Yoga for Hypertension - A Case Study

Mr. Chetankumar B Dandade and Ms. Sujata Deshmukh
Arogyadham, MGIMS Campus, Sevagram

Abstract:
Essential Hypertension leads to permanent harmful changes in blood flow to many organs and also places a burden on the Left Ventricle. Usually, these patients are treated with drugs (1,2). The effect of Yoga and Meditation (Vajrasana, Sukhasana, Shavasana, Pranayama, “Om” Meditation and Yoganidra) on blood pressure has been studied to explore the possibility of reducing the drug dosage and thus eliminating harmful side effects (1,4,6). The objective of this study is to evaluate the effect of yoga therapy (IAYT practices) and meditation on mild to moderate essential hypertensive patient. In this study one patient with hypertensive history was given IAYT (Integrated approach of yoga therapy) practices, Yoganidra and Om Meditation for 60 min daily in the morning and evening along with antihypertensive drugs (3,5,7). Different parameters were recorded at the beginning and again at the end of 1 week. Comparatively decrease in pulse rate, BP and weight were observed after IAYT practices. Result showed beneficial effect of IAYT (3).
Case Report
History of present illness: Mr. G P K is a 72 year old male (height is 162 cm. and his weight is 73 kg.) who came to Arogyadham (Sevagram) for an indoor 7-day yoga therapy treatment for hypertension. He had history of breathlessness, Giddiness and Pain in the neck, low back and knees.
Physical examination: His Physical (General) examination revealed pulse 76 beats/minute; Blood Pressure 178/96 mm Hg; respiratory rate 18 breath/minute; breathe holding time 9 seconds/minute; he had hypertension for 2 years and was on medication. His cardiovascular examination revealed that he did not have raised JVP (jugular venous pressure) and pedal oedema.
The management of hypertension at all the five levels of the Panch kosha
The practice of yoga includes physical postures and exercises, regulation of breathing, deep relaxation, meditation and yoga lifestyle modification (1,2). The techniques are capable of enhancing both physical and mental health. The psychopathological development of yoga practice is the basis of therapeutic effect (3). So, the improvement on disease process through yogic practice can be described as its positive effects (8,4).

IAYT practices followed for Hypertension
1 Sukshma vyayama (Loosing exercises)  Total 15 min
Head and neck movements, Complete hand exercises, Shoulder exercises,  Spinal twist and stretch ,  Hip rotation,  Knee rotation,   Ankle movements , QRT (Quick Relaxation Technique)         
2 Asanas (Physical postures) One min each; Total (9 min)
Ardha chakrasana,  Vajarasana ,  Vakrasana ,  Setubandasana,  Sarvangasana,  Bhujangasana,  Shalabhasana,  Makarasana,  Shashankasana. 
3 Breathing techniques (Pranayamas)
Hands in and out breathing (10 rounds/2 min), Hands stretch breathing (10 rounds/2 min), Tiger stretch breathing (10 rounds/2 min), Left nostril breathing (27 rounds/2 min) (Chandra Anuloma Viloma), Alternate nostril breathing (12 rounds/2 min) (Nadisuddhi), Humming bee breath (Bhramari) (2 min). 
4 Guided relaxation
YogaNidra (10 minutes at the end of Asanas and Pranayamas)
5 Meditations
Om Meditation (15 min Twice a day)

Measurements:  The effect of yoga therapy was studied using the following parameters:


Variable

Before yoga (BY)

After yoga (AY)

% change

Pulse (Beats/min)

76

68

11.76

Respiratory Rate (breath /min)

18

12

50

Sys. Blood Pressure (mm Hg)

178

152

17.10

Dia. Blood Pressure (mm Hg)

96

80

20

Breath Holding Time (Sec)

9

13

-30.76

Weight (Kg)

78.08

76.05

2.66

 

 

 

 

Conclusion:

Data analysis was done and the results showed decrease in heart rate, systolic and diastolic B.P. and other parameters also. Thus it can be concluded that yoga technique can be used as adjunctive treatment with drug therapy on mild and moderate hypertensives. Yoganidra, a kind of meditation and muscle relaxation technique can be used to treat mild hypertensives before beginning of drug therapy. It can be practiced as one of lifestyle modification therapy in pre hypertensive and those with strong family history.

References:

  1. Deepa T, Gowri Sethu, N Thirrunavukkarasu. Effect of yoga and meditation on mild to moderate, Essential Hypertensives. J of Clinical & Diagnostic Res. 2012 February; 6(1): 21-26.
  2. Marshall Hagins, Rebecca States, Terry Selfe and Kim Innes. Effectiveness of yoga for Hypertension: Systematic review and Meta analysis. Evid Based Complement Alternat Med. 2013;2013:649836.
  3. Anupama Tyagi, Mark Cohen. Yoga and Hypertension systematic review. Alternative Therapies. 2014 Mar/Apr;20(2):32-59.
  4. Jayashree Sen. Yoga: A Therapeutic Adjuvant. Ind J of Clinical Practice. 2013 July;24(2):118-121.
  5. Kimberly Blom, et al. Hypertension Analysis of stress Reduction using Mindfulness meditati on and Yoga (The HARMONY Study): study protocol of a randomised control trial. BMJ Open 2012;2:e000848. 
  6. Moa Wolff, Kristina Sundquist, Sara Larsson Lönn and Patrik Midlöv. Impact of yoga on blood pressure and quality of life in patients with hypertension – a controlled trial in primary care, matched for systolic blood pressure. BMC Cardiovascular Disorders. 2013;13:111.
  7. Subhash Chandra Manchada, Kaushal Madan. Yoga and hypertension. Hypertension Journal. 2015 Jul-Sep;1(1):28-33.
  8. Murugsan R, Govindarajulu N, Bera TK. Effect of selected yogic practices on the management of hypertension. Indian J physiol pharmacol. 2000;44(2):207-210.

Source: Sevamed - October 2016

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