Tuesday, April 2, 2013

Are You Practicing the Right Kind of Yoga for Your High Blood Pressure?

High blood pressure is extremely common in older adults.
Many doctors now recommend yoga to treat stress-induced high blood pressure. That's great, right? Yes and no. Yoga is a great way to calm the body and mind, but not all styles are created equal, and neither are all poses. Consider that few doctors understand the range of yoga styles on offer today, that the yoga community provides contradictory guidance on the relationship between yoga and high blood pressure and that high blood pressure is the leading risk indicator for stroke and heart disease, and it becomes clear that it's wise to proceed with caution. If you (or one of your students) have high blood pressure, read on to learn what you need to consider before reaching up into that first sun salutation.

1) Understanding high blood pressure

High blood pressure (also known as hypertension) is a condition in which blood is forced through the arteries at a higher than normal pressure. It typically means two things: 1) the heart must work harder to circulate blood through the body 2) because the blood vessels are stiffened, weakened or otherwise damaged or abnormal. It often occurs in older adults and in individuals who make unhealthy lifestyle choices, like poor diet, alcohol consumption and smoking or who experience high levels of stress for extended periods of time. High blood pressure can be mild to severe. Mild cases are usually treated with lifestyle changes (exercise, healthy eating and stress reduction), but severe hypertension often requires medication to manage and reduce because if left untreated, it can lead to life-threatening medical conditions like heart attack, stroke and kidney failure.

Blood pressure in healthy individuals will increase naturally when the heart is above the head and when the breath is held during exertion. The same applies to individuals with mild (pre) and severe hypertension, except engaging in movements that increase blood pressure in these individuals comes with greater risk. The first step to evaluating and choosing a yoga style that's right for you is to understand how bad your high blood pressure really is and what's causing it.

2) Considerations and cautions for choosing your yoga

In order to choose the right yoga for your condition, it's important to understand how yoga impacts high blood pressure. One way yoga is thought to help lower blood pressure is by increasing the strength of the heart through aerobic exercise. According to the Mayo Clinic, "it takes aerobic activity to control high blood pressure." Unfortunately, the American Heart Association states that "yoga does not count towards physical activity requirements of 150 minutes of moderate intensity aerobic activity per week." So unless you are practicing a particularly vigorous style of vinyasa multiple times per week, you probably aren't going to be exercising your heart enough to lower your high blood pressure and need to keep jogging, biking or hitting the treadmill in order increase heart strength.

Another way yoga is believed to lower blood pressure is by reducing stress. Stress and high blood pressure have been found to have a causal relationship in the short term, in that stressful situations can cause an immediate spike in blood pressure. Breathing exercises, meditation and yoga have been proven to reduce stress and lower blood pressure in several studies and individuals with stress-related moderate or severe hypertension can certainly benefit from a regular, gentle yoga practice that focuses on uniting breath and movement in a meditative setting.

3) Contraindicated actions: Inversions & Breathing 

Yoga inversions and holding the breath during strenuous poses can adversely affect individuals with high blood pressure, by actually increasing it. Inversions fall into two general categories: 1) poses in which the heart is is higher than the head 2) poses in which the feet are higher than the head. There are countless articles and infographics lauding the "benefits" of inversions, but here, we'll take a look at the risks. What happens when the heart or feet are higher than the head is that gravity causes blood to rush to the head and neck. If an individual has severe high blood pressure, then it could mean that their blood vessels are extremely weak or damaged. Sending blood to the head suddenly could add stress to those already weak vessels, and in the worst case scenario, cause one to burst and lead to a stroke. 

As mentioned above, yogic breathing exercises can help reduce stress, and in turn, blood pressure. But holding your breath during exertion can cause dangerous spikes in blood pressure. Many yogis will say that if you can't perform deep, diaphragmatic breathing in a pose, then you're not ready to do it, but for practitioners with high blood pressure it's more than a guideline, it's a rule. 

Bottom line: Gentle yoga focused on stress reduction and relaxation can help lower your moderate or severe high blood pressure, but if you have severely high blood pressure use extra caution when performing more strenous poses. Make certain you can breath deeply in all poses and avoid inversions. 



Victoria McColm is a consultant, connector and entrepreneur with a passion for yoga - and making it safer. She founded Prevent Yoga Injury and serves as Editor. She is the author of The Contraindication Index for Yoga Asanas - an essential reference guide to injuries, ailments, and medical conditions that can be exacerbated by certain yoga postures.  
Victoria entered teacher training with a consultant's mindset and immediately saw gaps in available yoga resources, as well as disconnects in the yoga community and industry at large. A problem solver by nature, she set out to fill these gaps and facilitate a needed dialogue on the issues of yoga safety. Her vision is to build Prevent Yoga Injury into a one-stop-shop for reliable and pragmatic information on best practice, yoga safety, injury prevention and contraindications. She is a registered yoga teacher with 200 hours of training and is a member of the Yoga Alliance Standards Committee Advisory Group. Follow Victoria on Facebook and Twitter.


  1. I`ve noticed that holding breath causes spikes in my heart beating rate, I thought that`s just "how it`s supposed to be"...

  2. Is there any book or website has a topic or content on how to do Yoga properly, that you can suggest to us?

  3. Yoga  inversions and holding the breath during strenuous poses can adversely affect individuals with high blood pressure, by actually increasing it.Yogic breathing exercises can help reduce stress, and in turn, blood pressure.