Table 3.
Yoga for hypertension: Precautions and contraindications
|
Yoga practice
|
Details of yoga practice
|
Precautions and contraindications
|
| Shatkriya (Yoga cleansing practices) | ||
| Shatkriya (Yoga cleansing practices) | Shankhaprakshalana (Alimentary tract cleansing); Agnisara Kriya (Activating the digestive fire); Vaman dhauti (Regurgitative cleansing); Vastra dhauti (Cloth cleansing); Nauli kriya (Abdominal massaging); Basti kriya (Yogic enema); Kapalbhati (Skull shining breath) | Contraindicated in hypertension[9]; Kapalbhati increases diastolic BP suggesting sympathetic stimulation[41]; Laghu shankhaprakshalana, the simplified and shorter version of shankhaprakshalana is suggested in mild to moderate hypertension[42] |
| Asana (Yoga postures) | ||
| Inversions and head below the heart postures | Shirshasana (Headstand pose); Sarvangasana (Shoulderstand pose); Chakrasana (Wheel pose); Halasana (Plough pose); Adhomukh shvanasana (Downward facing dog pose); Prasarit Padottanasana (Wide-Legged standing forward bend) | Cause a significant rise in both the systolic and diastolic arterial pressures; Contraindicated in hypertension[9,38]; Increase intrathoracic pressure and strain the cardiovascular system; Pooling of the blood in the head and neck region resulting in the rise of BP |
| Other asanas | Mayurasana (peacock pose); Dhanurasana (bow pose) | Compress the front of the diaphragm, which can raise the BP |
| Pranayama (Regulated breathing practices) | ||
| Pranayama pace | Fast breathing | Rapid breath practices may be unsafe in patients with hypertension and cardiovascular disease |
| Pranayama type | Bhastrika pranayama (Bellows breath) with rapid forceful inhalation and exhalation | Increases HR and BP, producing vasoconstriction[39] |
| Pranayama type | Surya bhedan/surya nadi pranayama (Right nostril breathing) | Sympathetic stimulating effect[39] |
| Pranayama technique | Kumbhaka (breath retention) | Significant increase in systolic, diastolic BP, and mean arterial pressure[40] due to combined effect of increased level of HR and total peripheral resistance during kumbhaka |
| Bandha (lock) | ||
| Bandha (lock); Practiced with breath retention | Mula Bandha (Root lock, pulling the perineum inward); Uddiyan Bandha (Abdominal lock, lifting of the diaphragm); Jalandhar Bandha (Chin Lock, pressing the chin on the chest and contracting the throat) | Long retention of breath strains the heart and is not recommended for hypertension[9]; If the jalandhar bandha is not performed properly, the BP is raised |
BP: Blood pressure; HR: Heart rate.