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Chapter-11
Yogic management of Hypertensive
Patient

Hypertension or high blood pressure is the most common
disease affecting the heart and blood vessels There is an agreement
at large that blood pressure of 120/80 is normal in a healthy adult.
Borderline high blood pressure is defined as diastolic pressure
between 85 and 90 mild high blood pressure is diastolic pressure
between 91 and 104 and moderate high blood pressure is diastolic
pressure between 105 and 115 severe high blood pressure is
diastolic pressure of 116 or higher. Isolated systolic hypertension is
systolic pressure greater than 160 in those whose diastolic pressure
is less than 90.
Hypertension could be caused by an increase in cardiac
output or in total peripheral resistance or both. In reality however
the major abnormality in most cases of well-established
hypertension is increased total peripheral resistance caused by
abnormally reduced arteriolar lumen for more than 95 percent of
the persons with hypertension. The cause of hypertension is known
and in that condition it is called essential hypertension. The
remaining percentage is secondary hypertension which has an

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identifiable underlying cause such as kidney diseases, adrenal
hyper secretion etc.
Psychological, physiological and environmental factors are
only three of the many factors that lead to high blood pressure. A
common misconception is that ageing causes hypertension. It
doesnt always though the universal average for the onset of
hypertension in the late thirties. Overweight people and those who
are tense and excitable are especially susceptible to hypertension;
emotional conflicts are also a cause.
The cells of the kidneys secrete the hormone rennin which
is influenced by sympathetic stress, the stress faced by the body
and the mind. Hence rennin secretion may well be under mental
influences. Rennin reacts with a chemical known as
angiotensinogen and this sets off a series of chemical changes
producing an end product known as angiotenson which causes
vaso-constriction and elevated blood pressure. This situation is
also influenced by the hormone aldosterone which retains salt and
water through the kidneys aggravating the condition.
The normal blood pressure under resting conditions should
be 120/80mm of mercury. Both the systolic and diastolic pressure
can be affected. Both have to be made normal with treatment. The
level at which the systolic pressure should be treated is 140mm and
the diastolic 90mm. Pressure of 130 to 135mm systolic and 85 to88
diastolic are labeled as high normal Systolic pressure is the
measurement made when the heart is contracting and the muscle

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pushes out blood from the ventricles and in the process presses on
the coronary arteries reducing its own blood supply. Hence if the
diastolic pressure remains above 90mm coronary artery filling will
be jeopardized.
This sympathetic stress is reduced the diastolic pressure is
reduced and coronary filling is normalized. High blood pressure is
a serious condition and requires prompt attention because it is an
underlying factor that brings about other cardiovascular and renal
disorders like stroke heart disease, kidney trouble and hardening of
the arteries. The pressure can remain stable or fluctuate. The latter
is a dangerous can produce a stroke high blood pressure works
insidiously. It affects the heart and blood vessels and then
indirectly other organs. When blood vessels get constricted, the
heart must work harder and a time comes when its own coronary
arteries can no longer nourish the heart then heart disease
develops. Similarly hypertension affects the brain and kidneys
resulting in stroke and uraemia both fatal conditions.
Yoga is an excellent means of treating high blood pressure.
As hypertension begins in the mind Yoga is of prime value.
However weight loss is essential for yogic management to be of
use and only dynamic exercises can reduce weight. Yoga can be
practiced side by side with weight-reducing exercises as Yoga
alone can prevent vascular complications due to its massaging
effect on the arteries Asanas make the arteries and capillaries

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reduced. The hibernative state removes the accumulated stress all
this happens over a period of time
Useful Yoga Practices
Asanas Pranayama
1.Ardhakati chakrasana 1. Sectional breathing
2.Garudasana 2.Nadishodhan pranayama
3Adrhamatsyendrasana 3.Brahmari
4.Bhujangasana
5.Usthrasana
6.Savasana
Diet
Consume less salt and fat Eat leafy vegetables more.

References
1. Bakhru, H.K, A Hand book of Nature Cure.
2. Neeraj Nagendra, Rogon Ki Sahi Chikitsha.
3. J ussawala, J .M, Natural Therapeutics.
4. Modi, V.D. Rogon Ki Saral Chikitsha.
5. Louis Kuhne, Rogon Ki Nayi Chikitsha.
6. Park, J .E, Text book of Preventive and Social Medicine.
7. Paul Benjamin, Health, Culture and Community.


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also slows. These poses increase in the tone and the excess
sympathetic tone is reduced. There is then a decrease in the tone of
the vasomotor centre in the brain (which controls the tone of the
arteries) and blood pressure drops.
Setu bandha, sarvangasana rests the brain and again the
cortical centers are rested and the mind is kept at its root. The lift
of the diaphragm and lungs and the emotional centre on the heart
which occurs in this asana stabilizes the blood pressure. Savasana
with normal inhalation and prolonged exhalation stabilizes the
sympathetic nervous system. The longer exhalation relaxes the
sympathetic nerves and the BP is controlled
Pranayama greatly influences the circularly system. With
each inhalation and exhalation the output of blood flow to the body
varies. This changes the blood pressure. In prolonged inhalation
(never done by normal people) the right ventricular (RV)output
increases and left ventricular (LV) output falls. In exhalation the
reverse occurs. Due to the increase in duration of inhalation and
exhalation significant pressure changes can occurs. The emphasis
on inhalation or exhalation depends on blood pressure being high
or low. The overdrive of the sympathetic nervous system is most
amenable to reduction by the practice of pranayama. The elasticity
of the aorta and major blood vessels is well maintained.
The steady rhythmic breathing helps control the autonomic
system. As the breathing rate reduces the stress on the body is

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elastic and allow more blood to flow into various areas resulting in
better relaxation of those tissues.
The sympathetic nervous system is always set on higher
level of charge in hypertensive. By the practice of Yoga the tone of
sympathetic discharge is brought down Shavasana relaxation is
like sleep. It is conscious sleep. In sleep the nervous system
recoups itself the same happens in Yoga. There is yet another
difference. In sleep the subconscious mind is still active and the
nerves are still tense. In Yoga every part of the nervous system is
kept passive and the relaxation of the nerves is far better.
The state of nerves in a hypertensive is one of overuse and
decreased excitability. Excitabilites means the ability to transmit
an impulse. In a hypertensive the nerves are exhausted and
overstrained. As the excitability of the nerve is inversely
proportional to the degree of activity, Yoga restores the elasticity
of the nervous system. A proper sleep pattern is essential for all
particularity for a hypertension patient. The delicate biorhythm in
the body which influences the neuro-endocrine circuit should
never be upset.
Forward bends are the linchpin of yogic management
without which the pressure never normalizes. Fluctuations of blood
pressure are controlled by these poses. When these posses are
practiced the thoracic cage is brought parallel to the ground and the
heart slows down as there is no strain to push the blood against
gravity to the brain. With the heart rate slowing the cardiac output