Yoga Therapy for Heart Health: What Does the Evidence Tell Us?
Most of us live with our hearts without paying much attention to them – until something happens. We may also think of heart disease as something that belongs to older age. Yet changes to our blood vessels can be present long before we feel any symptoms.
In the PESA study, researchers examined more than 4,000 people aged 40 to 54 who had no symptoms of cardiovascular disease. They found signs of early atherosclerosis – a build-up of fatty deposits in the arteries – in 63% of participants. Even among those classified as having a low risk of a future heart problem, 58% had detectable changes. This does not mean that all these people would go on to have a heart attack. But itt does remind us that heart health deserves our attention before a diagnosis.
There are also reasons to pay attention to younger adults. Research reported by the American College of Cardiology found that, among people admitted to hospital with heart attacks, the proportion aged under 40 rose during the years studied. We should be careful about applying that finding to everyone, but we should not assume that youth offers complete protection.
This is one of the questions behind our short course, Yoga Therapy for Healthy Hearts. How can we begin supporting our own heart health, and that of others, using the tools Yoga Therapy offers us?
The evidence gives us good reasons to consider both movement and stress reduction. Our work is to turn that understanding into a thoughtful practice for the person in front of us.
First, I ask how much someone sits
When I work with a client, I ask about their job and how much of the day they spend sitting. It tells me something important about the movement they may be missing. If someone has sat at a desk all day, why would I automatically give them a 90-minute practice that keeps them sitting?
Long periods of sedentary time are associated with poorer cardiovascular and metabolic health, even in people who also exercise. That does not make sitting inherently harmful, or mean that one yoga class can undo every hour spent at a desk. It does make me think carefully about what the person needs from our time together. Where their health and circumstances allow, I often favour a more active practice: standing, moving, strengthening and regularly changing position.
The feet, ankles and legs are a useful place to begin. Simple movements there can bring someone out of a long-held position and help them reconnect with parts of the body that have barely moved during the day. I also pay attention to how long we hold seated postures, particularly those that fold or compress the legs. This is a question of duration and suitability for the individual, rather than a rule against sitting.
What about meditation?
Movement is only one part of this picture. Stress reduction matters too, and there is research worth examining – with care.
A 2012 trial followed 201 Black men and women who already had coronary heart disease. Those assigned to a Transcendental Meditation programme had fewer events in a combined measure of death, heart attack and stroke than those assigned to health education. It is an interesting result, but it came from a relatively small study of a specific population and one particular form of meditation. It cannot tell us that meditation alone prevents heart attacks, or that every meditation practice will have the same effect. A later evidence review judged the findings on cardiovascular events to be uncertain.
One study I always return to when teaching about cardiovascular health is Dr Dean Ornish’s Lifestyle Heart Trial. His programme brought together changes to diet, moderate exercise, stress management – including yoga and meditation – and social support. After a year, the group following the programme showed some regression of coronary artery narrowing, while the usual-care group showed progression. Follow-up research examined whether those changes could be sustained.
What interests me here is the combination. We cannot separate yoga from the other parts of the programme and claim it produced the result by itself. But yoga and meditation had a place within a wider approach to heart health. That feels closer to how I understand Yoga Therapy: looking at the person’s movement, stress, habits and circumstances, then finding practices they can realistically use.
Choosing the right practice for the person
A heart-focused yoga practice does not have to be vigorous. Nor does it have to consist mainly of sitting or lying down. I might include gentle standing movements, work through the feet and legs, and find a comfortable, supported position for meditation. Rest can still be part of the practice; I simply consider when it is useful and how to make it comfortable.
I am particularly careful with inversions and with practices that put strain on the head, neck, chest or breath. Someone living with cardiovascular disease or high blood pressure needs an individual assessment, and their medical advice should guide what is appropriate. I would not make a blanket assumption that a posture is safe simply because it is familiar in a yoga class.
That is the foundation of Yoga Therapy for heart health as I see it. The evidence gives us good reasons to consider both movement and stress reduction. Our work is to turn that understanding into a thoughtful practice for the person in front of us.