Manage Hypertension with Yoga
By John M. de Castro, Ph.D.
“brisk walking, reducing salt intake, and practicing yoga can each benefit people with high blood pressure.” – Markus MacGill
High Blood Pressure (Hypertension) is an insidious disease because there are no overt symptoms. The individual feels fine. But it can be deadly as more than 360,000 American deaths, roughly 1,000 deaths each day, had high blood pressure as a primary or contributing cause. In addition, hypertension markedly increases the risk heart attack, stroke, heart failure, and kidney disease. It is also a very common disorder with about 70 million American adults (29%) having high blood pressure and only about half (52%) of people with high blood pressure have their condition under control. Treatment frequently includes antihypertensive drugs. But these medications often have adverse side effects. So, patients feel lousy when taking the drugs, but fine when they’re not. So, compliance is a major issue with many patients not taking the drugs regularly or stopping entirely.
Obviously, there is a need for alternative to drug treatments for hypertension. Exercise has been shown to effectively reduce blood pressure. Also, mindfulness practices have been shown to aid in controlling hypertension. Yoga practice is both an exercise and a mindfulness practice that has been shown to reduce blood pressure. The research has been accumulating. So, it makes sense to summarize what has been learned regarding the conditions under which yoga practice is effective in reducing hypertension.
In today’s Research News article “Content, Structure, and Delivery Characteristics of Yoga Interventions for Managing Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8995771/ ) Nalbant and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled studies of the conditions under which yoga practice is effective in reducing hypertension. They identified 34 published randomized controlled trials.
They report that the published studies found that yoga practice was overall effective in lowering diastolic and systolic blood pressure in patients with hypertension. In comparing trials that produced significant improvement in hypertension to those that didn’t they report that the successful trials incorporated balance of postures, breathing practices, meditation and relaxation practices, occurring over 2 sessions per week, and were delivered in a formal setting under supervision.
This summary of published research supports the use of yoga practice in the treatment of hypertension and defines the components that need to be present to produce significant benefits.
“Yoga leaves a positive impact on your mind and body. It is an effective way to lower blood pressure. Here are some effective yoga asanas for hypertension.” – Varsha Vats
CMCS – Center for Mindfulness and Contemplative Studies
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Nalbant, G., Hassanein, Z. M., Lewis, S., & Chattopadhyay, K. (2022). Content, Structure, and Delivery Characteristics of Yoga Interventions for Managing Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in public health, 10, 846231. https://doi.org/10.3389/fpubh.2022.846231
This systematic review aimed to synthesize the content, structure, and delivery characteristics of effective yoga interventions used for managing hypertension and to compare these characteristics with ineffective interventions.
Design and Method
The JBI and the PRISMA guidelines were followed in this systematic review. RCTs conducted among hypertensive adults were included. RCTs reporting at least one of the major components of yoga (i.e., asana, pranayama, and dhyana and relaxation practices) and comparing them with no intervention or any intervention were eligible. Sixteen databases were searched for published and unpublished studies without any date and language restrictions till March 15, 2021.
The literature search yielded 13,130 records. 34 RCTs (evaluating 38 yoga interventions) met the inclusion criteria. Overall, included studies had low methodological quality mostly due to inadequate reporting. Yoga reduced SBP and DBP compared to a control intervention (MD −6.49 and −2.78; 95CI% −8.94– −4.04 and −4.11– −1.45, respectively). Eighteen, 14 and 20 interventions were effective in improving SBP, DBP, or either, respectively. 13 out of 20 effective interventions incorporated all the 3 major components of yoga and allocated similar durations to each component whereas ineffective interventions were more focused on the asana and duration of asana practice was longer. The most common duration and frequency of effective interventions were 45 min/session (in 5 interventions), 7 days/week (in 5 interventions), and 12 weeks (in 11 interventions) whereas the most common session frequency was 2 days a week (in 7 interventions) in ineffective interventions. Effective interventions were mostly center-based (in 15 interventions) and supervised (in 16 interventions) and this was similar with ineffective interventions.
Despite the low quality and heterogeneity of included studies, our findings suggest yoga interventions may effectively manage hypertension. The differences between the effective and ineffective interventions suggest that effective yoga interventions mostly incorporated asana, pranayama, and dhyana and relaxation practices and they had a balance between these three components and included regular practice. They were mostly delivered in a center and under supervision. Future studies should consider developing and evaluating an intervention for managing hypertension using the synthesized findings of the effective interventions in this review.