High blood pressure, or hypertension, is a condition that affects about one third of adults in the United States, although many may be unaware they have it. In early stages, when blood pressure skyrockets, it can cause general symptoms such as headaches, dizziness, fatigue, difficulty breathing and nausea, as well as change in mood or a sense of confusion.
Although these symptoms may seem innocuous, chronically high blood pressure presents a challenge to the heart and other elements of the circulatory system, and is a risk factor for heart disease, heart attacks, stroke and kidney failure.
There are many factors that influence blood pressure, from uncontrollable facts like age, gender and family history, to those which are more manageable, like diet, body weight, fitness, medication (including ibuprofen, birth control pills and nasal decongestants), and response to stress.
Blood pressure is considered above normal (or prehypertension) at 120/80, and it is considered very high above 160/100. When blood pressure consistently measures above normal, doctors typically recommend lifestyle changes like losing weight, reducing salt intake and exercise, although medication is generally prescribed to those in the very high range, especially if there is evidence of damage to the heart, kidneys or eyes.
How Yoga Helps
Yoga's general health benefits can help lower blood pressure: students practicing more vigorous forms of yoga (like our Flow or Kriya class) may experience weight loss and improved cardiovascular fitness, two factors which are known to reduce high blood pressure. However, stress reduction is considered the most beneficial element of a yoga practice for managing blood pressure.
Although few studies definitively link increased perception of stress to higher blood pressure, it has been shown that stress certainly influences general health, as well as lifestyle choices and habits (such as poor diet, smoking, excessive drinking and poor sleep quality) which can contribute to high blood pressure. The stress management techniques yoga provides can help students respond to stress more healthfully and minimize the factors which increase blood pressure.
One of the strengths of yoga is it's focus on svadhyaya, or self-study. Practitioners are encouraged to observe the responses of their body and mind to postures and breathing practices. This practice of observing and learning to recognize patterns could potentially help students be more aware of situations that trigger high blood pressure, or the physical sensations of their blood pressure increasing, and can make them aware of tools (especially the breath) to help them remain calm and peaceful.
Five Techniques for High Blood Pressure
Most beginner poses will be safe for students with mildly high blood pressure, and attending a regular weekly class should be safe for them as well. However, there are contraindications (noted below) for students with very high blood pressure, and a more calming class (such as Restore) or, even better, introductory private sessions with a knowledgeable yoga teacher are recommended.
Setu Bandha Sarvangasana
Practicing a restorative version of setu bandha sarvangasana (bridge pose) by moving into and out of the pose with the breath would be most beneficial to those who have high blood pressure or who are taking medication to manage their blood pressure. Keep in mind that this pose is a mild inversion, and students with very high blood pressure may not be able to hold the lifted position safely.
Supported Reclined Relaxation Pose
A wonderful supported position for practicing attentive breathing (pranayama), this pose helps the chest remain expansive and the body relaxed for even breathing. Students lean a bolster on a block (or two) to bring it to a 25-40 degree angle. You can place a folded blanket at the top of the bolster to rest the head on as needed. Then the student will bring their lower back the bottom edge of the bolster and lie back on the bolster. Placing another bolster or rolled blanket under the knees will help reduce lower back strain. Remain here breathing for 3-5 minutes. Beginning students should simply allow their breath to flow naturally. Over time, students may be able to hold the breath out for a couple of counts to relax further--but only if they experience no dizziness, anxiety, headache, fatigue or difficulty with getting a full breath.
Students should rest in a comfortable version of savasana for ten to twenty minutes at the end of practice. It can be especially soothing to use an eye pillow--both to rest the eyes and for the grounding pressure on the brow. Encourage students to breathe and simply observe their thought patterns and body experience without being engaged.
Students sit comfortably. Using their right thumb to close their right nostril, students will inhale and exhale through only their left nostril at a natural pace and depth for several minutes (perhaps beginning with three minutes and working up to eleven as their comfort and schedule allows).
Students sit comfortably with hands either resting on knees or front ankle. As they inhale, they arch the spine, letting the chest lift and shoulders fall back; with their exhale, they round their spine forward. Students are encouraged to allow their breath time to enter and leave fully as they move, and to continue with this breath for three to five minutes.
Regular (at least weekly) yoga practice has been shown to reduce blood pressure here, here and here; however, it appears that a short (15-minute) daily practice of breath-focused yoga exercises may be more effective for reducing hypertension and improving general quality of life than attending a once-weekly group class.
Although yoga poses have benefits for general health, the most effective practices for managing hypertension seem to be relaxing and supported postures such as savasana (corpse pose) and breathing with awareness.
As one might expect, slow breathing practices have been shown to reduce blood pressure more than fast breathing, but both techniques appear to have a positive affect.
Tips, Contraindications and Considerations
Students should be aware that, although most forms of exercise lower blood pressure in the long-term, they may experience increased blood pressure while beginning their practice, especially in more challenging standing poses, backward bending poses, inversions and arm balancing poses.
Research indicates that standing postures in particular increase blood pressure in both new and experienced students while they are being held. Strain in a yoga pose is likely to increase blood pressure, and students with high blood pressure are encouraged to begin gently, patiently and with sensitivity to any symptoms of building blood pressure (tingling, dizziness, etc.) so that they can release and rest as needed. Teachers can look for struggle with breathing, redness in the face or trembling to read whether students with high blood pressure may need to rest or modify a posture.
Full inversions are not recommended for students with very high blood pressure, as these students are already at risk for stroke, eye injury and heart dysfunction. Even half-inversions, such as adho mukha svanasana (downward dog pose), may need to be modified if the student feels increasing pressure or symptoms of high blood pressure. With gentle practice, and as blood pressure begins to lower, inversions will become more appropriate for the student.
What is High Blood Pressure? - National Institute of Health
Yoga and High Blood Pressure: Taming a Silent Killer - Dr. Timothy McCall
Yoga and High Blood Pressure: Do's and Don't's for Yoga Teachers - Dr. Timothy McCall