Yoga: exercises for the heart. Research about yoga. Yoga and the cardiovascular system

Yoga, as a mystical practice of understanding the spiritual and inner world, has become as common as jogging and aerobics. Its newfound popularity has been a boon for people with high blood pressure, heart failure, and other forms of cardiovascular disease.

Yoga and the heart

The word "yoga" in Sanskrit means union. It integrates body, mind and spirit, day after day, into a single life experience, without separating them from each other. Exist different kinds yoga, from slow, calm hatha yoga to active, power load, called Ashtanga Yoga. In this article, the starting point is hatha yoga.

Hatha yoga helps balance the mind and body in three interrelated ways: physical postures called asanas, controlled breathing, and calming the mind through relaxation and meditation. All three work together.

How does it help improve cardiovascular health?

During yoga practice, muscles become stronger. All activities that activate muscles strengthen the heart and blood vessels. Physical activity makes our muscles sensitive to insulin, which is necessary to control blood sugar levels. By slowing your breathing rate, you lower your blood pressure and calm your sympathetic nervous system.

The poses and deep breathing are a type of physical meditation that focuses and clears the mind. In turn, meditation and mindfulness in yoga can help people with cardiovascular diseases.

Possible benefits

The words “may” and “could” appear abundantly throughout the article. This is because research into the link between yoga and cardiovascular disease is still in its infancy. Several dozen studies have examined the possible benefits of yoga for people with heart disease, but these studies are mostly small and lack the scientific rigor needed to prove cause and effect. But all this body of work suggests that yoga can:

• reduce high blood pressure;
• improve symptoms of heart failure;
• relieve rapid heartbeat;
• improve rehabilitation rates;
• lower cardiovascular risk factors such as cholesterol, blood sugar and stress hormones;
• improve balance, relieve arthritis, and improve breathing.

Several controlled studies help guide the decision, indicating what yoga “can and cannot” do for people with cardiovascular disease. And even if all the tests clearly support yoga, keep in mind that it is not a panacea, nor is it a magical protection against all diseases. It can only be an additional method of combating your illness.

Yoga attempt

Starting to do yoga is a problem for many. Those who have been involved in fitness, various cardio workouts, dancing, and static exercises are disappointed from the first lesson. And they stop practicing. Just look for yoga classes that include the full package - poses, breathing, meditation - rather than those that just offer to “lose weight” with yoga. And walk around more than three times.

People with heart disease often have other health problems, such as arthritis or osteoporosis, that limit their flexibility. A good yoga instructor creates a safe environment for her students and helps them modify poses to suit their abilities and limitations.

Don't be a passive recipient of treatment. The breathing and relaxation aspects of yoga are something you can do for yourself when it seems like nothing will help.”

Take care of yourself! Leave comments under the article :)

In almost any yoga class you will hear references to the heart. We “open the heart” in backbends, lift the heart center up, direct the radiance of our heart forward, heal a broken heart by working on Anahata - the heart charm. Such poetic and esoteric language is much more common in yoga classes than physiological and medical language. But in vain! Because recently there have been serious Scientific research about the positive effects of yoga practice on the cardiovascular system. Today I will tell you about the findings of a fairly recent study (December 2014), the results of which were published in the European Journal of Preventive Cardiology. The main conclusion that yoga can protect against heart disease has already spread throughout the world's press.

2,768 people took part in the study, led by Professor Myriam Hunink from Erasmus University Medical Center and Harvard School of Public Health in Boston. This scientific work also includes a review of 37 studies that found that yoga reduces major risk factors for cardiovascular disease. In particular, yoga classes reduce body mass index, prevent high cholesterol levels, and lower blood pressure and heart rate. True, no significant difference was found in the effectiveness of yoga and other forms of exercise. physical exercise.

Although this new data certainly adds to the argument for us yoga practitioners in favor of our favorite form physical development, they raise certain questions. How exactly does yoga work for heart disease? How does it reduce the risk of cardiovascular disease? We all know that aerobic exercise strengthens the heart and blood vessels. But yoga is usually not classified as such exercise, although yoga can be very different, including aerobic. Does this mean it is better to replace morning jog a couple dozen laps of Sun Salutations? Additionally, it is not clear from this study exactly which styles of yoga have such beneficial effects on cardiovascular health. After all, there is a significant difference between a gentle, meditative yoga class and a class consisting entirely of vigorous vinyasas. Which style of yoga is better for the heart?

“I think reducing stress plays a huge role in reducing the risk of cardiovascular disease,” says Dr. Carrie Demers, an integrative medicine physician known for her regular lectures on heart health. – Aerobic exercise is truly a surefire way to make your heart stronger. And we should all do this. But the fact that people who do non-aerobic yoga normalize their blood pressure and improve their lipid profile, as well as lose weight, suggests that there are other ways to prevent cardiovascular disease.”

