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Yoga and The Heart
Yoga and The Heart
77]
Brief Review
Yoga and the heart
Rahul Mehrotra1, MD, DNB
From the 1Department of The concept of “Yoga” is currently gaining a lot of popularity worldwide owing to
Abstract
Cardiology, Medanta ‑ The its various health benefits and other advantages such as safety and ease of practice.
Medicity, Gurgaon, There is considerable evidence accumulating related to its benefits on health,
Haryana, India especially cardiovascular health. There is, however, a lot of confusion related to the
term “Yoga” in the various studies as it comprises several different practices. More
good quality studies are needed utilizing different components of “Yoga” investigating
their effects on cardiovascular disease. There is also a change in the understanding of
the role of the heart in the human body.
Received: July, 2016.
Accepted: August, 2016. Key Words: Cardiovascular health, heartfulness, meditation, spirituality, stress, Yoga
DOI: 10.4103/2250-3528.192697 How to cite this article: Mehrotra R. Yoga and the heart. J Clin Prev Cardiol
2016;5:138-42.
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and are routinely prescribed for this purpose. The and it also reduced craving, a major factor why
benefits may be by modulation of parasympathetic smokers are unable to quit.[11] In a meta‑analysis of ten
tone, baroreceptor sensitivity, and by reducing stress. studies of Yoga‑based interventions, it was concluded
In a systematic review of all published studies on Yoga that majority of interventions were able to enhance
and hypertension, which included 48 randomized quitting‑smoking‑rates in the study participants and
controlled trials and a total of over 6600 patients, that Yoga‑based interventions held promise as smoking
it was shown that Yoga effectively lowered BP in cessation tools.[12]
both normotensive and hypertensive populations.[7]
Apart from the above‑discussed studies related to
The role of meditation in reducing BP has also been
conventional and unconventional risk factors for CAD,
studied. Hughes et al. studied mindfulness‑based stress
there have been studies which have demonstrated
reduction (MBSR), a structured protocol of mantra and
regression of established atherosclerotic plaques. In
breathing‑focused meditation, in 56 male and female
a study involving around eighty patients of metabolic
patients with prehypertension. Patients randomized
syndrome, Yoga‑based intervention (including asanas,
to the MBSR arm exhibited a 4.8 mmHg reduction in
pranayama, and meditation) was compared to control
systolic blood pressure (SBP) and a 1.9 mmHg reduction
group. At the end of a year, there was a significant
in diastolic BP (DBP) compared to a 0.7 mmHg
improvement in the parameters of metabolic syndrome
reduction in SBP and an increase in DBP in the control
along with a reduction in carotid intima‑media
group.[8] BP lowering by Yoga is a safe adjunct to diet
thickness in the intervention arm as compared to the
and exercise which is free of any toxicity apart from
control arm.[13] In another prospective randomized
being inexpensive. However, it is still not clear which trial involving 42 patients with angiographically
component, asanas, pranayama, or meditation, has the proven CAD, it was shown that the intervention arm
maximal BP lowering effect or it is a combination of all undergoing Yoga had significantly less anginal episodes,
these that works. improved exercise capacity, greater lesion regression,
Lipid lowering by statins is currently the cornerstone and less lesion progression compared to the control
of CVD risk reduction. However, the considerable arm at the end of 1 year.[14]
debate is raging related to the side effects of statins Another area where meditation, asanas, and pranayama
on long‑term use, and the practice of yogic techniques can be integrated in CV health is during the period
to lower lipid levels is a safe alternative which is after a major CV event. Incorporation of these practices
being evaluated. In a small study, Cooper and Aygen in cardiac rehabilitation programs is likely to improve
compared 12 patients with hypercholesterolemia adherence and retention rates rather than relying solely
who regularly practiced meditation with 11 control on diet and exercise prescription based programs, where
participants who did not practice meditation and found the long‑term adherence rates have been quite poor.[15,16]
a significant 10% (P < 0.005) reduction in fasting serum
cholesterol levels in those who practiced meditation There is no straightforward mechanism which can be
during a 13‑month period.[9] This effect is probably used to explain all the beneficial effects of different
mediated through a reduction in adrenergic activity constituents of Yoga‑such as asanas, pranayama,
and effect on serum cortisol due to the relaxation effect and meditation. Figure 2 summarizes few proposed
of meditation. mechanisms of action of all these yogic practices based
on studies carried out so far. It is not a comprehensive
Elevated cortisol level is now being considered as an and complete list since new mechanisms are being
emerging risk factor for CAD. It has been shown that revealed as our understanding is improving and new
it is related to raised fasting glucose, cholesterol, and research is being undertaken.
prevalent CAD independent of other risk factors. There
are several reports of reduction in serum cortisol levels As discussed above, there is an evolving body of
and blunting of rise in the levels in response to stress evidence demonstrating the effectiveness of Yoga‑based
in people who meditate.[10] This may well be one of the interventions in various stages of CAD prevention.
mechanisms by which meditation benefits the bodily However, the long‑term impact of different types of
functions. meditations, asanas, and pranayamas and their relative
value need to be systematically studied in a large
Smoking is a major risk factor for CAD worldwide, and diverse population for more clarity on the issue.
which is primarily related to human behavior. The The major problem has been the small sample size in
practice of meditation being directly related to bringing studies, the heterogeneous nature of Yogic interventions
about positive behavioral changes encourages healthy studied, short duration of follow‑up, and paucity of
lifestyle choices and avoiding risky behaviors like quality data [Table 1].
smoking and substance abuse. Besides, it is a very
safe and cost‑effective means of helping people quit Yoga and the Role of Heart
smoking. In a randomized trial, brief training (for
“The heart has its reasons which reason doesn’t know”
2 weeks or 5 h total) in mindfulness meditation
resulted in as much as 60% reduction in smoking, ‑Blaise Pascal
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142 Journal of Clinical and Preventive Cardiology ¦ Oct-Dec 2016 ¦ Volume 5 ¦ Issue 4