Physical Activity and Yoga in Non-Pharmacological Management of Hypertension

Several studies (large epidemiological studies) have shown that increased physical activity causes lowering of blood pressure (BP). The relationship between physical activity and BP is inverse, i.e., whenever there is increased in physical activity, BP tend to be lower and when there is less physical activity, BP tend to be higher, in same individual as well as for a group of individuals.ID-100261340

Physical activity and blood pressure:

In one meta-analysis (1) study it was reported that, regular aerobic exercise was associated with significant lowering of mean systolic blood pressure by 3.84 mm Hg and lowering of mean diastolic BP by 2.58 mm Hg and the reduction was seen among both individuals with high blood pressure as well as individuals with normal BP and individuals with normal body weight as well as in individuals with obesity or overweight.

In another meta-analysis (2), there was significant reduction of blood pressure (lowering of mean systolic blood pressure by 6.9 mm Hg and lowering of mean diastolic BP by 4.9 mm Hg) during daytime and in ambulatory position among hypertensive individuals in compare to other groups such as normal blood pressure group.

The causes of lowering of blood pressure was associated with decrease in the following factors such as systemic vascular resistance, plasma norepinephrine, plasma rennin activity, body weight, waist size, per cent body fat and insulin resistance.

Hence, it can be clearly said that increased physical activity is associated with reduction in blood pressure and should be part of holistic management of hypertension. In most hypertension management guidelines moderate physical activity (such as brisk walking or jogging or playing sports/games such as tennis, football, basketball, badminton etc.) for 30 minutes a day for at least five days a week is suggested. It is better if 30 minutes exercise can be continues for all seven days a week.

Yoga and stress management and hypertension:

Most experts agree that yoga and stress management is important in management of hypertension. Several studies have shown the beneficial effect of yoga in reducing BP and cardiovascular risk factors associated with hypertension. However, there is controversy regarding the usefulness of yoga and meditation and other relaxation techniques in management of hypertension. For example, a study in UK by Patel et al (3), has shown that there is significant long term benefit of reducing risk of coronary heart disease by yoga and other relaxation techniques. However, a study in Netherlands (4) has failed to show any significant benefits of various meditation and relaxation techniques in management of hypertension. Hence, yoga and stress management is not recommended by many nations in management of hypertension, due to lack of doubtless evidence.

References:

  1. Whelton SP, Chin A, Xin X, He J. Effects of aerobic exercise on blood pressure: A meta-analysis of randomized control trials. Ann Intern Med 2002; 136:493-503.
  2. Fagard RH, Cornelissen VA. Effects of exercise on blood pressure control in hypertensive patients. Eur J of Cardiovascular Prev Rehab 2007; 14:12-7
  3. Patel C, Marmot MG, Terry DJ, Carruthers M, Hunt B, Patel 56. M. Trial of relaxation in reducing coronary risk: four year follow up. Br Med J (Clin Res Ed) 1985; 290 : 1103-6.
  4. Van Montfrans GA, Karemaker JM, Wieling W, Dunning AJ. Relaxation therapy and continuous ambulatory blood pressure in mild hypertension: a controlled study. BMJ 1990; 300 : 1368-72.

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