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Strike a Pose to Lower Your Blood Pressure

November 23rd, 2015
Image courtesy of arztsamui at FreeDigitalPhotos.net

Image courtesy of arztsamui at FreeDigitalPhotos.net

By Kathrine Distel, PharmD Student Cedarville University School of Pharmacy

Hypertension or, as it is more commonly known, high blood pressure, is a chronic disorder that is becoming increasingly prevalent. It can be caused by a number of different factors, including a sedentary lifestyle, poor sleep habits, food choice and smoking. The most common treatment for high blood pressure is medication geared toward lowering blood pressure along with a suggestion to make some lifestyle changes. Unfortunately, those changes—namely diet and exercise—are unappealing at best to most people. Few people want to drastically alter their eating habits and rearrange their schedule so they can go to the gym every other day. Fortunately, there are plenty of other options that are emerging as effective ways to lower blood pressure without endlessly circling a track. One such option, yoga, has been in practice for many years.

Many people balk at the idea of doing yoga because it brings to mind impressive flexibility, leggings, and a room full of yoga mats. However, that doesn’t have to be the case. Thanks to the internet, you can pick a yoga instructor who moves at your pace in the privacy of your living room, avoiding all of the unappealing aspects of the exercise. A study1 conducted in India, a country that has been practicing yoga for centuries, found that regular yoga combined with blood pressure medications can produce significant decreases in blood pressure.

Study participants were divided into two groups. The first group, the control, continued to take their blood pressure medications as they had been with no changes besides instructions to avoid smoking, alcohol and any medications that may interfere with the study. The second group, besides the same set of instructions, began practicing yoga with trained yoga therapists three times a week. The sessions were about 45 minutes long and included preparatory practices, static postures, pranayama—exercises that focus on breathing control—and relaxation techniques. Participants were also encouraged to practice what they had learned throughout the rest of the week. 1

The study lasted for 12 weeks and, while the control group had no significant changes from its original measurements, the group practicing yoga showed some interesting results. When compared with both their own original measurements and the end results of the control group, the group practicing yoga had a significant decrease of both components of blood pressure (p < 0.05)—systolic and diastolic pressures— as well as mean arterial pressure (MAP) (p < 0.001). MAP is influenced by several different components, including blood pressure, heart rate, how much blood the heart is pumping every minute, and how much resistance the blood vessels are offering to the heart. When these values are low, the heart doesn’t have to work as hard and risks such as heart attack and stroke are decreased.1

There were two main limitations to this study. The sample size—70 people split evenly between the two groups—was a small one. Additionally, the study only lasted 12 weeks which did not allow it to assess the long-term effects of yoga on high blood pressure. However, other studies2-7 have also found yoga to have positive effects on blood pressure. One systematic review6 of 32 articles found that yoga could lower blood pressure in both healthy and hypertensive patients. Another study5, a year-long study in Hong Kong consisting of 182 participants, found that regular yoga practice could lead to decreased blood pressure, resting heart rate and waist circumference.

When the exercises for these studies were designed, the instructors kept in mind the group they would be teaching. The exercises were geared toward beginners and seniors. One case study, 7 which used resources such as a DVD and a YouTube video, evaluated the effectiveness of a modified chair yoga. This program increased safety for participants with decreased mobility or balance while still effectively lowering blood pressure. Participants also reported decreased anxiety and joint pain.

Results of systematic reviews3,6,8 have been mixed on the effects of yoga. Many, but not all of the trials found positive effects on blood pressure, some of those results were statistically significant while others were not. With so many varying results, there is still more research that needs to be done to determine a true measure of the effect of yoga on blood pressure.It is important to note that, because research into the effects of yoga on blood pressure is still relatively new, this practice has not yet been shown be effective in replacing blood pressure medications. Rather, it works well in conjunction with those medications.

So if your doctor has recommended a lifestyle change to aid in controlling your blood pressure, yoga may be a great place for you to begin. There are many free resources available, ranging from DVDs at the library to videos on YouTube, and it doesn’t require any equipment besides an open floor and perhaps a chair.

What do you think? Will you try yoga to assist in controlling your blood pressure?

 

References:

1. Pushpanathan P, Trakroo M, RP S, Madhavan C. Heart rate variability by poincaré plot analysis in patients of essential hypertension and 12-week yoga therapy. National Journal of Physiology, Pharmacy & Pharmacology. 2015;5(3):174-180.

2. Centre for Reviews aD. Yoga and hypertension: A systematic review (provisional abstract). Altern Ther Health Med. 2014:32-59.

3. Cramer H, Haller H, Lauche R, Steckhan N, Michalsen A, Dobos G. A systematic review and meta-analysis of yoga for hypertension. Am J Hypertens. 2014;27(9):1146-1151.

