Yoga, an ancient Indian practice once viewed as only for the very fit and flexible, has become as American an activity as jogging and aerobics. Its newfound popularity could be a boon for people with high blood pressure, heart failure, and other forms of cardiovascular disease.
A small but promising body of research suggests that yoga's combination of stretching, gentle activity, breathing, and mindfulness may have special benefits for people with cardiovascular disease.
Yoga and the heart
The word "yoga" comes from a Sanskrit term that means union. It aims to join body, mind, and the day-to-day challenges of life into a unified experience rather than keep them separate. There are different forms of yoga, from the gentle, peaceful hatha yoga to the active "power" form called ashtanga. We focus here on hatha yoga because it is a good starting point.
Hatha yoga's path to balancing the mind and the body involves three interconnected threads: physical postures called "asanas," controlled breathing, and calming the mind through relaxation and meditation. The three work together.
How could this improve cardiovascular health? Getting into the various postures during a yoga session gently exercises the muscles. Anything that works your muscles 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 help slow the breathing rate. Taking fewer but deeper breaths each minute temporarily lowers blood pressure and calms the sympathetic nervous system, which is responsible for generating stress hormones. The postures and deep breathing offer a kind of physical meditation that focuses and clears the mind. Meditation and the mindfulness of yoga have both been shown to help people with cardiovascular disease.
The words "may," "might," "can," and "could" are liberally scattered throughout this article. That's because research into the connection between yoga and cardiovascular disease is still in its scientific infancy. Several dozen studies have explored the possible benefits of yoga for people with heart disease, but these trials are mostly small or lack the scientific rigor needed to show cause and effect. This body of work suggests that yoga may
- reduce high blood pressure
- improve symptoms of heart failure
- ease palpitations
- enhance cardiac rehabilitation
- lower cardiovascular risk factors such as cholesterol levels, blood sugar, and stress hormones
- improve balance, reduce falls, ease arthritis, and improve breathing for people with chronic obstructive pulmonary disease.
Several randomized controlled trials under way should help pin down what yoga can — and can't — do for people with cardiovascular disease. Even if all of the trials provide unequivocal support for yoga, keep in mind that it won't offer magical protection against heart disease or a cure for it. Instead, yoga could be a useful method for coping with cardiovascular disease.
Beginning yoga can be a challenge. Attending a general yoga class populated by fit 30-somethings who expect a good workout can be a disheartening introduction.
If you are a few gray hairs beyond 30, look for a yoga class that includes the full package — poses, breathing, and meditation — rather than one that offers just exercise with a yoga bent to it.
People with heart disease often have other health concerns, like arthritis or osteoporosis, that limit their flexibility. A good yoga instructor creates a safe environment for his or her students and helps them modify poses to meet their abilities and limitations.
Creatine for muscle strength
Q. I'm 70 and exercise 30 minutes a day. I've heard that creatine supplements might help build muscle strength. Is there anything to it?
A. Creatine is a natural substance, largely found in muscle, that's sold as a supplement. There's some evidence that it can help young athletes build muscle mass and improve athletic performance that requires short bursts of muscle activity, such as sprinting. For that reason, it is banned by some, but not by all, sports organizations.
However, there is little evidence that it can build muscle bulk or strength in older adults like you. Some small studies have suggested that it might be helpful for those with a few diseases that afflict older people, such as heart failure and Parkinson's disease.
In my judgment, there is currently no convincing evidence of adverse effects from doses that the manufacturers recommend, which are typically 2 to 3 grams per day. However, there are very few studies of sufficient size and duration to be confident about this. Note also that the FDA does not regulate the manufacturing of supplements as it does prescription drugs. So even if the creatine itself is fine, the other substances used to create a tablet or capsule could contain impurities.
I think there's little, if any, evidence that creatine supplements could help you build or maintain muscle strength at your age, and, because of the lack of regulation of supplements, there is some potential for harm. I wish there were more solid information, but there isn't. For now, to be on the safe side, I'd advise against taking creatine.
— Anthony L. Komaroff, M.D.
Editor in Chief, Harvard Health Letter
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