Research Highlights:

  • A study including nearly 3,500 adults in India with heart failure found that participants in a yoga-based cardiac rehabilitation program reported improved quality of life and walking distance compared to the group that received enhanced standard care.
  • However, there was no statistically significant difference in the combined rate of death, hospitalization or stroke between the yoga-based cardiac rehab group and the enhanced standard care group.
  • The study investigated whether people with heart failure may benefit from participating in yoga-based cardiac rehabilitation alongside usual heart failure treatment. The yoga-based cardiac rehab program was developed to provide an affordable and accessible alternative to a traditional cardiac rehab program in communities with limited resources and for patients who may prefer a low-impact physical activity option.
  • Note: The study featured in this news release is a research abstract. Abstracts presented at the American Heart Association’s scientific meetings are not peer-reviewed, and the findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

Embargoed until 4:00 p.m. CT/5:00 p.m., ET, Saturday, Nov. 7, 2026

This news release contains updated information provided by the researchers and not listed in the abstract.

“Between 8 and 10 million people in India are living with heart failure, many of whom are typically 10 years younger, on average (most younger than age 65) compared to adults with heart failure living in high-income countries,” said lead study author Dorairaj Prabhakaran, M.B.B.S., M.D., D.M., executive director of the Centre for Chronic Disease Control in India, President-Elect, World Heart Federation, Geneva and adjunct professor at Rollins School of Public Health at Emory University in Atlanta. “Reducing hospitalizations and improving quality of life and physical function for heart failure patients, these are valuable shifts that are much needed in countries like India.”

Cardiac rehabilitation programs are medically guided and designed for people who have experienced a heart attack, heart failure, or heart surgery. Cardiac rehab programs can lower the risk of another cardiac event and improve a person's ability to engage in daily living and activities through exercise guidance, education on healthy living, and counselling for stress relief. However, cardiac rehabilitation can be costly, and participation rates are low, particularly among women, older adults and people from some racial and ethnic groups, according to the 2025 American Heart Association Scientific Statement: Cardiac Rehabilitation in Women.

“Cardiac rehab programs are inaccessible to many, and their uptake is poor in many countries,” said Prabhakaran. “Innovations are needed to reduce costs, scale up cardiac rehab and make it sustainable. Yoga is culturally acceptable in countries like India, and it can provide many of the benefits of cardiac rehab at a lower cost. A yoga-based cardiac rehabilitation delivered by a single healthcare professional may be effective, scalable and sustainable. However, the evidence for such an approach is sparse.”

What are the study’s key findings?

  • At three months, participants in the yoga-based cardiac rehab group had significantly greater improvement in quality of life than the enhanced standard care group: their Minnesota Living with Heart Failure Questionnaire scores improved by about 8 points (lower scores indicate better quality of life).
  •  There was no statistically significant difference between groups in the combined rate of death, hospitalization or stroke: 364 participants (21.0%) in the yoga-based rehab group died, were hospitalized or had a stroke during a median follow-up of 15 months, compared to 401 (22.8%) in the enhanced standard care group.
  • Greater improvements were also observed in the yoga cardiac rehabilitation group patients’ physical functioning abilities compared to the enhanced standard care group when based on the distance participants could walk in six minutes and the between-group difference in change from baseline. Participants in the yoga group walked, on average, 25.5 meters farther than the participants in the enhanced standard care group.
  • The health status based on EQ-5D-5L questionnaire (Quality-adjusted utility-values with Indian dataset) was better among the people who underwent the yoga-based cardiac rehabilitation than the comparison group.

“This study tested a yoga-based cardiac rehabilitation program incorporating health education and tailored behavior change with individual participant goals and a standardized set of physical practices of yoga,” said Prabhakaran. “We found the Yoga-CaRe program helped improve quality of life and physical function in people living with heart failure. In our trial, a board-certified yoga & naturopathy practitioner delivered this structured, yoga-based cardiac rehabilitation package for adults with heart failure. These results are potentially scalable and sustainable in settings where cardiac rehab is not easily available and resources are limited. The cultural acceptability of the yoga-based rehab was also high, as shown by strong participation in the supervised sessions and in home practice. Though a formal cost-effectiveness analysis is yet to be conducted, we expect it to be affordable and accessible for patients with heart failure.”

What are the study’s details, background, design and limitations?

  • Between April 2023 and December 2025, the trial recruited almost 3,500 adults with heart failure across 16 medical centers in India; 27% were women; and the median age was 57 years. Nearly 40% of participants were recruited from inpatient/hospital settings.
  • Study participants had heart failure with reduced ejection fraction, or HFrEF, which means the heart’s main pumping chamber pushes out 40% or less of the blood it contains with each heartbeat. The study also included patients hospitalized for acute decompensated heart failure and those with chronic heart failure.
  • About half of the study participants had New York Heart Association (NYHA) Class III heart failure, which means they had marked limitation of physical activity: they were comfortable at rest, but less-than-ordinary activity caused fatigue, heart palpitations or shortness of breath.
  • Of the 3,492 heart failure patients with reduced ejection fraction, half were randomly assigned to participate in the yoga-based cardiac rehabilitation program (n=1,737 in the intervention group), and the other half received enhanced standard care (n=1,755 in the control group).
  • The intervention group received Yoga CaRe – a standardized and structured yoga program – and health education using “Healthy Living with Heart Failure” booklet with tailored advice using a goals-based approach. The program was delivered in 20 supervised sessions over three months, and then one session every three months until the end of follow-up.
  • The second group received enhanced standard care that included three health education/information sessions over three months, and the same health information booklet used by the patients in the intervention group.
  • The researchers measured the time to the first medical event, which was a composite of death by any cause, hospitalization for any reason or a stroke occurrence during the study follow-up period.
  • The study also measured the participants’ quality of life after three months using the Minnesota Living with Heart Failure Questionnaire. The self-reported questionnaire includes 21 questions pertaining to the physical, emotional and socioeconomic ways heart failure can adversely affect a person’s life.
  • Researchers also assessed the participants’ 6-minute walk distance.
  • The EuroQol 5D-5L (EQ-5D-5L), a standardized, self-reported survey to measure a person’s health-related quality of life, including mobility, self-care, usual activities, pain/discomfort and anxiety/depression, was conducted at three months.
  • The quality of life, 6-minute walk distance and quality-adjusted utility value (a score that describes how good or difficult a person's health condition feels in everyday life that is often used to compare the benefit of different treatments) were assessed at 6, 12 and 24 months.
  • The study has some limitations. As is the case with all cardiac rehabilitation trials or behavioral interventional trials, the study intervention cannot be blinded because participants knew which cardiac rehab they were participating in. Secondly, the number of interactions between the patients and yoga instructors in the intervention sessions was higher than the enhanced standard care (20 sessions versus 3 sessions), which could have impacted the results.

The authors note that future research should be centered around implementing yoga-based cardiac rehab at-scale and also evaluating this approach in other healthcare settings and countries.

“This trial is one of the largest studies of cardiac rehabilitation in people with heart failure that evaluated an alternative cardiac rehab program that may be easier and more cost-effective to deliver in limited-resource settings,” said Prabhakaran.

Co-authors, disclosures and funding sources are listed in the abstract.

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

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