“I think the reasons for the positive effects of yoga on the cardiovascular system come down to two things:– says K. Demers. – On the one hand – physical exercise, on the other – stress reduction. Stress provokes the development of all risk factors for cardiovascular diseases. When you live in a state of chronic stress, your blood pressure inevitably rises. As cortisol levels increase, cholesterol levels also increase. Hypertension and atherosclerosis develop. If we engage in breathing exercises, stretching, and the practice of mindful relaxation—which in many cases means doing yoga—then we significantly reduce the risk of developing and developing heart disease.”

This study, which included a review of 37 others, looked at people practicing different styles of yoga. The question of which style of yoga is better for heart health has not really been raised by researchers. But if stress reduction is the key factor, then the aerobic nature of physical activity ceases to be a priority condition. By the way, in 2013, Maria G. Araneta, a doctor from the University of California (San Diego), conducted a study that showed that the gentle restorative practice of yoga helps get rid of excess weight, and this is one of the main risk factors for cardiovascular diseases. This effect is achieved by reducing the level of cortisol, the stress hormone, in the body.

There is another aspect that is more difficult to measure than body mass index, blood pressure or cholesterol levels. For many people, the main healing factor in yoga is its emotional and spiritual benefits over other types of physical development.

“I think yoga does more than just reduce stress, train muscles and breathe in more oxygen,– says yoga teacher Shari Friedrichsen, who often conducts seminars on yoga for heart disease. – Yoga gives us the opportunity to really start paying attention to ourselves, teaches us to recognize ourselves, understand who we are. And I think that's the most valuable thing. In yoga, we begin to look at our heart as an organic part of the holistic process of healing our whole self.”

However, additional research is required to obtain answers to the questions that literally beg: why and how yoga works for the heart and blood vessels, what type of yoga for stress and for the heart is more effective, etc., etc. However, the findings from K. Demers' study seem very promising. What about whether, instead of jogging on the treadmill, you should do more Downward-Facing Dogs :)?

Study author K. Demers argues that regular aerobic exercise is still important: “We should not neglect aerobic exercise, because thanks to it the heart and blood vessels become more reliable, more resistant to stress, we gain strength and endurance. But you can also turn yoga into an aerobic workout. Most of us won't do this though. I have a different intention when I practice yoga. I breathe just as deeply on a run or bike ride as I do in yoga, but it's my body that's doing the work, and I want it to sweat. When I do yoga, I synchronize movement with breathing, focus on stretching, opening my body, increasing space within myself, etc. Yoga also strengthens the body, but yoga and aerobic exercise definitely have different tastes. I believe we need both to be healthy people.”

I would like to add that in one lesson we can combine both. Warm-up, aerobic block for 30-40 minutes, stretching and “opening” of the body and joints - this is the usual order that I follow in yoga classes with people with whom we do not pursue specific health goals. The research discussed in this post confirms that this order is the surest path to a healthy heart and more.

Ischemia– a discrepancy between two factors: 1) the need for oxygen and 2) its delivery to the tissues.

Need tissues in oxygen depends on the initial level of metabolism: for example, the kidneys consume about 10% of all oxygen entering the body, although their weight is about 0.5% of total mass bodies; the brain consumes about 25%, with a weight of about 2% of the total mass. The need for oxygen also changes with changes in the functional activity of the organ: in a state of relaxation, skeletal muscles consume less oxygen, and during exercise, its consumption increases; at rest, the heart contracts less often, which means its need for oxygen is less; during physical activity, the heart rate increases, and the myocardium’s need for oxygen increases.

Delivery oxygen in the tissue depends on a number of factors: on the work of the circulatory system (how actively the heart performs its pumping function and ensures the movement of blood through the vascular system), venous return (which depends on the work of peripheral muscles and respiratory activity), blood composition (that is, the amount of hemoglobin - oxygen carrier), patency of arterial vessels (through which blood carrying oxygen enters the tissues).

Coronary angiography. Contrast image of myocardial arteries.

Normally, there is a physiological correspondence between the need and delivery of oxygen, and when the need changes, the body changes the level of delivery. If for some reason the delivery process suffers, and the increase in demand is not accompanied by a more active supply, an intracellular oxygen deficiency (hypoxia) occurs, which leads to metabolic disorders and can ultimately lead to dysfunction and cell death.

A condition in which delivery does not meet tissue oxygen demand is called ischemia. Most often, ischemia is caused by a decrease in blood delivery through the arterial vessels - which, in turn, is caused by atherosclerosis(deposition of lipids in the vessel wall, formation of lipid atherosclerotic plaque and narrowing of the vascular lumen).

In some cases, under the influence of provoking factors (for example, a hypertensive crisis), damage to the surface layer of the atherosclerotic plaque occurs, which initiates the formation of a blood clot on its surface, followed by occlusion (blockage) of the artery. This, in turn, leads to the cessation of arterial blood supply to this area of ​​tissue, its damage and necrosis.

