2022). Effect of six months pranayama training on stress-induced salivary cortisol response among adolescents-Randomized controlled study. EXPLORE, 18(4), 463–466. https://doi.org/10.1016/j.explore.2021.07.005
Moorthy, S., Koshy, T., Kumar K, M., Chandra A, J., Bhaskar, E., & Silambanan, S. (2022). Hematological Markers in the Assessment of Severity of COVID-19 Infection—A Retrospective Cross-Sectional Study. Journal of Health Sciences and Surveillance System, 10(3). https://doi.org/10.30476/jhsss.2021.92646.1368
Piazza, G. (2014). Varicose Veins. Circulation, 130(7), 582–587. https://doi.org/10.1161/CIRCULATIONAHA.113.008331
Pramanik, M., Rajkumar, N. C., Elayaraja, M., Gogoi, H., Rajiv Gandhi University, & Govindasamy, K. (2023). Effects of a 12-Week Yoga Training Intervention on Blood Pressure and Body Composition in Obese Female Adolescents: A Randomized Controlled Pilot Study. Physical Rehabilitation and Recreational Health Technologies, 8(3), 162–171. https://doi.org/10.15391/prrht.2023-8(3).05
Rajagopalan, A., Kuppusamy, M., & Gandhi, T. S. (2022). Meditation Alleviates Psychological Distress and Sleep Quality in COVID-19 Patients during Home Isolation. Journal of Young Pharmacists, 14(4), 441–443. https://doi.org/10.5530/jyp.2022.14.89
Sengupta, P. (2012). Health Impacts of Yoga and Pranayama: A State-of-the-Art Review. International Journal of Preventive Medicine, 3(7), 444–458.
Sergii, K., Yuliya, K., Anastasiia, Y. (2021). Alternative methods of kinesotherapy with the use of elements of yogi asans for type 2 diabetes mellitus. Fizicna Reabilitacia ta Rekreacijno-Ozdorovci Tehnologii,6(2), 5-12. https://doi.org/10.15391/prrht.2021-6(2).01
Venugopal, V., Geethanjali, S., Poonguzhali, S., Padmavathi, R., Mahadevan, S., Silambanan, S., & Maheshkumar, K. (2022). Effect of Yoga on Oxidative Stress in Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis. Current Diabetes Reviews, 18(2), e050421192663. https://doi.org/10.2174/1573399817666210405104335
Wankhar, D., Prabu Kumar, A., Vijayakumar, V., A, V., Balakrishnan, A., Ravi, P., Rudra, B., & K, M. (2024). Effect of Meditation, Mindfulness-Based Stress Reduction, and Relaxation Techniques as Mind-Body Medicine Practices to Reduce Blood Pressure in Cardiac Patients: A Systematic Review and Meta-Analysis. Cureus. https://doi.org/10.7759/cureus.58434
Ward, L., Nault, D., Cramer, H., & Moonaz, S. (2022). Development of the CLARIFY (CheckList stAndardising the Reporting of Interventions For Yoga) guidelines: A Delphi study. BMJ Open, 12(1), e054585. https://doi.org/10.1136/bmjopen-2021-054585
Wauthier, L., Favresse, J., Hardy, M., Douxfils, J., Le Gal, G., Roy, P. M., Van Es, N., Ay, C., Ten Cate, H., Lecompte, T., Lippi, G., & Mullier, F. (2023). D-dimer testing: A narrative review. In Advances in Clinical Chemistry (Vol. 114, pp. 151–223). https://doi.org/10.1016/bs.acc.2023.02.006
Whiteley, M. S. (2022). Current Best Practice in the Management of Varicose Veins. Clinical, Cosmetic and Investigational Dermatology, Volume 15, 567–583. https://doi.org/10.2147/CCID.S294990
Yamuna, U., Pravalika, B., Madle, K., Majumdar, V., & Saoji, A. A. (2024). Effect of Yoga in Industrial Workers with Chronic Venous Insufficiency: A Randomized Controlled Trial. Journal of Integrative and Complementary Medicine, jicm.2023.0691. https://doi.org/10.1089/jicm.2023.0691