4. Hagins M, Rundle A, Consedine NS, Khalsa SBS. A randomized controlled trial comparing the effects of yoga with an active control on ambulatory blood pressure in individuals with prehypertension and stage 1 hypertension. J Clin Hypertens (Greenwich). 2014;16(1):54-62.

5. Siu PM, Yu AP, Benzie IF, Woo J. Effects of 1-year yoga on cardiovascular risk factors in middle-aged and older adults with metabolic syndrome: A randomized trial. Diabetology & Metabolic Syndrome. 2015;7(1):1-12.

6. Yang K. A review of yoga programs for four leading risk factors of chronic diseases. Evidence-based Complementary & Alternative Medicine (eCAM). 2007;4(4):487-491.

7. Awdish R, Small B, Cajigas H. Development of a modified yoga program for pulmonary hypertension: A case series. Altern Ther Health Med. 2015;21(2):48-52.

8. Centre for Reviews aD. Yoga for hypertension: A systematic review of randomized clinical trials (provisional abstract). Complement Ther Med. 2014:511-522.

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19 Responses to “Strike a Pose to Lower Your Blood Pressure”

  1. Vineeta Rao Says:

    What’s interesting to me about this post is the concept that internet resources like youtube can be used to make lifestyle changes like exercise less intimidating. It’s so easy to use and personalize that people of many ages and generations could find an activity that they enjoy to help reduce some of these chronic disease states.

    I would definitely caution people to be careful in choosing a program, though — yoga in its original form is tied very closely to Hinduism and can easily stray into the spiritual realm. Haven’t done much research myself, but it seems like a lot of these articles have a modified version that’s primarily intended for health benefits!

  2. Jessica Ward Says:

    Great article! One thought: How does yoga compare with more traditional forms of low-impact exercise like walking? For instance balancing the rewards of lowered BP with the risk of injury in trying to achieve too-advanced poses. I know research is limited and there is not a flat-out answer to this right now, but it is something to consider.

  3. Nicholas Rudy Says:

    Great job! The article mentions that many of the yoga programs were geared towards beginners and seniors. I wonder how blood pressures of this group would compare to a group of younger people (middle-aged, 40-50s) who more capable of advanced poses. Just a thought for future research!

  4. Katie Woodard Says:

    This is a very interesting article! I agree with Vineeta that it’s great that there are so many resources like DVDs, Youtube videos, etc. to help give people opportunities to practice this exercise. However, I wonder if unsupervised physical activity would be completely safe for patients whose blood pressure is uncontrolled. They might be better off to begin their exercise in a class with a trained instructor who knows their medical history and is CPR certified. The classes you mentioned with instructors who planned exercises intentionally geared toward participant needs sound especially beneficial. I also think the camaraderie in a class would encourage participants to stick with it until the habit of doing yoga becomes routine. Maybe after some time, they could learn to do the poses safely and get their blood pressure to a more consistent level before taking advantage of the at-home resources.

  5. Dominic Yeboah Says:

    This very interesting and I have also heard a lot of benefits from doing yoga. What types of exercise is associated yoga and if there is what is the difference between yoga and traditional exercise? Is there any difference between men and women on the effectiveness of yoga on high blood pressure reduction?

  6. Hannah Chittenden Says:

    This article was very interesting and well done Katie,

    The studies you found gave a very complete picture of the research done on yoga and how it impacts blood pressure. One idea for further research could be looking into how the different types of yoga impact hypertension compared to one another. I knew there were a couple different types, but according to yogajournal.com, there are many different styles of yoga. There is Kundalini Yoga, restorative yoga, hot yoga, and power yoga, just to name a few. The different types have different focuses, such as spiritual, strength, flexibility, and relaxation. It would be interesting to research if one style over the others is better at lowering blood pressure.

  7. Caleb Thompson Says:

    Individually tailored at-home exercises could easily be less intimidating to most people who need to initiate life changes. However, I wonder what the long-term success of these programs would be? Did the study participants complete the yoga program because they were in a study? In real-life situations I wonder if patients would stick with an exercise/life change program that has no accountability?

  8. Morgan Says:

    I thought that this article was really great! I think that the main reason the exercises like yoga help to lower your blood pressure is because it is causing you to relax. Yoga is known to help with stress and anxiety, so it would make sense that the more relax that you are the lower your blood pressure may be. I think that a reason there were mixed reviews on whether yoga may have been effective may come from the fact that some of the studies the patients involved just replied whether they were doing what they were told to do or not, so there could be a hawthorne effect going on!

  9. Akwasi O Appiah Says:

    This is a great way to reduce high blood pressure.I love this idea and personally i always listen to my body and do what i feel right in spite of what i feel . I do not suffer from hypertension but i still think its a great idea.To get the best results, you would have to practice more to know which yoga exercise works better for you.How is Yoga different from stretching? and do i have to be flexible to do Yoga?

