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Yoga therapy for hyper tension and ischemic heart disease

Today in the modern world hyper tension and ischemic heart disease is the number one killer of human being in the world, but this is a very silence killer. People can live with this diseases without knowing about it until there death, because there is no specific symptoms that we can see and feel. But in the same time with a very simple test we can diagnose this disease.

So why people suffer from these diseases?

Today people life style is very different from the past. We changed many habits and traditional way of living and this was affecting also our body and also our mind. The new life style that most of the modern world had adopted today includes an unhealthy food (high calorie, high fat, junk food). People use the modern machine to do so many activities that we used to do in the past with our body. For example we are using vehicles and not walking any more, we are using washing machine and not washing by the hands, we are using machine for making the food instead of cooking our self… all this makes us less active physically and usually today works are not including physical work (more of computer and siting work). Another thing is stress that is increasing in the modern society because of different factor, and this plays a big role in these diseases.

So first let's understand how the heart works?

The heart is the most important organ in the body, it is like a machine that doesn't stop even for one minute from birth to death. It is made out of very strong muscle that by contraction and relaxation create the flow of circulation of the blood to each and every organs in the body. In the blood there is exchange of gases, nutrition and hormones. The structure of the heart is made out of four chambers. From two of the chambers the heart sending the blood to the body through large very elastic arteries that can stand in the high pressure that the flow of the blood is coming from the heart. And the blood comes back from the body to the heart through two large veins to the other two chambers. The pulmonary artery and aorta carry blood away from the right and left ventricles. The superior and inferior vena cava enters the right atrium from above and below and the pulmonary veins enters the left atrium. Without the supply of blood (oxygen and sugar) to the organ the body cannot work. The heart himself has a blood supply through the coronary arteries and there branches, because the heart is also an organ in the body, and to be able to function nonstop there is big blood supply to the heart.

What is blood pressure?

Force of the blood fluid inside the artery walls, Measured in units of mm Hg. Blood pressure varies with contraction of the heart. When the rooms of the heart are shrinking arterial blood pressure will be at its peak and this is called "systolic blood pressure". The time between the contractions in the rooms, blood pressure drops and falls to the Lowest, it is called "diastolic blood pressure". The maximum value is always systolic blood pressure. The minimum value is always the diastolic blood pressure.

Blood pressure:

diastolic systolic Group of blood pressure 80> 120> normal 80-89 120-139 prehypertension 90-99 140-159 Hypertension stage 1 100_< 160_< Hypertension stage 2 120< 210< Malignant hypertension

Hypertension:

Hypertension is a chronic disease when the blood pressure is high. This disease can kill us without knowing that we are sick in this disease because there are no special symptoms.

What happen when the blood pressure is high?

In a normal person the blood vessels are elastic in childhood and with the normal process of ageing the blood vessels are losing their elasticity and becoming little hard. The reason that the blood vessels have elasticity is because that in different situation in life we need different blood pressure, for example when we are running we are increasing the heart rate and the blood pressure, and when we are in rest or sleeping the heart rate is slow and also the blood pressure in the vessels is low. When the blood vessels becoming hard the body doesn't have this much flexibility when he need to use different blood pressure because the blood vessels cannot use there layers of muscles for contracting and relaxing the blood vessels. So when someone needs to increase the heart rate due to hard physical work there is too much pressure on the walls of the hard blood vessels because they are not elastic.

Why it is dangers?

From the heart we have big arteries and slowly they become very thin to be able to rich each and every cell of the body. These small blood vessels are called capillaries, when there is a big flow of blood that comes in pressure to them and they lost their elasticity they can be damage and stop the supply of blood to some organs. Organs like eyes, kidneys, heart and brain are the most fast to get hurt because they require a lot of blood supply. This can lead to a heart attack and stroke through the process of atherosclerosis. Atherosclerosis is a thickness of the arteries walls as a result of invasion and accumulation of white blood cells (termed "fatty streaks") and containing both living active WBCs (called inflammation) and remnants of dead cells, including cholesterol and triglycerides.