Tissue necrosis due to cessation of arterial blood supply is called heart attack and can occur in any organ that has an arterial blood supply.

In an adult, the process of atherosclerosis to one degree or another occurs throughout the entire arterial bed - therefore, vasoconstriction, a decrease in arterial blood supply and ischemia can develop in any organ and in any tissue. The digestive organs, urinary system, skeletal muscles, and other systems and organs can suffer from atherosclerosis and ischemia.

However, the most fatal manifestations of ischemia occur in the heart and brain. Cerebral infarction and the principles of post-stroke rehabilitation are discussed in the corresponding section.

Cardiac ischemia(IHD) is a chronic disease, most often caused by atherosclerosis of the coronary arteries, leading to myocardial ischemia (heart muscle), in some cases complicated by coronary artery thrombosis, which causes necrosis of the heart muscle (myocardial infarction).

One of the chronic manifestations of IHD is angina pectoris – syndrome that occurs during physical activity. During exercise, the heart begins to contract more often and stronger (as this is necessary for blood supply to muscles and other organs), which leads to an increase in the myocardium's need for oxygen. In the presence of atherosclerosis and narrowing of the vessel, the level of blood flow remains the same; thus, demand increases, but delivery does not. This leads to an imbalance of demand and delivery, that is, ischemia. Myocardial ischemia causes the development of a typical pain sensation in the heart region (most often behind the sternum). Pain in the heart area (which can also radiate to the left side of the chest, left shoulder, arm, lower jaw and other areas), which occurs during physical activity and is associated with myocardial ischemia, and is called angina pectoris.

With a stable course of angina, pain in the heart occurs at the same level of physical activity and, as a rule, proceeds in the same way (localization, nature and intensity of pain, irradiation, duration, response to drugs).

Provoking factors (such as increased blood pressure) can lead to damage to the surface of the atherosclerotic plaque, which triggers the process of thrombus formation on its surface. As the clot enlarges and the coronary artery narrows, the usual manifestations of coronary artery disease may worsen: for example, angina pectoris occurs at a lower than usual level of exercise; localization changes; the duration and intensity of pain increases; the effectiveness of the drugs decreases. Such a deterioration in the clinical course is called unstable (progressive) angina and is an indication for mandatory hospitalization.

Subsequent expansion of the thrombus can lead to complete occlusion of the vessel, cessation of arterial blood supply to the corresponding area of ​​the myocardium and its necrosis - myocardial infarction (MI).

Myocardial infarction is the most common cause of death in developed countries, as it can grossly disrupt the contractility of the heart muscle (in this case, the pumping function of the heart suffers) and cause electrophysiological instability of the myocardium (which leads to cardiac arrhythmias of varying degrees of severity). Necrosis muscle tissue may be complicated by its rupture and hemorrhage into the pericardial cavity. The complications listed above (as well as a number of others) can irreversibly disrupt the functioning of the heart and lead to death.

Myocardial ischemia. Photo from cardio.by-med.com

If a person remains alive after a myocardial infarction, then inflammation develops in the necrosis zone, followed by scar formation (post-infarction cardiosclerosis). The scar, which is made up of connective tissue, is unable to contract and therefore the overall pumping ability of the heart is reduced. As a result, in the case of a significant area of ​​myocardial damage, a persistent decrease in the pumping function of the heart develops - heart failure.

Physical exercises occupy an important niche in the treatment and rehabilitation of patients with coronary artery disease. A large meta-analysis of the Cochrane database showed that exercise in patients with coronary artery disease reduced overall mortality by 27% and mortality from cardiovascular events by 31%.

Moreover, after an acute cardiovascular event (myocardial infarction or an episode of unstable angina), most patients do not know what level of exercise is necessary and indicated for them; this uncertainty leads the patient to avoid any physical effort and promotes a sedentary lifestyle.

To apply physical exercises that are appropriate to the patient’s health status, they are developed and applied. cardiac rehabilitation programs(PCR). For this purpose, it is first carried out load test(NT) with a stepwise increase in load level, ECG registration and blood pressure monitoring. This allows you to determine the optimal and safe level of load, to find out the possible ischemic threshold (the level of heart rate at which ischemia occurs, which is not subjectively felt by the patient). A bicycle ergometer or treadmill (treadmill) is usually used as a load during NT.

As a result of the load test on special techniques a heart rate level is calculated that is safe with respect to the occurrence of ischemia and at the same time provides training therapeutic effects. In the future, when carrying out RCC, the possibility of regular medical monitoring, registration of basic parameters (ECG, blood pressure) and correction of the load level is necessary.

Optimal beneficial effects on the health of patients with coronary artery disease can only be achieved with aerobic training endurance training, performed at least 30 minutes a day 3-5 times a week. Also useful interval training with alternating short episodes high intense exercise(20-30 sec) followed by 2 times longer recovery episodes. In this case, short episodes of intense exercise stimulate the adaptation of the peripheral vascular system in the leg muscles without the risk of overloading the central circulation. However, the conclusion about the safety and effectiveness of this type of training is only preliminary and must be confirmed in randomized controlled trials.

