Immediate effect of chandra nadi pranayama (left unilateral forced nostril breathing) on cardiovascular parameters in hypertensive patients.

INTRODUCTION: Recent studies have reported differential physiological and psychological effects produced by exclusive right and left nostril breathing and clinical research is required to prove immediate and sustained efficacy of these techniques in various psychosomatic conditions such as hypertension (HT). The present study was designed to determine immediate effects of 27 rounds of exclusive left nostril breathing, a yogic pranayama technique known as chandra nadi pranayama (CNP) on cardiovascular parameters in patients of essential HT. MATERIALS AND METHODS: Twenty two patients of essential HT under regular standard medical management were individually taught to perform CNP by a qualified yoga instructor with a regularity of 6 breaths/min throughout a performance of 27 rounds of CNP. Pre and post intervention heart rate (HR) and blood pressure (BP) measurements were recorded using non-invasive semi-automatic BP monitor and Students t test for paired data used to determine significant differences. RESULTS: Twenty seven rounds of CNP produced an immediate decrease in all the measured cardiovascular parameters with the decrease in HR, systolic pressure (SP), pulse pressure, rate-pressure product and double product being statistically significant. Further, gender-based sub-analysis of our data revealed that our male participants evidenced significant reductions in HR and SP with an insignificant decrease in diastolic pressure, while in female participants only HR decreased significantly with an insignificant decrease in SP. DISCUSSION AND CONCLUSION: It is concluded that CNP is effective in reducing HR and SP in hypertensive patients on regular standard medical management. To the best of our knowledge, there are no previously published reports on immediate effects of left UFNB in patients of HT and ours is the first to report on this beneficial clinical effect. This may be due to a normalization of autonomic cardiovascular rhythms with increased vagal modulation and/or decreased sympathetic activity along with improvement in baroreflex sensitivity. Further studies are required to enable a deeper understanding of the mechanisms involved as well as determine how long such a BP lowering effect persists. We recommend that this simple and cost effective technique be added to the regular management protocol of HT and utilized when immediate reduction of BP is required in day-to-day as well as clinical situations.

Effect of yoga therapy on reaction time, biochemical parameters and wellness score of peri and post-menopausal diabetic patients.

BACKGROUND: Yogic practices may aid in the prevention and management of diabetes mellitus (DM) and reduce cardiovascular complications in the population. The present study has been undertaken to evaluate the effect of yoga therapy on reaction time, biochemical parameters and wellness score of peri and post-menopausal diabetic patients. MATERIALS AND METHODS: 15 peri and post-menopausal patients receiving standard medical treatment for type 2 DM were recruited and reaction time and biochemical investigations were done before and after a comprehensive yoga therapy program comprising of three times a week sessions for six weeks. A post-intervention, retrospective wellness questionnaire compiled by ACYTER was used to evaluate the comparative feelings of the patients after the therapy program. RESULTS: Yoga training reduced auditory reaction time (ART) from right as well as left hand, the decrease being statistically significant (P<0.05) for ART from the right hand. There was a significant (P<0.01) decrease in fasting and postprandial blood glucose levels as well as low density lipoprotein. The decrease in total cholesterol, triglycerides, and very low density lipoprotein and increase in high density lipoprotein was also statistically significant (P<0.05). All the lipid ratios showed desirable improvement with a decrease (P<0.01) of TC/HDL and LDL/HDL ratios and increase (P<0.05) in the HDL/LDL ratio. DISCUSSION OR CONCLUSION: Shortening of RT implies an improvement in the information processing and reflexes and is the first such report in diabetic patients. This has clinical significance and is worth further exploration with wider, well controlled, randomized studies in the diabetic population. Changes in blood glucose levels may be due to improved insulin sensitivity, decline in insulin resistance and increased sensitivity of the pancreatic b cells to glucose signals. Yoga improved the 'heart friendly' status of lipid profile in our subjects and as our participants were peri and post-menopausal, the decrease in cardiovascular risk profile is of greater significance. A comprehensive yoga therapy program has the potential to enhance the beneficial effects of standard medical management of diabetes mellitus and can be used as an effective complementary or integrative therapy program.

Immediate cardiovascular effects of pranava pranayama in hypertensive patients.

Slow, deep, pranayama-based breathing training has been shown to be effective in reducing blood pressure (BP). The present study was undertaken to determine immediate effects of performing pranava pranayama on cardiovascular parameters in hypertensive patients. 29 hypertensive patients who were on medical treatment and also attending yoga sessions were recruited for the present study. Supine heart rate (HR) and BP were recorded before and after performance of pranava pranayama for five minutes. Post intervention statistical analysis revealed a significant (P < 0.05) reduction in systolic pressure (SP) and a more significant (P < 0.01) reduction in HR, pulse pressure and double product (Do P). The reduction in rate-pressure product (RPP) was highly significant (P < 0.001). Pranava pranayama is effective in reducing HR and SP in hypertensive patients within five minutes of the practice. This may be due to a normalization of autonomic cardiovascular rhythms as a result of increased vagal modulation and/or decreased sympathetic activity and improved baroreflex sensitivity along with an augmentation of endogenous nitric oxide production. Our findings have potential therapeutic applications in day-to-day as well as clinical situations where blood pressure needs to be brought down at the earliest. The significant fall in RPP and Do P signifies a reduction in oxygen consumption and work done by the heart. It is concluded that pranava pranayama, a simple and cost effective technique can be used in the management of hypertensive patients in addition to the regular medical management. Further studies are required to enable a deeper understanding of the mechanisms involved and its usefulness in the long- term management of hypertension.

Immediate effect of sukha pranayama on cardiovascular variables in patients of hypertension.

UNLABELLED: Hypertension is one of the most common health disorders, and yoga has been shown to be an effective adjunct therapy in its management. Earlier studies have reported blood pressure (BP)-lowering effects of slow, deep breathing after 3 weeks and 3 months of training and beneficial immediate effects of slow, deep breathing in reducing premature ventricular complexes and lowering blood pressure. None of these immediate studies used the concept of pranayama, involving conscious internal awareness of the whole breathing process. This study was undertaken to determine the immediate cardiovascular effects of sukha pranayama in hypertensive patients. METHODS: Twenty-three hypertensive patients attending the Yoga OPD at JIPMER were recruited for the study and instructed to perform sukha pranayama for 5 minutes at the rate of 6 breaths/min. This pranayama involves conscious, slow and deep breathing with equal duration for inhalation and exhalation. Heart rate (HR) and BP were recorded before and immediately after the intervention. RESULTS: Post-intervention statistical analysis revealed a significant (p < .05) reduction in HR and a highly significant (p < .001) reduction in systolic pressure, pulse pressure, mean arterial pressure, rate-pressure product, and double product with an insignificant fall in diastolic pressure. DISCUSSION: It is concluded that sukha pranayama at the rate of 6 breaths/minute can reduce HR and BP in hypertensive patients within 5 minutes of practice. This may be due to a normalization of autonomic cardiovascular rhythms as a result of increased vagal modulation and/or decreased sympathetic activity and improved baroreflex sensitivity. Further studies are required to understand possible mechanisms underlying this beneficial immediate effect and to determine how long such a beneficial effect persists.