Yoga-Based Cardiac Rehab Lifts Quality of Life in Heart Failure Trial

Late-breaking science presented Saturday at the American Heart Association's Scientific Sessions in Chicago shows a structured yoga program delivered by a single board-certified yoga and naturopathy practitioner improved quality of life for people with heart failure with reduced ejection fraction. At three months, the yoga group's Minnesota Living with Heart Failure Questionnaire scores improved by about eight points, with lower scores meaning better quality of life. The trial split 3,492 adults across 16 medical centers in India, with 1,737 in the yoga intervention and 1,755 in enhanced standard care.

The hard outcomes told a different story. Over a median follow-up of 15 months, 364 participants (21.0%) in the yoga-based rehab group died, were hospitalized or had a stroke, compared with 401 (22.8%) in the standard care group. The difference was not statistically significant. Participants in the yoga arm did walk an average of 25.5 meters (84 feet) farther than the comparison group in six minutes, and their EQ-5D-5L health status scores came out better.

Lead author Dorairaj Prabhakaran, executive director of the Center for Chronic Disease Control in India, president-elect of the World Heart Federation and an adjunct professor at Emory University's Rollins School of Public Health, framed the stakes around access. Between 8 and 10 million people in India live with heart failure, he said, and they are typically about 10 years younger than patients in high-income countries. Cardiac rehab is costly with poor uptake globally, so Prabhakaran argued innovations are needed to cut costs and scale it up. Yoga, he said, is culturally acceptable in India and can deliver many of the same benefits at lower cost.

The intervention, Yoga CaRe, combined a standardized yoga program with health education from a 'Healthy Living with Heart Failure' booklet and tailored, goals-based advice. Participants got 20 supervised sessions over three months, then one session every three months through the end of follow-up. The control group received three health education sessions over the same three months and the same booklet. Recruitment ran from April 2023 to December 2025; 27% of participants were women, median age was 57, and nearly 40% were enrolled from inpatient settings. About half had NYHA Class III heart failure, and the trial included both patients hospitalized for acute decompensated heart failure and those with chronic heart failure.

Prabhakaran said the results are potentially scalable where cardiac rehab is scarce and resources are limited, pointing to strong participation in supervised sessions and home practice as evidence of cultural fit. He added that a formal cost-effectiveness analysis has not yet been done but he expects the approach to be affordable. The authors flagged two limitations: the intervention could not be blinded because participants knew which rehab they were in, and the yoga group had 20 instructor interactions versus three in standard care, which could have influenced results. Future research, they said, should focus on implementing yoga-based cardiac rehab at scale.