Training within the framework of RCC should be carried out under medical supervision and under the guidance of a rehabilitation physician! For certain categories of patients (severe ischemic heart disease, ventricular arrhythmias, heart transplantation), it is recommended to develop cardiac rehabilitation programs in a hospital setting.

As a result of correctly selected training heart rate and a cardiac rehabilitation program, an increase occurs. physical endurance, increasing the ischemic threshold (that is, increasing the level of heart rate at which ischemia occurs), reducing the frequency and intensity of angina attacks, increasing the survival period. In patients with heart failure, structured exercise programs improve quality of life (reducing shortness of breath and fatigue) and reduce mortality and hospitalization.

Hatha yoga is not an aerobic exercise option and cannot provide the full range of positive effects recorded for cardiac rehabilitation programs for coronary artery disease. However, when used as part of comprehensive rehabilitation, yoga practice can bring a number of positive effects.

Thus, a randomized controlled trial showed that yoga classes for 18 months, 5 times a week for 45 minutes, lead to a statistically significant decrease in heart rate, systolic and diastolic blood pressure in patients with coronary artery disease. Another study involving 80 patients with stable coronary artery disease shows an improvement in respiratory function and lung diffusion capacity as a result of 3 months of asana and pranayama practice compared to controls.

Numerous studies show modulation of autonomic tone as a result of yoga practice and increased parasympathetic activity. nervous system, which is important for ischemic heart disease.

The construction of the practice of hatha yoga for ischemic heart disease (as well as any option for the use of physical exercises for this disease) should be based on the results of stress tests that determine the safety of using physical exercises in a particular patient and threshold heart rate values ​​that should not be exceeded. In addition, current ultrasound data (EchoCG) should be taken into account. It is better if the nature and intensity of the load is determined by a cardiologist-rehabilitation specialist, taking into account all the data.

If we formulate the general principles of yoga practice for ischemic heart disease, then first of all we should mention techniques that should be limited or excluded:

1) Sympathotonic techniques: kapalabhati, bhastrika, surya-bhedana, active dynamic vinyasas, warming techniques with active shortened exhalation. An increase in the tone of the sympathetic system contributes to an increase in heart rate and the strength of myocardial contractions, which, in turn, increases the myocardial oxygen demand and promotes ischemia. One of the directions of pharmacological treatment of coronary artery disease is the prescription of beta blockers - drugs that selectively block adrenal receptors of the heart and thereby reduce sensitivity to sympathetic influences. Therefore, it is advisable to limit the use of techniques that enhance sympathetic influences - either by removing them from the training program altogether, or by using them in combination with parasympathetic compensations. Separate studies show that the use of kapalabhati for 10 minutes twice a day for two weeks by patients with stable coronary artery disease in combination with the practice of anuloma-viloma (alternate breathing) in the same volume did not lead to any negative results; At the same time, a statistically significant improvement in external respiration functions was noted. It can be assumed that the slow type of breathing (anuloma-viloma) played the role of a compensatory, parasympathetic technique in relation to the sympathotonic technique (kapalabhati). It is possible that the use of kapalabhati in patients with stable coronary artery disease receiving standard pharmacotherapy does not lead to undesirable effects even when used in isolation - however, controlled studies are required to clarify this issue; Until then, you should adhere to the precautions mentioned above, excluding sympathotonic techniques or using them with sufficient parasympathetic compensation.

2) Inverted asanas. There are no studies on the effect of inverted body positions on the course of coronary artery disease, however, it can be assumed that long-term fixations in an inverted body position, increasing pressure in the cavities of the heart, will enhance the contractile function of the heart (according to the Frank-Starling law*) and increase the myocardial oxygen demand. In addition, inverted positions in case of organic heart pathology can generally have a negative effect on intracardiac hemodynamics, so the issue of using inverted asanas is best decided with the involvement of a cardiologist.

3) Long-term static fixations involving large groups skeletal muscles(parshvakonasana, virabhadrasana 1 and 2, chaturanga-dandasana, etc.). Static muscle contraction increases total peripheral vascular resistance and thereby increases the load on the left ventricle of the heart, increasing the myocardial oxygen demand.

In general, for IHD, the safest mode of practice is with a predominance of parasympathetic elements: practice of asanas without long-term fixations in a relaxation mode, intermediate short shavasanas, ujjayi in the proportion of visama-vritti (1: 2), uddiyana-bandha, brahmari, nadi-shodhana (anuloma- viloma), brahmari, savasana and yoga nidra.

At the same time, a more active practice regime is possible, but to build it it is necessary to obtain results load test with determination of the threshold heart rate. During exercise, you should monitor your heart rate (by periodically counting your pulse or using sports equipment for monitoring), without exceeding the heart rate that has been determined to be safe during exercise testing.

