Holistic Approaches to Heart Health: Yoga

Nicole L. Hatcher, DHS(c), MPAS, PA-C
Adjunct Professor, Kaplan University School of Health Sciences

Nearly every week, new information about treatments for heart disease is printed in newspapers and magazine and broadcast on television. Do you sometimes feel overwhelmed when trying to pick and choose which approaches are best for you? If so, you certainly are not alone. This article is the first in a series that will explore complementary approaches to heart health, emphasizing the beneficial effects of holistic therapies related to exercise and fitness, nutrition, stress management, and much more. We begin this series with a look at yoga and its role in heart health. But first it is important to understand how truly devastating heart disease is in America and why new approaches are so important.

Cardiovascular disease, also referred to as heart disease, is the leading cause of death for both men and women in the United States. In 2006, heart disease claimed the lives of 864,480 Americans, accounting for 34.3 percent of all deaths.1 It is currently estimated that 80 million American (approximately 1 in 3) adults are living with one or more types of heart disease.1 Not only does heart disease have a dramatic impact on the health of Americans, it also greatly impacts health care expenditure. In 2010, heart disease is expected to cost America $316.4 billion including the costs of direct health care services, medications, and lost productivity.1

Typically the term cardiovascular or heart disease refers to a number of distinct heart conditions, the most common of which is coronary artery disease. Coronary artery disease is caused by a buildup of plaque in the arteries that results in decreased oxygen and blood flow to the heart muscle. Risk factors for heart disease include cigarette smoking, hypertension or high blood pressure, high cholesterol, diabetes, obesity, physical inactivity, poor diet, and family history.2


Even though heart disease is increasingly prevalent in America, you do not have to sit idle and accept this as your fate. Prevention is one proven key to living a heart healthy life and there are several well-researched traditional approaches for reducing your risk for heart disease. These approaches include smoking cessation, exercising for 30 minutes on most days of the week, proper management of medical conditions such as high blood pressure, diabetes, and high cholesterol, eating a well balanced diet, and maintaining a healthy weight.3 As heart disease becomes more costly for Americans, medical providers, researchers, and patients alike look for additional strategies that can lower risk and improve heart health.

The paradigm shift towards holistic medicine is raising awareness of complementary therapies that can impact heart disease alongside traditional approaches. Emerging research is increasingly highlighting the role of yoga in reducing risk for heart disease. Yoga is an ancient mind-body discipline that originated in India, but has grown in popularity in the Western world in recent years. The word yoga comes from the Sanskrit word “yug” meaning to join or to bind and denotes “the joining of the lower human nature to the higher”.4, 5 Hatha yoga is the most commonly practiced form of yoga in the United States. Yoga sessions can vary greatly in content and time, but a typical session lasts 30 to 45 minutes. Each session has 3 essential components:

  1. physical exercises, known as asanas or postures,
  2. breathing exercises, known as pranayamas, and
  3. concentration techniques such as meditation.4, 5

Yoga can also be a form of low impact exercise. Most yoga sessions typically represent low levels of physical activity with metabolic expenditures similar to that of walking on a treadmill.6 The changing intensity of yoga causes energy expenditure to vary. Although not meeting the recommended exercise requirements established by the American Heart Association, yoga can be combined with other forms of physical activity to improve physical fitness in sedentary individuals.6

Yoga has been shown to alter lung, brain, and metabolic functions resulting in beneficial effects on the baseline cardiovascular status in healthy individuals.5 In addition yoga has been shown to improve chronic conditions that are known to increase risk for developing heart disease. In a study conducted at the Integral Health Clinic, an outpatient lifestyle modification facility, 98 subjects ages 20 to 74 with diseases such high blood pressure, coronary artery disease, and diabetes were studied to reveal the impact of a brief lifestyle modification program based on yoga. At the conclusion of the study, subjects were noted to have marked reductions in blood glucose levels and unhealthy cholesterol levels as compared to levels prior to the beginning the lifestyle modification course.7

One of the most profound studies on the relationship between yoga and heart disease was conducted in India in 2000. A group of 42 men with a documented history of coronary heart disease, proven by coronary angiography, were randomly placed in a control group without yoga and an intervention group. The intervention group was treated with a user-friendly program consisting of yoga, control of risk factors, diet control, and moderate aerobic exercise. The control group was managed with conventional methods that included risk factor control and an American Heart Association step I diet.8 At the end of one year, the 21 subjects that participated in yoga had a significant reduction in the number of weekly chest pain episodes, improved exercise capacity, and reduction in body weight. Even more impressively, the yoga intervention group showed a significant reduction in plaque progression and an increase in plaque regression as compared to the control group.8 This study suggested that yoga intervention, when combined with other risk reduction measures, has the potential to halt the progression of heart disease.

Heart disease is a major contributor to disease, disability, and death in the United States and worldwide. Traditional ways of preventing heart disease have been well established in the medical community, but because of the impact of this devastating disease complementary strategies are increasingly being put to the test. Yoga is growing in popularity in the Western world and is a safe, inexpensive, and non-invasive way to improve quality of life and reduce the many of the risk factors associated with heart disease. Any person with known heart disease or risk factors for heart disease should consult with their medical provider before proceeding with yoga.


1. D. Lloyd-Jones et al., “Heart Disease and Stroke Statistics—2010 Update. A Report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee,” Circulation, 121 (2010):e1-e170.
2. J. McPherson, “Coronary Artery Atherosclerosis,” Emedicine. On the Internet at http://emedicine.medscape.com/article/153647-overview.
3. J. Torpy, A.E. Burke, and R.M. Glass, “Coronary Heart Disease Risk Factors,” Journal of the American Medical Association, 302 no. 21 (2009): 2388.
4. C. Lee, Yoga FAQ, Yoga Journal. On the Internet at http://www.yogajournal.com/basics/820.
5. R Mamtani and R. Mamtani, “Ayurveda and Yoga in Cardiovascular Diseases,” Cardiology in Review, 13 no. 3 (2005): 155-162.
6. M. Hagins, W. Moore, and A. Rundle, “Does practicing Hatha Yoga Satisfy Recommendations for Intensity of Physical Activity Which Improves and Maintains Health and Cardiovascular Fitness?” BMC Complementary and Alternative Medicine, 7 no. 40 (2007).
7. R.L. Bijlani et al., “A Brief But Comprehensive Lifestyle Education Program Based on Yoga Reduces Risk Factors for Cardiovascular Disease and Diabetes Mellitus,” The Journal of Alternative and Complementary Medicine, 11 no. 2 (2005): 267-274.
8. S.C.Manchanda et al., “Retardation of Coronary Atherosclerosis With Yoga Lifestyle Intervention,” Journal of Association of Physicians of India, 48 (2005): 687-694.

Nicole Hatcher, DHS(c), MPAS, PA-C

Dr. Nicole Hatcher is an adjunct professor at Kaplan University’s School of Health Sciences and teaches the course Models of Health and Wellness. In addition, she works full-time as a physician assistant in cardiology in Norfolk, Virginia. Dr. Hatcher received a Bachelor of Science in Physician Assistant Studies from Howard University and a Master of Advanced Physician Assistant Studies from Oregon Health & Science University. She holds a Doctor of Health Science degree from Nova Southeastern University.

Kaplan Higher Education Corporation is a division of Kaplan, Inc., a subsidiary of The Washington Post Company.

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