Type 2 diabetes mellitus (T2DM) is associated with a markedly increased risk of atherosclerotic cardiovascular disease (ASCVD), which remains the leading cause of morbidity and mortality in this population. Despite standard pharmacological management, a substantial residual cardiovascular risk persists, highlighting the need for complementary lifestyle-based interventions. Yoga, a traditional mind–body practice, has shown benefits in improving glycemic control, lipid profile, stress, and autonomic balance; however, its impact on composite ASCVD risk and underlying molecular mechanisms in individuals with T2DM has not been adequately studied.

The Yoga-AtheroCaRRe study is a prospective, randomized, open-label, blinded end-point (PROBE) trial designed to evaluate the efficacy of a structured yoga lifestyle intervention in reducing 10-year ASCVD risk in individuals with T2DM. A total of 150 participants will be randomized in a 1:1 ratio to receive either a structured yoga lifestyle program along with standard care or enhanced standard care alone. The intervention includes supervised yoga practices, breathing exercises, meditation, and lifestyle modifications.

Primary outcome is the change in 10-year ASCVD risk score at 3 and 6 months using validated risk prediction tools. Secondary outcomes include changes in glycemic status, lipid profile, psychosocial stress, autonomic function, endothelial function, inflammatory and oxidative stress markers, and ASCVD-related gene expression. This study aims to generate evidence on the clinical and molecular benefits of yoga as a sustainable adjunctive strategy for cardiovascular risk reduction in T2DM.