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* Frank-Starling Law -the physiological law according to which the force of contraction of myocardial fibers is proportional to the initial value of their stretching; that is, as the filling of the heart chambers increases, the force of myocardial contraction also increases.

Bibliography:

1) Jolliffe JA, Rees K, Taylor RS, Thompson D, Oldridge N, Ebrahim S. Exercise-based rehabilitation for coronary heart disease. Cochrane Database Syst Rev Update. 2001; (1):CD001800 Update SoftWare

2) Joseph Niebauer “Cardiorehabilitation. Practical guide" Moscow, Logosphere, 2014

3) Wisloff U, Stiylen A, Loennechen JP, Superior cardiovascular effect of aerobic nervous system training versus moderate continuous training in heart failure patients: a randomized study. Circulation.2007: 115 (24): 3086-3094

4) Fox KF, ​​Nutall M, Wood DA et al. A cardiac prevention and rehabilitation program for all patients at first presentation with coronary artery disease. Heart. 2001; 85:533-538

5) Piepoli MF, Davos S, Francis DP, Coats AJ. Exercise training metaanalysis of trials in patients with chronic heart failure. BMJ. 2004; 328:189-194

6) Pal A, Srivastava N, Narain VS, Agrawal GG, Rani M. Effect of yogic intervention on the autonomic nervous system in the patients with coronary artery disease: a randomized controlled trial. East Mediterr Health J 2013 May;19(5):452-8.

7) Asha Yadav, Savita Singh & KP Singh. Effect of yoga regimen on lung functions including diffusion capacity in coronary artery disease patients: A randomized controlled study. Int Journal of Yoga, 2015, Vol. 8, Issue 1, p. 62-67

8) Asha Yadav, Savita Singh & KP Singh. Role of pranayama breathing exercises in rehabilitation of coronary artery disease patients – a pilot study. Indian Journal of Traditional Knowledge, Vol. 8 (3), July 2009

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A study by the Californian Scientific Institute of Preventive Medicine has proven that regular yoga classes can prevent the development of cardiovascular diseases. Properly selected yoga asanas can lower blood pressure, strengthen the heart muscle and normalize the pulse without pills. Yoga helps to recover even after cardiac surgery and reduces stress.

“Integrated practice has a qualitative impact on all structures human body, - speaks Rauf Asadov, yoga instructor, author of the Organic people organic-people.com, “Yoga in the Parks” projects and the I love yoga community. — But if you specifically want to strengthen your heart, you should pay attention to yoga asanas that reveal thoracic region. We have collected them in our complex.”

The poses in this complex are given in such a sequence that you can perform them, smoothly flowing from one to another. However, you can also do asanas in any order. Stay in each of them for a while four breathing cycles(inhale-exhale).

To complete the complex you will need a mat.

If you have heart problems, consult your doctor before starting to practice.

A set of yoga asanas for a healthy heart

1. Tadasana (mountain pose)

Stand on the edge of the mat so that it is behind you. Feet hip-width apart, the outer edges of the feet parallel to the outer edges of the mat, emphasis on three points - the heel, the outer edge of the foot, the base thumb. Lightly stretch the mat with your feet in different directions so that your kneecaps are pointing straight forward. Pull the tailbone inside the body, tucking the pelvis, open chest, moving your shoulders back and down, reach up with the top of your head.

2. Bend back

Standing with your feet pelvis-width apart, bend your knees slightly and, tucking your tailbone even more and raising your arms up and back, bend over and open your chest up as much as possible. Return to tadasana.

3. Malasana (garland pose)

Place your feet the width of the mat, with your toes slightly apart. Bring your palms together in front of your chest and exhale as you squat down. Spread your hips apart, place your elbows between your knees. Push your hips in different directions with your hands, while lowering your pelvis as low as possible, and stretch the top of your head up - stretch the line of your back. Tuck your tailbone further into your body.

* If your feet do not fully fall onto the mat, place a block or folded blanket under your heels.

4. Utthita parsvakonasana (extended side angle pose)

In malasana, place both palms on the mat and step your left foot back. Straighten it and turn your left foot at an angle of 45 degrees. Its outer edge should be flush against the mat. Bend your right leg at the knee at a right angle. Place your right palm in front of your right foot and push your knee from the inside with your right shoulder, and push your shoulder inward with your knee. The shoulder should be directly above the palm, the right arm and right shin perpendicular to the floor. As you inhale, turn your body to the left and open your left arm up. Your hands should form a straight line. Look up. With each exhalation, try to lower your pelvis lower and move your left arm further back, relaxing your back muscles and opening your chest as much as possible. As you exhale, lower your left hand to the floor, step your right foot back and step your left foot towards your left palm. Repeat utthita parsvakonasana on the other side. Then step your right foot toward your right palm and sit on the mat on your buttocks, knees bent, feet flat on the floor.

