Yoga and high blood pressure

People with high blood pressure often wonder what alternative or complementary treatments beyond standard medications can help them manage their blood pressure. Yoga has raised the interest of both patients and scientists in this context.

In the USA and Europe, a bewildering number of yoga styles and techniques have developed over the years. Some are more body- focused, while others mainly involve meditation and breathing techniques. The impact of these on the yogi’s blood pressure can be quite different, so it is important to know what effect each technique has.

Older scientific studies seemed to show that only yoga exercises with a focus on medication and breathing techniques were beneficial, while the more body- centric techniques with a focus on posture were not helpful. Slow breathing, relaxation and meditation stimulated the parasympathetic nervous system, the adversary of the sympathetic nervous system which is activated in stress situations and drives blood pressure up.

But a carefully designed study in 2018 painted a much more complex picture. Comparing one group with exclusively breathing and medication techniques to a second group spending about half the exercise time on postures, and a third control group that did not practice yoga, the initial findings seemed to support existing knowledge. Participants of the meditation class had, from the onset, lower blood pressure than the control group, while posture class participants’ blood pressure was highest.

Over 12 weeks of weekly classes, this picture remained unchanged. Participants of the posture and control groups had higher blood pressure at the end of 12 weeks than in week 1, while the blood pressure of participants of the meditation class continuously dropped further.

After 12 weeks, the regular, weekly yoga classes ended, and it was left to the participants to put to practice what they had learned, on their own. Repeat blood pressure assessment four months later, however, showed a very different picture.

At week 28 after starting yoga classes, people practicing a combination of posture and meditation yoga showed a reduction of their systolic blood pressure by about 6 mm Hg compared to week 12-, and 3-mm Hg compared to week 1. By contrast, the purely meditation-based yogi now had higher average blood pressure values, and their BP was 3 mm higher than at week 12, or 1.5 mm Hg higher than in week 1. Both meditation groups had average BP values lower than the control groups, showing an overall positive benefit of yoga as a complementary treatment to standard hypertension management.

The authors felt that the reversal of benefits between the yoga groups was likely due to more people from the posture-oriented group continuing to practice yoga beyond the initial 12 weeks, and spending more time per week to practice compared to those continuing to do meditation.

The good news, though, is that yoga can thus be counted amongst the scientifically proven ways of blood pressure management, although it needs to be stressed that the effect is seen on top of medication, not instead of.

Reference for the scientifically minded:

Holger Cramer et al. Yoga in arterial hypertension. Dtsch Arztebl Int. 2018 Dec 14;115(50):833-839. doi: 10.3238/arztebl.2018.0833

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