Yoga is an ancient physical, mental and spiritual practice that originated in India. The word ‘yoga’ derives from Sanskrit and means to join or to unite, symbolizing the union of body and consciousness.

Yoga is an invaluable gift from our ancient tradition. Yoga embodies unity of mind and body, thought and action … a holistic approach [that] is valuable to our health and our well-being. Yoga is not just about exercise; it is a way to discover the sense of oneness with yourself, the world and the nature.

Despite awesome advances in modern medicine, globally millions die of cardiovascular diseases every year. Allopathy depends on powerful drugs that have many undesirable side effects, especially when administered over a period. There is a pressing need for introducing yoga as an add-on, complimentary system to augment modern Medicare.

Indian yogic tradition is pre-historic believed to originate 5000 years ago. The first book of humankind, Rigved, mentions about yogic meditation. Yajurved exhorts us to practice yoga for enhancing mental health, physical strength and prosperity. Upanishads are replete with yogic concepts and Bhagavadgita (~3000BC) mentions the term yoga.

Standardise yoga ha eight limbs or key facets:

1. Yamas (observance),
2. Niyamas (self-discipline),
3. Asana (physical postures),
4. Pranayama (breath regulation),
5. Pratyahara (sensory withdrawal),
6. Dharana (concentration),
7. Dhyana (meditation), and
8. Samadhi (integration).

1. Ashtanga (Patanjali) Yoga,
2. Hatha Yoga,
3. Bhakti Yoga,
4. Karma Yoga,
5. Jnana Yoga,
6. Mantra Yoga,
7. Kriya Yoga,
8. Kundalini Yoga.

Modern yoga styles are predominately comprised of Hatha Yoga. Core components of Hatha Yoga include:

1. Stretching exercises and physical postures (Asanas),
2. Breath control (Pranayama) and
3. Concentration techniques (Meditation).

Yoga may elicit cardiovascular changes through neurological pathways such as

1. The hypothalamic-pituitary adrenal (HPA)
2. Sympatho-adrenal medullary (SAM) axes and
3. The autonomic nervous system (ANS)
4. Physical exercise mechanisms

Modulation of the HPA and the SAM may potentially reduce over-activation, over-production, and release of glucocorticoids, catecholamine, and subsequent pro-inflammatory cytokines which are considered as key contributors to increased CHD risk.
Increased muscle activity and subsequent cardiovascular and respiratory improvements during postures (asana) and breathing (pranayama) of yoga is believed to be induced, in part, by increased nitric oxide level and antioxidant capacity in the blood vessels.
This alteration in endothelial function and arterial stiffness may explain the blood pressure lowering property of yoga.

1. Ultimate benefits are:
2. Improvement in negative mood and depression symptom
3. Improvement in fatigue
4. Improvement in blood pressure
5. Decreased insulin resistance
6. Improvement in lipid profiles

Stress can be defined as a state of worry or mental tension caused by a difficult situation. Nearly 44% of the respondents in India stated that they were struggling financially, compared with the global average of 29%. Depression rates at 15% to 30% in CHD populations in comparison to approximately 7% in the general population.

Stress affects both the mind and the body. Observational studies have shown that patients with CHD who are lonely, hopeless, helpless and despondent do worse compared to those who feel at ease with their surroundings.

Yoga encourages mental and physical relaxation, which helps reduce stress and anxiety. They also promote the release of feel-good hormones that can positively affect how you handle stress. Focusing on the present moment during your yoga practice enhances your awareness, boosts your concentration, and centers your mind.

Especially, breathing exercises, known as pranayama in Sanskrit, teach you to relax, regulate your breath, and breathe deeply. This helps reduce stress and calm your body and mind. Breathing techniques can also enhance your sleep quality and encourage mindfulness. Alternate nostril breathing (nadi shodhana) ujjayi breathing, breath of fire (kapalabhati), lion’s breath (simhasana), sitali breath, humming bee breath (bhramari).

A US based study has demonstrated that mindfulness-based stress reduction (MBSR) such as yoga, reduced the average number of visits to primary care physicians, suggesting that yoga may contribute to general health and particularly in cardiac health in populations that are subject to significant mental stress.

Several studies suggest that yoga may significantly improve risk factors for CVD like body weight, lipid profile, blood pressure, smoking, psychosocial stress and type 2 diabetes mellitus.

In the most widely cited Lifestyle Heart Trial, patients with CHD were assigned to an experimental group (very low-fat vegetarian diet, discontinuation of smoking, stress management training and moderate exercise) or to a usual-care control group for 1 year.
The most dramatic finding was regression in coronary artery stenosis, significant decrease in blood pressure and a decline in the frequency of angina attacks.

Mount Abu Open Heart Trial, based on principles of meditation, a vegetarian diet and, moderate aerobic exercise found that important health improvements (cardiovascular, metabolic and psychologic aspects), and a reduction in coronary stenosis and cardiac events.

A few other studies have demonstrated that yoga may be useful in control of premature ventricular ectopics and may also decrease the atrial fibrillation burden in patients with paroxysmal atrial fibrillation.

There is no right or wrong time to practice yoga. Everyone has a different lifestyle, so you can practice it whenever you find the time, either in the morning or in the evening. Both have their own pros and cons. Considering the same, you can decide when you want to practice it.

There is no right or wrong time to practice yoga. Everyone has a different lifestyle, so you can practice it whenever you find the time, either in the morning or in the evening. Both have their own pros and cons. Considering the same, you can decide when you want to practice it.

One of the reasons for advocating yoga to patients is low risk of side effects, when yoga is performed in moderation. Although most patients do well, appropriate yoga requires proper training and guidance.

However, there are some issues that need some attention. For example, aggressive and sudden changes in yoga postures may be stressful. Several cardiovascular specific side-effects have been reported. For example, a patient developed vertebral artery occlusion after neck manipulations during yoga practice.

It is very important that one should perform yoga under proper training and guidance. vigorous yoga practice should be avoided in the elderly or people with high ocular pressure disorders.

Patients with hypertension or CHD should avoid shoulder standing exercises that flex the neck to avoid neck arterial damage. These patients should also avoid inverted asana (shoulder stand and head stand).

Most importantly, patients with any disease should not rely on practice of yoga instead of standard medical practice; rather the two approaches should be used together for a complementary effect.

Trainer must be certified from Yoga Certification Board, From AYUSH, Well Experienced, Learnt from Yoga Professional teacher. App- WHO mYoga from Ministry of AYUSH is available.