A Systematic Review of Yoga and Hypertension : Is yoga an effective antihypertensive therapy ?

Lifestyle modification is a cornerstone of hypertension treatment, yet most recommendations currently focus on diet and exercise and do not consider stress reduction strategies. Yoga is a spiritual path that may reduce blood pressure through reducing stress, increasing parasympathetic activation and altering baroreceptor sensitivity; however, despite existing reviews on yoga and cardiovascular disease, diabetes, metabolic syndrome and anxiety suggesting yoga may reduce blood pressure, no comprehensive review has focused on yoga and hypertension. A systematic review of all published studies on yoga and hypertension was performed revealing 39 cohort studies, 30 non-randomised controlled trials, 48 randomised controlled trials and 3 case reports with durations ranging from 1 week to 4 years and involving a total of 6693 subjects. Most studies reported that yoga effectively reduced blood pressure in both normotensive and hypertensive populations. These studies suggest that yoga could be an effective adjunct therapy for hypertension and worthy of inclusion in clinical guidelines, yet the great heterogeneity of yoga practices and the variable quality of the research makes it difficult to recommend any specific yoga practice for hypertension. Future research needs to focus on high quality clinical trials along with studies on the mechanisms of action of different yoga practices.