Yoga as Antihypertensive Lifestyle Therapy

 


 The 2017 American College of Cardiology and the American Heart Association (AHA) Guidelines redefined hypertension to a lower blood pressure threshold of 130 mm HG for systolic blood pressure (SBP) and 80 mm Hg for diastolic blood pressure (DBP).

 Considering these guidelines, 46 % of US adults now present with hypertension. The 2017 American College of Cardiology /AHA Guidelines highlight the importance of regular exercise for the management of hypertension along with the DASH diet.

 A meta-analysis published by Mayo Clinic Proceedings in March 2019 found that when yoga is practiced with breathing exercises ( pranayama) and meditation-relaxation techniques it is a viable antihypertensive lifestyle therapy that helps to reduce blood pressure (1).

 The study showed that the practice of yoga three times a week reduced systolic blood pressure by 11 mm Hg and 6 mm Hg in the case of diastolic pressure. These reductions of blood pressure equal or exceed the decrease reported by aerobic exercise. Therefore, we need more randomized controlled studies to investigate this benefit and to recommend yoga as part of the management of blood pressure.

The trials included in the meta-analysis published by the Mayo Clinic were considered eligible if the yoga classes integrated breathing, meditation-relaxation techniques and physical postures. Blood pressure had to be reported before and after the intervention for the yoga and control groups. The meta-analysis included 3517 adult participants; the studies had to include a non-exercise/non-diet control group. All the studies considered were published in peer-reviewed English language journals.

The purpose of the meta-analysis was to estimate the antihypertensive effects of yoga, so they emphasized the need to have a control group of participants that did not exercise to evaluate the efficacy of yoga as an intervention to reduce blood pressure. Forty-nine controlled yoga trials satisfied the criteria. The results indicated that yoga was an effective intervention.

Keeping blood pressure under control is of vital importance to protect the health of the brain, heart, eyes and kidneys.

 How can yoga help to keep blood pressure under control? First of all, the practice needs to be safe. Yoga has to include breathing exercises and meditation-relaxation to be effective. Even without the physical postures, meditation itself has been shown to help to lower blood pressure and calm anxiety in addition to providing other health benefits (2 and 3).

The practice of yoga is holistic, so there are multiple physiological responses that play a role in the way this discipline guides the body to become more resilient to stress. Research has shown that the practice of yoga is associated with an increase of BDNF (brain-derived neurotrophic factor), beta-endorphins and a reduction of cortisol levels (4). Yoga as a mind-body practice may have an effect on the hypothalamic-pituitary axis, the regulation of the expression of genes and the inflammatory response (5).

More research is needed to understand the ways yoga can be integrated into conventional medicine to optimize the management of medical conditions and to improve outcomes.



References:

1) https://pubmed.ncbi.nlm.nih.gov/30792067/

2) https://www.ahajournals.org/doi/10.1161/JAHA.117.002218

3) https://pubmed.ncbi.nlm.nih.gov/30425326/

4) https://www.sciencedaily.com/releases/2017/08/170822104855.htm

5) https://www.frontiersin.org/articles/10.3389/fpsyg.2020.02259/full

6) https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/aha-diet-and-lifestyle-recommendations




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