Cardiac Health & Yoga

Cardiac health is a big part of primary care. Elevated blood pressures and elevated cholesterol, even diabetes all plays a role in heart health, as does obesity and even stress. Heart failure is sort of the end result of progressive heart health decline. I am often encouraging clients to take yoga, and there is great misconception as most think yoga is about flexibility, maybe it isn't for men, or maybe you have to be fit to do yoga, but yoga really is for everyone. It's about movement and as we age, we move in more routine ways, less in ways that challenge our bodies, and sometimes not much at all. We get tighter and tighter, often without even realizing it. Our muscles shorten and become weaker, including our heart.

Interestingly, if those with coronary artery disease practice yoga for a year, not only do they decrease their angina episodes, but they also improve their exercise capacity and lower their body weight (Sengupta, 2012). Yoga also lowers our cholesterol, all of it. Our total cholesterol is lowered, but specifically the bad cholesterol such as our LDL and triglycerides similar even to outcomes offered with statin drugs. Even our blood pressure is improved with regular yoga practice.

Revascularization procedures are required less often in those who practice yoga (Sengupta, 2012). And if angiographs are performed, if yoga is practiced through the next year, significantly more lesions regress in that time in those consistent in their practice. Yoga retards the progression of atherosclerosis even in those with severe coronary artery disease.

Obesity and elevated blood pressures are strong factors for ischemic heart disease, and yoga has been found particularly helpful in the management of obesity (Sengupta, 2012). Not only our weight, but our body density or body composition is improved each year we practice yoga (Bera & Rajapurkar, 1993). You don't have to be young or thin or fit or flexible to practice yoga. I went to my first yoga class in my mid-40s and became a yoga instructor when I was still working to regain my health. It's part of my daily commitment to myself, part of my own healing journey, and because I am so aware of its life-altering impact, both as a clinician and as a yoga practitioner, I offer yoga free to my clients every morning.

What's interesting about yoga, is that although there is mounting evidence on its benefits for health and wellbeing, this isn't explained by caloric expenditure, even lowered weight and better cholesterol levels (Sengupta, 2017). The practice of asanas does not always bring about increased, rapid large muscle activity and energy generation. However, the effects of yoga in the management of hyperlipidemia and obesity remain significant.

Not only does yoga assist in measurable benefits to one's heart health, but numerous studies have found yoga training for just 6 weeks can improve our sweating response and produce marked increases in our respiratory pressures and endurance, and if practiced for 12 weeks, our maximum expiratory pressure is improved, as well as inspiratory pressure, even our ability to hold our breath longer after expiration and inspiration (Sengupta, 2017). Hand grip strength is also improved.

Breath work or pranayama is an intentional aspect of yoga practice, and studies have found that just 6 weeks of pranayama breathing practice can improve our ventilatory functions, which is important for heart health (Sengupta, 2017). Not only is our respiratory rate improved, but our forced vital capacity, our forced expiratory volume, our maximum voluntary ventilation, peak expiratory flow rate, and our ability to hold our breath, each of which is important for optimal lung health. When we have surgery, these points are measured by our respiratory therapist and part of what creates post-surgical decline is our inability to effectively expand our lungs, especially with anesthesia on board. This is part of the challenge asthmatics face, and part of why pregnant women with asthma sometimes suffer higher risk pregnancies because they are so use to shallow breaths and aren't cognizant of decline respiratory health. Yoga can help mitigate some of this.

Respiratory muscles are like skeletal muscles. When we practice yoga, we create isometric contractions which is known to increase skeletal muscle strength. Breath holding time depends on that initial lung volume, so the more we can bring into our lungs, the less involuntary contractions of respiratory muscles are required, thereby lessening the discomfort we experience when we hold our breath (Sengupta, 2017). When we practice yoga, we are consistently being mindful of our breath, to some degree overriding the stimuli to our respiratory centers, thus acquiring some level of control over our respirations. This, along with improved cardio-respiratory performance, may explain the prolongation of breath holding time in those who practice yoga.

References

Bera, T. K. & Rajapurkar, M. V. (1993). Body composition, cardiovascular endurance and anaerobis power of yogic practitioner. Indian Journal of Physiol Pharmacol, 37, 225-228.

Sengupta, P. (2012). Health impacts of yoga and pranayama: a state-of-the-art review. International Journal of Preventive Medicine, 3(7), 444-458.