5. Table Pose

From a sitting position, move your hands beyond the pelvic line and lower your palms to the floor, fingers pointing forward. As you inhale, pushing off the floor with your feet and palms, lift your pelvis, stomach and chest as high as possible until your body is parallel to the floor. Look at the ceiling, point your navel inside your body and tighten gluteal muscles. Coming out of the asana, lower your pelvis onto the mat, lie on your back, straighten your legs, left hand along the body, and the right one goes back behind the head. Roll over your right side and lie on your stomach, prepare for the next pose.

6. Dhanurasana (bow pose)

Take a lying position on your stomach: legs apart hip joints, arms along the body. Bend your knees and clasp them with outside by the ankles, pressing thumbs stop to each other. Tightening your gluteal muscles, inhale and lift your legs and chest off the floor. Look ahead, don't throw your head back. Exhale and lower your pelvis, hips and chest to the floor. Release your grip on your ankles and place your head on the floor, turning it in any direction. Move your pelvis from side to side, relaxing the sacrolumbar region. To exit the asana, release your ankles and lie on your stomach, push your palms off the floor, while exhaling, lift your body, kneel and sit on your heels.

7. Ushtrasana (camel pose)

From a sitting position on your heels, straighten up, your knees lying on the floor at the width of your hip joints. Place your toes on the floor. Tightening your gluteal muscles, begin to gently bend back while exhaling. Alternately place your palms on your heels. Your thighs and arms should be perpendicular to the floor. As you inhale, stretch your belly forward, opening your chest more and pointing it upward. Direct your gaze upward, neck muscles stretched. As you exhale, release your grip on your hands, straighten up and sit on your heels.

Can yoga improve your cardiovascular health? This question interests both those who have diseases of this system and those who think about their prevention in a timely manner. Of course, yoga (a combination of asanas, yoga and meditation techniques) is a comprehensive measure to improve the health of the body. And in some cases of cardiovascular diseases it will be very effective. However, you should not think that yoga is a panacea for everything. After all, as practice shows, in some cases yoga does not have a significant effect on the cardiovascular system.

In what situations can yoga improve the cardiovascular system? To answer this question, we turned to research on this topic.

From the editor: Speaking about research on the impact of asana practice on the cardiovascular system, it is necessary to note the following: even in those works that describe specific asana complexes, it is difficult to give an unambiguous assessment of the falsity or truthfulness of the work. After all, we do not know how intense the evaluated training was: what was the technique of performing asanas among the subjects and what tempo of the lesson was chosen for the study. Therefore, we strongly encourage you to think critically about all the information you read below. Remember that all studies on yoga show only possible results from its practice, but do not say that every practitioner will definitely achieve them.

Yoga and Heart Rate: Different Yoga Styles, Different Effects

Speaking about yoga, it is difficult to draw an unambiguous conclusion about its effect on the body. The fact is that different styles of hatha yoga dictate their own characteristics and rules. And different author's styles can have diametrically opposite effects.

For example, it is impossible to answer unequivocally whether yoga increases or decreases heart rate (HR). After all, the load is different in different styles of yoga. Somewhere the training is taking place in at a relaxed pace, with an emphasis on concentration and awareness, somewhere on the contrary there is a fast pace, close to aerobic exercise. Accordingly, some practice will help slow down your heart rate, and some, on the contrary, will help increase it.

For example, in one of the studies described in William Broad’s book “Scientific Yoga. Demystified,” states that the practice of Ashtanga Vinyasa yoga increases the heart rate to 95 beats per minute with an average of 70 beats per minute.

But in contrast to this active direction, one can cite such a style as Yin yoga. In this method, on the contrary, it is common to hold the same pose for a long time, achieving relaxation in it. During training using this method, an increase in heart rate, of course, is also very likely. But it will not reach the level of heart rate during Ashtanga Vinyasa practice.

Meanwhile, there are branches of yoga that, on the contrary, cause a slowdown in all life processes, including heart rate. True, there “yogic exercises” are not asanas, but concentration and meditative techniques. Many people know the statement that ancient yogis were able to stop all processes in the body, including the heartbeat. In modern times, when studying this phenomenon, it was proven that yoga practitioners are unlikely to be able to completely stop the heartbeat, but some yoga can significantly slow down the heartbeat.

So in 1961, a researcher from the University of Michigan, Basu Kumar Bagchi, published the results of his study, the subject of which was one of the most famous yogis of our time - Sri Tiyumalai Krishnamacharya. At the time of this study, Krishnamacharya was already 67 years old and not in his prime. Therefore, he did not immediately consent to the study. However, after persuasion, Guru modern yoga nevertheless agreed to participate in this experiment.

Electrodes were connected to it, after which the famous yogi closed his eyes and concentrated his attention on internal sensations. As a result of this study, it was proven that, despite the fact that Krishnamacharya was not able to completely stop the heartbeat, he was able to significantly slow it down.

