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Yoga & Heart Health - What is the Truth?

Dr. S.C. Manchanda*

                             
The word yoga comes from a Sanskrit word "Yug" meaning to join. It connotes the joining of the lower human nature to the higher. Yoga can simply be defined as mind body technique involving physical exercises (ASANAS), breath control (PRANAYAMAS) and concentration and thinking techniques (MEDITATION) which promotes physical, mental emotional and spiritual well being. Yoga is believed to help detoxify the body, mitigate chronic fatigue, enhance endurance and improve organ and immune functions (1). Beneficial effects of meditation have also been reported in allergies, asthma, anxiety, depression, acid-peptic disease, irritable bowel syndrome, migraine, diabetes; cardiovascular disease etc (2). Yoga appears to be especially beneficial in heart disease.

Yoga for control of risk factors of heart disease:
Modem life style stressors have been shown to be a major contributory factor to many diseases including heart disease. A U.S. study showed that mind fullness based stress reduction (MBSR) such as yoga reduced the average number of visits to primary care physicians in inner city areas suggesting that yoga may contribute to general health and particularly in cardiac health in populations that are subject to significant mental stress (3). Several other studies suggest that regular yoga practices can significantly improve coronary heart disease risk factors like body weight, lipid profile and blood pressure (4-6).


Yoga & Hypertension:
Several controlled and uncontrolled studies have shown the long term usefulness of yoga in the treatment of hypertension (1,7-9). Shavasana (Corpse posture) was shown to lower blood pressure in earlier studies (1). In a randomized trial, yoga was found to be equally effective as antihypertensive therapy over an 11 weeks period (9). Another randomized study demonstrated that yoga is capable of producing long term beneficial effect in the treatment of hypertension (7). The mechanism of yoga induced blood pressure reduction may be attributed to progressive attenuation of sympatho-adrenal and rennin-angiotensin activity with restoration of baroreceptor sensitivity (5,9). Yoga may also reduce left ventricular hypertrophy due to hypertension (10).


Yoga & Diabetes Mellitus:

Yoga has been shown to be simple and economical therapeutic modality as an adjuvant for NIDDM patients. In a group of diabetics who practiced yoga regularly, there was significant reduction of hyperglycemia and decrease in oral hypoglycemics to maintain adequate blood sugar control (11).

Regression of coronary artery disease:
Three controlled studies (12-14) utilizing coronary angiography have demonstrated that yoga practices with low fat vegetarian diet caused significant regression of coronary obstructions in comparison to the usual care control group. In addition, the need for interventional procedures was significantly reduced. LDL cholesterol, triglycerides, body weight, angina and exercise induced ischaemia were significantly reduced in the yoga groups. All three studies reported excellent compliance of yoga practices with no side effects.


Yoga for cardiac rehabilitation:
Yoga has been shown to be beneficial in recovery process after myocardial infarction. It has contributed to general well being, decreased physiological arousal, better sleep and appetite (15). The functional capacity of patients could also improve in post myocardial infarction patient rehabilitation process. Subjects who practiced PRANAYAMAS (controlled yogic breathing) achieved higher work rates and reduced oxygen consumption per unit work without an increase in blood lactate levels (4,16).
The quality of life as measured by Well Being Inventory (SUBI) has also shown to be improved in post infarction patients (17). Yoga practice has also been found to be useful in preventing adverse outcomes of coronary disease by improving resistance to stress (18).


Conclusions:
Yoga is a mind body holistic life style intervention which has been demonstrated in several studies to be extremely beneficial for primary and secondary prevention of coronary heart disease. Though most of the studies are small and large trials are needed to confirm the findings, yet in view of the existing evidence, it appears that the yoga should be incorporated in the primary and secondary prevention of cardiovascular disease and that it can play a primary or a complimentary role in this regard (19).


