A three-month pilot study of patients with hypertension appearing in the Canadian Journal of Cardiology demonstrates that adding yoga to a regular exercise training regimen supports cardiovascular health and well-being and is more effective than stretching exercises. Incorporation of yoga reduced systolic blood pressure and resting heart rate and improved 10-year cardiovascular risk.

Yoga is part of spiritual and exercise practices for millions of people worldwide. With yoga practice becoming a widely accepted form of exercise, the body of yoga research is growing. It is a multifaceted lifestyle activity that can positively enhance cardiovascular health and well-being. Physical exercises such as stretching exercises and the physical components of yoga practices have several similarities, but also important differences.

"The aim of this pilot study was to determine whether the addition of yoga to a regular exercise training regimen reduces cardiovascular risk," explained lead investigator Paul Poirier, MD, Ph.D., Quebec Heart and Lung Institute—Laval University, and Faculty of Pharmacy, Laval University, Quebec, Canada.

"While there is some evidence that yoga interventions and exercise have equal and/or superior cardiovascular outcomes, there is considerable variability in yoga types, components, frequency, session length, duration, and intensity. We sought to apply a rigorous scientific approach to identify cardiovascular risk factors for which yoga is beneficial for at-risk patients and ways it could be applied in a healthcare setting such as a primary prevention program."

Investigators recruited 60 individuals with previously diagnosed high blood pressure and metabolic syndrome for an exercise training program. Over the 3-month intervention regimen, participants were divided into 2 groups, which performed 15 minutes of either structured yoga or stretching in addition to 30 minutes of aerobic exercise training 5 times weekly.

Blood pressure, anthropometry, high-sensitivity C-reactive protein (hs-CRP), glucose and lipids levels as well as the Framingham and Reynolds Risk Scores were measured. At baseline, there was no difference between groups in age, sex, smoking rates, body mass index (BMI), resting systolic and diastolic blood pressure, resting heart rate and pulse pressure.

After 3 months, there was a decrease in resting systolic and diastolic blood pressure, mean arterial blood pressure and heart rate in both groups. However, systolic blood pressure was reduced by 10 mmHg with yoga vs 4 mmHg with stretching. The yoga approach also reduced resting heart rate and 10-year cardiovascular risk assessed using Reynold's Risk score.

While yoga has been shown to benefit hypertensive patients, the exact mechanism underlying this positive effect is not fully understood. This pilot randomized study shows that its benefits cannot be simply attributed to stretching alone.

"This study provides evidence for an additional non-pharmacologic therapy option for cardiovascular risk reduction and blood pressure control in patients with high blood pressure, in the setting of a primary prevention exercise program," noted Dr. Poirier.

"As observed in several studies, we recommend that patients try to find exercise and stress relief for the management of hypertension and cardiovascular disease in whatever form they find most appealing. Our study shows that structured yoga practices can be a healthier addition to aerobic exercise than simply muscle stretching."