Our bodies detect and react to changes in our blood pressure. If all is well, these natural responses are enough to keep our blood pressure within a normal healthy range. Sometimes our inbuilt functions are not enough, and our blood pressure creeps out of the normal range. It’s possible for people to have low blood pressure, which may cause symptoms like dizziness and fainting. Other people have high blood pressure, which often has no noticeable symptoms. Even though it might not cause obvious symptoms, untreated high blood pressure can lead to serious health conditions such as heart disease and stroke.
Reducing high blood pressure is vitally important to everyone’s current and future health, and yoga has been identified as an alternative treatment option that has positive long-term effects on regulating blood pressure. It’s important to seek individual medical advice on the best way to manage your blood pressure - yoga may be just one part of your overall blood pressure management plan.
How the Body Controls Blood Pressure
Blood pressure is supposed to be slightly variable – for example, it’s normally lower while you’re asleep and higher when you are active. It’s important these variations stay within a healthy range, so your body has strategies to control blood pressure.
In the walls of our blood vessels, and inside the heart, there are sensors called baroreceptors. These baroreceptors measure pressure, and the nervous system uses the information to make any adjustments needed to change the pressure. This might happen via changing the speed or force of the heartbeat, relaxing or contracting blood vessel walls, or altering kidney function to change fluid levels in the body.
This system works best if the baroreceptors are sensitive and responsive. When baroreceptors are more sensitive, they detect changes earlier, allowing the nervous system to react more quickly to keep blood pressure at a healthy level.
Research has confirmed that blood pressure control is improved by making the baroreceptors more sensitive, and that several yoga techniques are effective in sensitizing the baroreceptors. These effects are part of the physiology of yoga practice.
Breathing exercises and blood pressure
Slow deep breathing increases the sensitivity of the baroreceptors. A long, slow exhalation phase is particularly good for improving blood pressure control.
For this to be effective, the breathing exercises need to be suited to an individual’s ability and experience. Breathing too much can trigger dizziness and even fainting, while breathing too little will cause oxygen levels to drop and likely feel rather unsafe. Neither of those extremes will be useful in improving baroreceptor sensitivity, so always practice breathwork with techniques and timings that are reasonable for your body.
Inversions and blood pressure
Inversions - poses that involve turning the whole body or parts of it upside down - can increase the sensitivity and responsiveness of these baroreceptors. However, people with high blood pressure must approach inversions with care.
The positive effects of inversions can occur due to the change in the effects of gravity on blood flow. When gravity is reversed by an inverted posture, blood from the legs and lower torso flows easily to the heart, filling a heart chamber called the right atrium. Pressure sensors in this atrium detect a higher pressure as the atrium fills, and this results in the nervous system sending messages to slow the heart down. A slowed heart rate leads to lower blood pressure.
Some asanas can also stimulate the baroreceptors by directly applying external pressure on blood vessels. For example, Shoulderstand stimulates sensors in the major arteries that run through the front of your neck and deliver blood to the brain. During Shoulderstand, your chin presses deeply into your neck and upper chest, clamping down on the arteries and making the local pressure very high. When the sensors report this pressure, your nervous system thinks that the delicate tissues of the brain are under too much pressure from too much blood. The response is to lower the rate and force of your heartbeat, and to relax and expand blood vessels to reduce pressure.
The complication with practicing inversions is their potential to temporarily increase blood pressure. This may happen because the body is not capable of making the expected adjustments, even though the baroreceptors are detecting pressure. It may also happen because beginners often feel nervous and unbalanced when learning to practice an inversion. The stress and muscular tension involved in trying to hold the inversion activates a different part of the nervous system, and causes blood pressure to rise.
Because of the stress of learning to hold the pose, the benefits of inversions will only be felt if the pose can be held steadily, easily and comfortably for at least 30 seconds. For this reason, beginners should build up their inversion practice very slowly, and people who have high blood pressure should take advice from their physician before practicing inversions at all. Inverted postures often have modifications that can be used to make them safe for people with high blood pressure.
Exercise and blood pressure
Exercise is commonly recommended as a way to lower blood pressure. Research has shown that conventional exercise, performed moderately, will decrease blood pressure. Active yoga asana practices such as Vinyasa Yoga can therefore lower blood pressure because of the aerobic workout they provide. For these general health benefits, recommendations are to exercise at a moderate intensity for thirty minutes to an hour, most (but not all) days of the week.
Modifying Yoga for High Blood Pressure
The modifications that make asana safe for practice with high blood pressure typically involve keeping the head at or above the level of the heart. This allows blood to flow with little change in pressure or the effects of gravity, creating less stress for those with high blood pressure.
It will also be useful to practice poses in a low-stress manner. The Hatha Yoga practice of alternating resting poses with more demanding poses is recommended for blood pressure management.
Yoga practices directly aimed at stress relief are also highly recommended, as stress is recognized as a contributing factor in high blood pressure.
Inversion modifications for blood pressure
Legs up the Wall (Viparita Karani)
Many inversions, including Headstand and Shoulderstand, place the head below the heart. In order to keep the head level with the heart, you can practice a supine inversion such as Legs up the Wall. You will receive inversion benefits such as lymphatic drainage and improved return of blood from the lower body. Legs up the Wall also helps you relax and breathe deeply.
