Hypertension is one of the primary risk factors for stroke, ischemic heart disease, chronic kidney disease and cardiovascular diseases[1]. The relationship between blood pressure and risk of cardiovascular disease events is continuous, consistent, and independent of other risk factors. The higher the blood pressure, the greater is the chance of coronary artery disease, heart failure, stroke, and kidney diseases. Management of other risk factors is essential and should follow the established guidelines for controlling these coexisting problems that contribute to overall cardiovascular risk[2]. Yoga is one such alternative healthcare practice thought to improve blood pressure control. Complementary therapy like yoga is having effect on mental and physical health[3]. The yoga emphasis on promotion, prevention and curative measures and helps to maintain normal blood pressure. The potential of gentle restorative yoga as a therapeutic option for hypertensive patients[4].Pranayama can be added as a supportive therapy with drugs in mild or moderate cases of hypertension[5]. Slow breathing practices are effective in reducing BP and are recommended as the first treatment for low-risk hypertensive and prehypertensive patients who are reluctant to start medication[6].The present study aimed to evaluate the effectiveness of yoga therapy on blood pressure among hypertensive subjects.

80 subjects (Control-40; Hypertensive-40) with ages ranging from 35 to 50 years were selected at random using the random sample technique. These subjects had blood pressure readings between 130/90mmHg - 160/100 mmHg are considered hypertensive. The study was conducted in Department of Physiology, Kurnool Medical College. A standard sphygmomanometer was used to measure and routinely monitor the blood pressure levels of hypertensive subjects. The hypertensive subjects were scheduled for yoga therapy for a period of 12 weeks, and their blood pressure readings were noted. We conducted the pre-test and post-test levels of blood pressure among hypertensive subjects in the present study. The willingness of the subjects obtained to conduct the study and all the values were recorded and analysed.  

In experimental group, out of 40 samples 8(20%) were 36-45 years of age, 14(33.33%)were 46-55 years of age, 18(45%) were 56-65 years of age, in control group 10(25%)were 36-45 years of age, 14(35%)of them were 46-65 years of age, 16(40.00%)were 56-65years of age. The male subjects in experimental group were 18(45%) were males, 22(55%) were females, and in control group was 20(50%) were males, 20(50%) were females. The occupation in the experimental group was 12(30%) belonged to sedentary worker, 18(45%) of them belonged to moderate worker, 10(25%) belonged to heavy worker, and in control group 12(30.00%) belonged to sedentary worker 16(40%) of them belonged to moderate worker, and 12(30%) belonged to heavy worker. The food pattern in experimental group was 11(27.5%) belonged to vegetarian, 29(72.5%) belonged to non-vegetarian and in control group 8(20.00%) of them belonged to vegetarian and 22(80.00%) of them belonged to non-vegetarian. The duration of hypertension in experimental group was 13(32.5%) belonged to for 3 months, 19(47.5%) belonged to for 6 months, 8(20%) belonged to since year and in control group 14(35%) belonged to for 3 months, 20(50%) belonged to for 6 months and 6(15%) belonged to for 1 year. The education in experimental group was 38(95%) belonged to literate and 2(5%) in belonged to illiterate and in control group was 40(100.00%) belonged to literate and 0(0.00%) belonged to illiterate. The family history in experimental group was 18(46.67%) belonged to Hereditary, 22(53.33%) belonged to Non hereditary and in control group was 20(50.00%) belonged to Hereditary, 20(50.00%) belonged to Non hereditary[Table 1].

Table 1: Distribution of subjects according to demographic variables in experimental and control group

The blood pressure level in experimental group was 0(0%) had normal blood pressure, 820.0%) had Pre-hypertension, 22 (55%) had stage-1 hypertension, 10(25.00%) had stage-2 hypertension whereas in control group 0(0%) had normal blood pressure level, 11(27.5%) had Pre-hypertension, 21(52.5%) had stage-1 hypertension, 10(25%) had stage-2 hypertension in the Pre-Test [Table 2 & Graph 1].

Table 2: Assessment of blood pressure level among hypertension subjects in experimental group and control group (Pre-Test)

Table 3: Assessment of blood pressure level among hypertension subjects in experimental group and control group (Post-Test)

Table 4: Comparison of Pre-test and Post-test blood pressure level among hypertension subjects in experimental and group and control group

 The mean score of blood pressure level in experimental group was 1.70 in post-test and 2.83 in control group post-test. The estimated value was 5.16 with significantly suggested that that yoga was effective in reducing the blood pressure level among subjects with hypertension[Table 5].

Table 5: Comparison of Post-test blood pressure level among hypertension subjects in experimental and group and control group

The level of blood pressure reduction due to yoga is similar to that of other lifestyle modifications like reduced intake of sodium and alcohol [7] and exercise [8]. Different studies stated that the benefits of yoga could only be maintained by the regular practice and integration of these techniques in the day-to-day life[9]. Regular yoga and meditation are required to maintain positive effects on the blood pressure and baseline weight[10]. Different yoga interventions were compared, and it was observed that only the studies that included breathing and/or meditation techniques without postures had significant effects on hypertension[11]. Studies incorporating yoga postures, meditation, and breathing resulted in higher BP reduction [12]. The key components of yoga intervention for hypertensive patients are breathing and meditation rather than physical activity[13]. Even this small reduction in BP in people with hypertension reduces the risk of cardiovascular events [14]. Yoga reduces BP significantly as compared to the no-treatment group and is comparable to exercise and other non-pharmacological treatment groups. Exercise and other non-pharmacological treatments reduce BP compared to the no-treatment group[12]. The amount of BP reduction achieved by yoga is significant and clinically relevant. Yoga practices combined with antihypertensive drugs have been shown to reduce BP and pulse rate during resting conditions, during stimulus-induced conditions, and in mild-to-moderate hypertension[15]. In our study, the mean score on blood pressure level in experimental group was 3.01 in pre-test and 1.70 in post-test. In control group the mean score on blood pressure level was 2.96 in pretest and 2.83 in post-test among subjects with hypertension. The mean score of blood pressure level in experimental group was 1.70 in post-test and 2.83 in Post-test of control group. Our study acknowledges the  significant improvement upon earlier mind-body studies by incorporating an active control group [16], and may help yoga-specific effects from general time or measurement-related influence whereas most prior yoga studies limited with statistically significant [17].There was significant reduction in blood pressure level in subjects with hypertension after intervention of yoga therapy for a period of 12 weeks in our study in agreement with previous literature[11,12,17].

The current study suggests that regular practice of yoga could be helpful with significant reduction in blood pressure level in patients with hypertension and its associated comorbidities.

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