Harvard Heart Letter

Yoga's health advantages may extend to the heart

New research suggests yoga may be as good as moderate exercise for lowering heart disease risk.

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With its focus on body, mind, and breath, yoga shows promise for improving heart health.

Yoga's surge in popularity has spurred a parallel rise in research on this ancient practice. About 21 million people in the United States practice yoga, according to a recent survey. Enthusiasts cite more flexibility and less stress as key benefits from a regular practice. Now, a review of 37 studies finds that yoga may also help lower the risk of heart disease—perhaps even as much as conventional exercise such as brisk walking.

"Yoga is unique because it incorporates physical activity, breathing, and meditation," says Dr. Gloria Yeh, an associate professor of medicine at Harvard Medical School and co-author of the new report. Each of those separate elements has positive effects on cardiovascular risk factors. "But yoga incorporates all three into an activity that's both enjoyable and accessible," says Dr. Yeh.

Lowered LDL and more

In her review, people who took yoga classes saw improvements in a number of factors that affect heart disease risk. On average, they lost 5 pounds, shaved 5 points off their blood pressure, and cut 12 points from their harmful LDL cholesterol. The review appeared in the Dec. 16, 2014, issue of the European Journal of Preventive Cardiology.

The studies in the review were diverse both in terms of the participants (who ranged from young, healthy people to older people with health conditions) and the types of yoga, which included gentler as well as more energetic forms. Many forms of yoga are less strenuous than other types of exercise, says Dr. Yeh. Plus, she adds, "It's easy to modify, which makes it perfect for folks who might otherwise be scared off by the thought of exercise."

Yoga: Choosing a type and a teacher

The myriad forms of yoga weave together three interconnected threads: physical postures called "asanas," controlled breathing, and relaxation and meditation to calm the mind. Many teachers incorporate a blend of different yoga styles.

If you're new to yoga, seek out a beginner or "gentle" class, especially if you're over 65 or have any medical conditions. Two of the most popular forms taught in America, Hatha and Iyengar, are good choices for beginners. Hatha yoga features gentle, slow, smooth movement, with a focus on integrating your breathing with the movements. Iyengar is similar but places more emphasis on body alignment and balance and uses props such as straps, blankets, and blocks. Another option is chair yoga, a gentle form of yoga practiced sitting in a chair or standing using a chair for support.

You can find classes at dedicated yoga studios as well as at health clubs, community or senior centers, or even hospitals. Costs range from about $15 to $20 per class.

Finding an experienced, trained teacher who understands your needs is important. The National Center for Complementary and Integrative Health offers tips on choosing practitioners at nccih.nih.gov/health/tips/selecting.

Potential benefits

Performing the varied postures during a yoga session gently stretches and exercises muscles, which is good for your heart and blood vessels. Activity also helps muscles become more sensitive to insulin, which is important for controlling blood sugar. The deep-breathing exercises may help lower blood pressure. And the mind-calming meditation, which quiets the nervous system and eases stress, also may help people with heart disease.

In addition, studies find that yoga helps enhance cardiac rehabilitation, which doctors recommend for people recovering from a heart attack or cardiac surgery. A program at Harvard-affiliated Massachusetts General Hospital, for example, integrates yoga into cardiovascular fitness rehab, says Christie Kuo, a nurse who teaches the classes. Some of the poses are modified to accommodate balance issues, which can be an issue for people who take certain blood pressure medications that may leave them a little light-headed.

The muscle stretching is a good way to cool down after the aerobic conditioning, but the breathing and meditation help as well, says Kuo. "Paying attention to your breathing is important during the strength-training part of rehab. And the mindfulness and greater awareness from the meditation can help you cope with stress of your illness, eat more healthfully, and sleep more soundly, all of which help your recovery," she says.