  10. Brandon Spears Says:

    I really found this article to be interesting in the fact that a form of exercise like yoga could have such a dramatic effect on blood pressure. The question I would have, Katie, is did any of your sources talk about possible mechanisms of action as to why yoga reduces blood pressure so effectively? For example, does it have to do with the actual exercises causing the blood pressure reduction, is it possibly the reduction in stress that effects blood pressure most, or is it a combination? I know from experience how much stress can increase blood pressure so I was curious as to whether the reduction in blood pressure has more to do with stress reduction or physical activity?

  11. Travis Mentch Says:

    People often get tired of hearing their health professionals tell them they need to change their diet and exercise habits. Therefore, I think it is important to explore things like yoga which is not a traditional type of exercise people usually think about. I believe it is important for people to find a physical activity that they enjoy, so the exercise doesn’t feel like work. I think people should at least give activities like yoga a try before ruling them out. Maybe it would be helpful to provide people with certain yoga positions they could do while at a desk instead of just sitting in a chair at work all day. This way, it does not take extra time out of their day. With the additional benefits of yoga mentioned in the comments above, I think this would be a great recommendation for people with high blood pressure to consider.

  12. Maame Debrah-Pinamang Says:

    I really enjoyed your article, as a person who enjoys the occassional yoga session. I enjoy yoga to relax in a way that is not too strenuous to me. Although I currently do not have high blood pressure, I find it interesting that high blood pressure medications in addition to yoga and regular exercise can provide beneficial results. Do you know if there have been studies done to study the effects of regular yoga exercise in preventing the onset of high blood pressure?

  13. Belinda Darkwah Says:

    This was a very intriguing article. It sometimes is very sad that the medical profession chooses to medicate first without trying other non-drug therapies. I went on a medical missions trip to Laos in high school and the doctor at the clinic I was helping at suggested to all his patients who suffered from hypertension to try meditation exercises like yoga. Since prescription hypertension medication therapy is limited in developing countries, health care providers in the mission field has to come up with creative non-drug therapies for their patients. This article reminded me of that experience. I think it is definitely something American health professionals should start recommending. Any sort of exercise can help manage hypertension, but yoga helps ease the mind and soul as well.

  14. Kofi Amoah Says:

    Kathrine, a very well done on this article! I admired your analysis of the article, stating its limitations. What were some of the strengths of the article? I wondered if the subjects/participants’ activity levels prior to the study were mentioned at all? If a person with a sedentary lifestyle starts to indulge in a any physical activity, that should be enough to have a positive effect overall health. Indeed, lifestyle modifications are very effective in the management of chronic diseases. Relaxation techniques are definitely the way to go, when hypertension is concerned.

  15. Ahlin-Joel M Sanvee Says:

    This is an interesting blog post. I believe that are so many non pharmacological approach or treatment of many diseases and yoga is definitively one. Unfortunately, many of us believe most of the time in using drugs to cure diseases.

  16. Elizabeth Aziz Says:

    Hello Katie! I really enjoyed your article. It was very fascinating that the control group continued their blood pressure medications. It was a great way to be able to compare medications vs. lifestyle changes. I have never tried yoga because I did previously think you had to be extremely athletic and in shape which I am not. This article has changed my mind in perhaps trying it out. I agree that there are some limitations to the studies like sample size. I also wonder if performing yoga actually caused the participants to change a few other things about their lifestyle. I know that when I work out, it also effects my eating habits. For instance, I will eat healthier when I workout. It would be interesting to see if practicing yoga effected other parts of their life! Great post!

  17. Ankit Pandav Says:

    Great job Katie!
    As I was growing up in India, every Saturday morning all of the students would have to conduct physical exercise, and the yoga was one of the exercises. However, I do have concerns regarding the yoga that we conduct here in the states versus in India. For example, when we say we are eating Chinese food from a local Chinese restaurant, that doesn’t really mean its truly authenticated Chinese food rather it is “americanized-chinese” food. In the same manner, I wonder if the yoga in the U.S. is americanized or modified to meet our needs? Also, If it is modified, will it have the affect as it did on the participant in India? The affects of yoga in American patients would be a great future study.

  18. Caleb S Tang Says:

    Tai-chi (China) is also a relaxing and stretching exercise rudiment similar to yoga (India). I wonder what the actual commonalities are between the two styles. For example, are there specific yoga exercises geared towards improving heart health? In Chinese culture at least, the body is mapped in a completely different way than what westerners understand. There are pressure points riddled all over the body. Acupuncture is one therapy that directly pushes the body’s buttons in order to fix a variety of bodily ailments. Is yoga and tai-chi touching on similar pressure points all over the body through non-invasive exercise to improve heart health?

  19. Insang Yang Says:

    Great article and interesting founding, because nowadays living healthy lifestyle is everyone’s interest. So I would like to see the further researches on this study. However, since Yoga is not intensive aerobic exercise, how does it help us to lower the blood pressure? If yoga is effective, and lowers the blood pressure then what is its advantage on other anaerobic exercises?

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