A similar opinion about the ability of yoga to reduce the frequency of cardiovascular events was voiced by Harvard cardiologist Herbert Benson. In his book The Relaxation Response, published in 1975, he wrote: “simple relaxation techniques have a striking effect on subjects, helping to slow the heart rate, reduce the respiratory rate, reduce oxygen consumption and blood pressure (if it was elevated).” .

It turns out that when discussing the effect of yoga on the body, one cannot draw any conclusions without referring to specific techniques. And any speculation about the effect of yoga, without indicating the exact means and methods, can hardly be considered reliable. However, a competent and thoughtful approach will allow you to get all the benefits from such a multifaceted practice as yoga.

It's no secret that aerobic exercise improves the functioning of the cardiovascular system. Is yoga an aerobic exercise? Carolyn S. Clay, a researcher at Texas State University in the field of sports medicine, tried to find the answer to this question in 2005.

Together with four of her colleagues, she led the study, where 26 female volunteers who had at least some experience in yoga took part(at least 1 month). The purpose of the study was to determine what percentage of VO2 max(an indicator of the body’s ability to absorb and metabolize oxygen) used at rest(while sitting on a chair) while walking fast(on a treadmill) and during yoga practice. Unfortunately, we found only a rough description of these yoga classes: they included the Surya Namaskar complex and a set of other asanas. The scientists compared the results obtained with the indicators recommended by the American College of Sports Medicine: this organization advises performing cardio training using 50-85 percent of maximum aerobic potential (VO2 max).

Scientists carried out relevant measurements(blood oxygen level measurement) before and after 30-minute workouts. Their study found that while walking briskly on a treadmill, subjects used about 45 percent of their VO2 max, while doing yoga, on average, only 15 percent. The most aerobic part of the yoga workout turned out to be the Surya Namaskar complex - during its execution, the subjects used 34 percent of VO2 max.

To summarize, the following can be noted: Surya Namaskar significantly increases the intensity of the gymnastics session. Therefore, if the goal of your training is to increase the intensity of physical activity, you can successfully use this complex.

Lost in translation

In the process of searching and studying research on the effects of yoga on the cardiovascular system, you can fall into euphoria: the Russian-language Internet is replete with stories about the benefits this practice brings to the cardiovascular system. Allegedly, “yoga reduces major risk factors for cardiovascular disease,” “prevents high cholesterol levels,” and “lowers blood pressure and heart rate.” As evidence of these statements, the results of two foreign studies on this topic are presented.

However, let's turn not to the Russian translation, but to the originals of these studies. And let us see that their authors, when discussing the benefits of yoga for the cardiovascular system, were not so optimistic.

In 2014 The results of a study conducted by a group of scientists from Harvard and Erasmus Universities were published in the European Journal of Preventive Cardiology. This group included: Paula Chu, Rinske A Gotink, Gloria Y Yeh, Sue J Goldie, MG Myriam Hunin. The study was devoted to the topic the effectiveness of yoga on risk factors for cardiovascular diseases and metabolic syndrome.

The basis for the study was the theory that yoga is a popular psychophysical practice that can reduce the risk of cardiovascular diseases and metabolic syndrome (metabolic syndrome is a combination of risk factors for cardiovascular diseases and type 2 diabetes mellitus – approx. author).

Research method: systematic review and meta-analysis of existing works, selected in a special way.

The analysis used studies randomly selected from MEDLINE, EMBASE, CINAHL, PsycINFO and The Cochrane Central Register of Controlled Trials. Studies were selected according to their criteria: English, peer-reviewed, based on the practice of asanas by adults, containing relevant findings. Two independent reviewers selected the articles and assessed their quality.

From 1404 studies, 37 studies were selected for evaluation using a randomized controlled trial, 32 studies for evaluation using a meta-analysis method.

Scientists found the following: when comparing the results of those people who did yoga and those who did not do it, those who did yoga found improvements in systolic and diastolic blood pressure, lowering heart rate and lowering blood cholesterol levels.

However, the researchers indicated that while the results were encouraging, their validity and certainty were limited by the small sample size, heterogeneity, and average quality of the randomized controlled trial design.

In 2014 The European Society of Cardiology has published the results of a joint study by scientists from the Faculty of Medicine of the Department of Internal and Integrative Medicine of the Essen-Mitte Clinic (Cramer H, Lauche R, Haller H, Dobos G) and an employee of the Department of Internal and Complementary Medicine of Berlin Immanuel Hospital Berlin (Michalsen A).

Research topic: A systematic review of yoga for heart disease.

The study was based on assessing the quality of existing works on this topic in order to determine the reliability of their evidence base.

Purpose of the study: to determine whether it is possible to reach an authoritative conclusion that yoga can be recommended as an adjuvant measure for the treatment of heart disease.

