Cureus. 2026 May 22;18(5):e109457. doi: 10.7759/cureus.109457. eCollection 2026 May.
ABSTRACT
Cardiovascular diseases (CVDs) rank among the leading causes of global mortality, with high systolic blood pressure (SBP) being a primary driver. In low- and middle-income countries (LMICs) like India, rising hypertension prevalence and limited healthcare access necessitate effective, scalable, and culturally relevant management strategies. This systematic review and meta-analysis (SRMA) aimed to evaluate the clinical effectiveness of various non-pharmacological lifestyle interventions compared to usual care among Indian adults with hypertension or pre-hypertension. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a comprehensive search of databases, including PubMed, Google Scholar, and Cochrane, was conducted for studies published between January 2000 and December 2025. The inclusion criteria focused on randomized controlled trials (RCTs) and observational studies involving Indian adults (≥18 years) with primary hypertension. Data were synthesized using a narrative review and a random-effects meta-analysis (using R software) for studies with extractable blood pressure outcomes. Fourteen studies (N = 1,547 participants) met the inclusion criteria, evaluating yoga (e.g., pranayama, meditation), aerobic exercise, dietary salt reduction, and multi-component lifestyle programs. A meta-analysis of seven RCTs revealed that lifestyle interventions significantly reduced SBP by an average of 4.78 mmHg (95% confidence interval (CI): -6.17 to -3.39) and diastolic blood pressure (DBP) by 2.06 mmHg (95% CI: -3.11 to -1.02) compared to usual care. Yoga and meditation-based approaches demonstrated the largest clinical reductions in blood pressure. Statistical heterogeneity was low for SBP (I² = 0%) and moderate for DBP (I² = 16.7%). Lifestyle interventions, particularly yoga-based and physical activity programs, are effective adjuncts to standard pharmacological therapy for hypertension in India. These low-cost, non-invasive strategies offer significant potential for integration into national non-communicable disease control programs aimed at reducing cardiovascular risk.
PMID:42338876 | PMC:PMC13283942 | DOI:10.7759/cureus.109457