References:

  1. Raub JA: Psychophysiologic effects of hatha yoga on musculoskeletal cardiopulmonary function, a literature review. J. Altern Complement. Med 8:797,2003.
  2. Meditation Practices for Health: State of the Research (2007), prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. www.ahrq.gov.
  3. Roth B, Stanley TW. Mindfulness-based stress reduction and healthcare utilisation in the inner city: preliminary findings. Alter Therapies Health Med 2002; 8:6066.
  4. Bera TK, Rajapurkar MY. Body composition, cardiovascular endurance and anaerobis power of yogic practitioner. Indian J Physiol Pharmacol 1993; 37:225228.
  5. Schmidt T, Wijga A, Yon Zur Muhlen A, Brabant G, Wagner TO F. Changes in Cardiovascular risk factors and hormones during a comprehensive residential three month kriya yoga training and vegetarian nutrition. Acta Phys Scand Suppl 1997; 161:158162.
  6. Mahajan AS, Reddy KS, Sachdeva U. Lipid profiles of coronary risk subjects following yogic lifestyle intervention.  Indian Reart J 1999; 51:3740.
  7. Patel C. Twelve month follow up of yoga and biofeedback in the management of hypertension. Lancet 1.62,1975.
  8. Marugesan R, Govindarajulu N, Bera TK et. al. Effort of selected yoga practices on the management of hypertension Indian J Physiol Pharmacol 44:207 :2000.
  9. Selvamurthy W Sridharan K, Ray US. A new physiological approach to control essential hypertension Indian J. Physiol PharmacoI42:205,1999.
  10. Konar D, Latha R, Bjuvanesvaran JS. Cardiovascular response to headdown- body-up postural exercise (Sarvangasana). Indian J Physiol Pharmacol 2000; 44:392400.
  11. Jain SC, Uppal A, Bhatnagar SO, Talukdar B. A study of response pattern of non-insulin dependent diabetics to yoga therapy. Diabetes Res Clin Practice Suppl. 1993; 19: 6974.
  12. Ornish D, Scherwitz LW, Billings JH et.al. Can lifestyle change reverse coronary heart disease? The life style heart trial Lancet 336. 129, 1990.
  13. Manchanda SC, Narang R, Reddy KS et. al. Retardation of coronary atherosclerosis with yoga life style intervention. J. Assoc. Physc, India 48:687,2000.
  14. Gupta S, Selvamurthy W, Arora R et.al. Reversal of coronary heart disease by Rajyoga. Vegetarianism and exercise. World Conference on Clinical Cardiology and Preventive Cardiology, Mount Abu, India, September, 2006.
  15. Telles S, Naveen KY. Yoga for rehabilitation: An overview. Indian J Med Sciences 1997; 51: 123127.
  16. Raju PS, Madhavi S, Prasad KV, Reddy MY, Reddy ME, Sahay BK, Murthy KJ. Comparison of effects of yoga and physical exercise in athletes. Indian J Med Res 1994; 100:8186.
  17. Malathi A, Damodaran A, Shah N, Patil N, Maratha S. Effect of yogic practices on subjective well being. Indian J Physiol Pharmacol 2000; 44:202206.
  18. Pandya DP, Vyas VH, Vyas SR. Mind body therapy in the management and prevention of coronary disease. Comprehensive Therapy 1999; 25:283293.
  19. La Forge R. Mindbody fitness: Encouraging prospects for primary and secondary prevention. J Cardiovasc Nursing 1997; 11: 5365.

Courtesy:  Proceedings of the CME on Health Challenges and Opportunities in the New Millennium (SOBSICON-2012) held at HIHT, Dehradun during January 27-29, 2012.

 


* Dr. S.C. Manchanda is a Senior Consultant in the Department of Cardiology at Sir Ganga Ram Hospital, New Delhi. He has a vast experience of 40 years in teaching, research and treating patients. He has over 400 scientific papers in various National and International Medical Journals including 50 chapters in Standard Medical Books. He is also a recipient of several National & International Awards including PADAMSHRI by President of India.
  
e-mail: doctormanchanda@yahoo.com