Research method: systematic review and randomized controlled trial.

Studies were selected from Medline/PubMed, Scopus, the Cochrane Library and IndMED. They looked for references to fatal and non-fatal exacerbations of heart disease, as well as information about improvements in health, quality of life and evidence of a reduction in the risk of cardiovascular disease. The Collaboration and GRADE assessed the integrity of these studies and the quality of their evidence base.

Seven randomized control trials (RCS) were selected from trials of 624 patients that compared patient care interventions using yoga with usual patient care interventions.

It turned out, what is the impact on the health of people suffering from coronary heart disease?(4 studies), there was little effect. The following were identified: a small percentage reduction in mortality, a slight reduction in episodes of angina attacks, a low increase in the level of vitality and a minimal reduction in the risk of cardiovascular diseases.

In cases of patients with heart failure(2 studies) found that yoga had minimal effect on reducing the risk of death, very little effect on increasing vitality, and no effect on their standard of living.

In the case of cardiac dysrhythmia, in which the patient was implanted with a cardioverter-defibrillator (1 study), the situation was similar. The results showed that the possibility of reducing the risk of death as a result of yoga practice was very low.

The general conclusion of the analysis of research data: based on the results obtained, we can conclude that the auxiliary use of yoga is ineffective in cases of cardiovascular diseases (coronary heart disease, cardiac arrest, cardiac dysrhythmia).

The benefits of yoga for blood vessels and heart

So the idea of ​​the positive effect of yoga on cardiovascular health is a myth? Really, the practice of yoga will not help improve the health of the heart and blood vessels? To the delight of yoga fans, the answer to these questions is no.

In fact, yoga has beneficial effects on the cardiovascular system. It is an effective means of preventing heart and vascular diseases. However, only in the case when this is not the only means of prevention used, but one element of a number of measures.

This is precisely the idea expressed by the European Heart Journal in its 2016 article _. It described recommendations for the prevention of cardiovascular diseases in clinical practice. According to this article, one of the factors in the prevention of cardiovascular diseases is the psychosocial factor. AND in order to minimize the risk of cardiovascular diseases necessary counteract stress, depression, anxiety and nervous tension. According to the European Heart Journal, practice of asanas, meditation, breathing exercises and concentration techniques- This effective techniques to solve this problem.

The European Heart Journal also recommends use moderate physical exercise as a means of preventing cardiovascular diseases. The workout recommended there consists of the following stages: warm-up, main part (aerobic exercise and muscle strengthening exercises), cool-down and flexibility exercises. Wherein for older adults, the European Heart Journal recommends incorporating neuromotor exercises(i.e. those exercises that help maintain and improve motor skills: balance, dexterity and coordination). The European Heart Journal lists this type of activity as tai chi and yoga.

Benefits of yoga for patients with heart failure

In 2009 Paula Rei Pullen wrote her dissertation on:

Benefits of Using Yoga to Treat Patients with Heart Failure(The Benefits of Yoga Therapy for Heart Failure Patients).

Purpose of the study: to study the effects of yoga on patients with heart failure (HF) and identify; identify the effects of yoga on cardiovascular endurance, flexibility, inflammatory markers, and quality of life in stable patients.

Research method: 40 subjects (who had not previously practiced yoga) with systolic or diastolic heart failure were randomly selected and divided into 2 groups.

This study lasted 8 weeks, during which the first group attended 16 yoga lessons (2 lessons per week), where they performed several asanas in sequence. These were Sukhasana, Dandasana, Pashchimotanasana, Tadasana, Utthita Trikonasana, Virabhadrasana, Utkatasana, Vrikshasana, Bhujangasana, Adho Mukha Svanasana, Balasana, Upavishta Konasana, Badha Konasana, Gomukhasana, Marichiasana 3, Viparita Kazani and Savasana. The subjects held each asana for 3-5 respiratory cycles while focusing your attention on the present moment. Each participant was fitted with special equipment before the yoga class to measure their pulse, blood pressure and weight during each visit.

As a result of the study, Paola Rae Pullen concluded that for patients with heart failure, yoga practice is an effective and safe adjunct to standard medical care. Thanks to yoga classes, patients with heart failure improve their quality of life (this was revealed through a survey), in endurance, flexibility and inflammatory biomarkers.

Conclusion

Analyzing the research conducted on the topic of yoga, the following conclusions can be drawn:

• For some cardiovascular diseases (for example, heart failure), yoga is an effective and safe auxiliary element of therapy that can significantly improve the quality of life of practitioners.

• Yoga is an auxiliary tool for the prevention of cardiovascular diseases. For this purpose, it is most effective to use it in conjunction with aerobic training.

It turns out that in some cases yoga actually has benefits for the cardiovascular system. However, yoga is not a miracle cure for all heart diseases. And for the prevention or treatment of diseases of the cardiovascular system, yoga will be effective only as an auxiliary (and not the main or only) remedy.