To come into Legs up the Wall (Viparita Karani):
- Begin seated side-on beside a wall.
- Position yourself so that your hip and shoulder lean against the wall.
- Gently lower your upper body down to the ground away from the wall.
- Lift the legs up against the wall.
- Wiggle closer toward the wall or away from the wall until you are in a comfortable, relaxed position.
Once in the pose, your head and arms are relaxed. You can use props such as a blanket or pillow for comfort. Focus on deep breathing and relaxation.
To come out of Legs up the Wall, bring your knees toward your chest and gently hug them in. Then gentle roll to one side. Remain there for a few breaths before sitting up.
Legs up the Wall (Viparita Karani)
Forward Bend (Salamba Paschimottanasana)
Supported Seated Forward Bend with chair
Forward Bend can be practiced in a supported position, so the head is more level with the heart. Suggestions for modifying Forward Bend include:
- Placing a cushion on your knees and resting your head on the cushion.
- Resting the arms, or the forehead and folded arms, on the back of a chair
Yogic Squat (Malasana) instead of Crow (Kakasana)
Instead of inverting into the balance pose of Crow, practice the Yogic Squat pose Malasana. This pose replicates many of the benefits of Crow, opening the hips and stretching the inner thighs. If you find it difficult to keep your heels on the mat in Malasana, a block or folded blanket underneath the heels will help.
Yogic Squat or Garland Pose (Malasana)
Upward-Facing Intense Stretch Pose (Urdhva Mukha Paschimottanasana) instead of Plough (Halasana)
In Plough Pose, much of the body is above the level of the heart. For a more blood pressure friendly practice, it can be replaced with Upward-Facing Intense Stretch Pose. In this pose your tailbone and lower back may curve up off the floor, but they don’t lift up as they would in Plough Pose.
Urdhva Mukha Paschimottanasana II
To come into the pose
- Lie on your back with feet together and hands beside you, palms pushing against the floor.
- Lift your legs off the floor and catch hold of your calves or ankles.
- Gently pull your knees or shins toward your nose, keeping your head, shoulders and middle back on the floor.
To make this pose more accessible, you can bend your knees or open your legs to hip-width apart. Hold the pose steadily as long as comfortable and breathe evenly.
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Easy Sun Salutation
There are many versions of Sun Salutations (Surya Namaskar), and for managing blood pressure the preferred version is the Easy Classical Surya Namaskara. When practiced slowly, with a focus on breath and clarity of mind, Sun Salutations are said to have a meditative effect. Practicing the easy series at a slow pace also helps improve blood pressure control.
Follow these steps to practice Easy Classical Surya Namaskara:
- Stand straight and tall with your shoulders relaxed and your feet shoulder-width apart. Let your arms relax next to your body.
- Breathe in and out, bringing your palms together in front of your chest.
- Breathe in and reach your arms up toward the ceiling. Keep your gaze straight forward, and your spine neutral.
- Breathe out, reaching forward and out, and bend your knees slightly to place your palms on the floor. Send you gaze between your knees, with the crown of your head reaching toward the floor.
- With your hands on the floor, breathe in and step your right leg backward and bring your right knee to the floor behind you. Look forward, keeping your shoulders back and down.
- Breathe out and bring your left knee to the floor behind you. Your knees are hip-width apart below your pelvis, and your hands are below your shoulders. Look toward the floor, with the back of your neck long.
- Breathe in, push your belly button toward the floor, raise your chin, and lift your tailbone.
- Breathe out and reverse the stretch, rounding your spine toward the ceiling. Release your head toward the floor, but avoid forcing your chin toward your chest.
- Breathe in and bring your right foot forward to the outside of your right hand. Gaze forward, with your shoulders relaxed down and the back of your neck long.
- Breathe out, keeping your hands where they are, and bring your left foot forward outside your left hand. Your knees are slightly bent. Gaze between your knees, with the crown of your head reaching toward the floor.
- Breathe in and reach your hands forward and up to the ceiling, standing tall. Gaze forward, with the back of your neck long. Allow your spine to stay in its natural curve.
- Breathe out, bringing your hands in front of your chest, palms together. This completes half a round. Repeat to the left (left leg stepping first back and forward) to complete one full round of Sun Salutation.
For more detailed instructions on Sun Salutations, read our guide to Surya Namaskar.
Blood Pressure Summary
Our bodies are equipped with special sensors and a range of internal responses to keep our blood pressure in a healthy range, but sometimes this control isn’t effective enough. We can help improve the efficiency of the system by using yoga to increase the sensitivity of the receptors, and to improve our general health and fitness. Yoga is also well known as a stress management practice, which further adds to its usefulness in managing blood pressure issues.
For some people, it may be best to avoid inversions as they can overwhelm the pressure management system instead of stimulating it, thereby causing an increase in blood pressure. This should be judged on an individual basis, preferably in communication with a health professional, as everyone’s body and health circumstances are unique.