When someone is suffering from hypertension he doesn't feel any symptoms, that why this disease is called the silence killer. Only by checking the blood pressure one can know that he is having this disease.

What are the causes for hypertension?

In 95% of the people the cause of the disease does not know, but there are few hypotheses for it:

- Diet that is high in salt and fats. - Alcohol - Stress - Lack of exercise (that help in the process of hardening he blood vessels). - Smoking of cigarette and different drugs. - Obesity - uses of different medicines - Different diseases - Genetic

How does stress increase the blood pressure?

The blood vessels are working under the autonomic nerves system. ANS is divided to tow part: Sympathetic and parasympathetic.

Sympathetic: working in stress, creating constriction of blood vassal in the skin and in the digestive system, widening the blood vassal of lungs and muscles, increasing pulse & hart rate, widening the pupil of eyes, increase breathing and blood sugar level, stimulate the adrenalin gland. All this prepare the body to fight or flight situation. This happens in stress, fear, anger.

Parasympathetic: working in relaxation, creating widening of blood vassal to the digestive system, increase the peristalsis movement in intestine, contracting the pupil of the eye, increase saliva and secretion from glands, slow down the heart rate, constrict bronchi. This system works to keep the homeostasis of the body, and prepare the body to cope up with the changes inside and outside the body.

The ANS is regulating by the hypothalamus that this is the center in the brain that related to emotion, so ANS is influenced by our emotional state. When we are having any angry, fearful or stressed emotion the hypothalamus sends a message to activate the sympathetic nerves system. When we are living our life in an environment full of stress, anxiety, tension or worry our body works most of the time with the sympathetic nerves system and then the heart rate is always high which means that the blood pressure on the blood vessels is always high. First thing when someone is diagnosed by a doctor with hypertension the doctor will recommend of taking medicine to lower the blood pressure to control the body, but this solution will not overcome the main cause of the disease. When one is diagnose in hypertension he should check his life style and try to think what the main cause for it and what he can change in his life style. One can change the habit of smoking, drinking, diet, exercise, and to have some relaxation to calm down the mind. Hypertension can cause to atherosclerosis and this can lead to ischemic heart disease. IHD= ischemic heart disease: Ischemia is restricted blood supply to some organ because of obstruction in the blood vessel. In the heart the ischemia happen in the blood vassals that bring the blood to the muscles of the heart, they are called the coronary artery. Ischemic heart disease also known as coronary artery disease, atherosclerotic heart disease and coronary heart disease, it is the most common type of heart disease and cause of heart attacks. The disease is caused by plaque building up along the inner walls of the arteries of the heart, which narrows the arteries and reduces blood flow to the heart. This can lead to a heart attack when there is less or no supply of blood to the heart muscle because of the blockage. After one heart attack the heart muscle are damage so only less part of the heart will work and then the person will have restriction in hard work, because he will get tired early. Also in this disease there are no early symptoms and one will not feel anything for many years. But after there is quite big plaque that narrow the passage of the blood flow one can feel the next symptoms: Stable angina- one will fell pain in the chest, left shoulder and in the jaw during exercise, Fear, high emotion, or any other activity that will increase the heart rate. Unstable angina- one will feel the same pain also during rest without any effort. Variant angina- this is extremely rare situation, when the coronary artery twitching for some reason and causes event of ischemia and pain. This condition pass after a while and it is not due to the process of thickening of the arteries walls.

How does someone get to know that he have IHD?

- When someone is complaining on angina. - Exercise ECG – Stress test - Echocardiography - Coronary angiography - Intravascular ultrasound - Magnetic resonance imaging (MRI) - Exercise radioisotope test (nuclear stress test, myocardial scintigraphy) - X-ray of the chest - Blood test

What does patient do when he fined that he suffer from ISH?

First doctor should check the state of the disease, and if there is not too much clot one maybe can continue as normal with change of life style to prevent farther blocks. When there is block that restrike the patient there are anti Anginotiot medicine that reduce angina and angina attacks, Catheterization and medication to dissolve the clot and angioplasty Coronary artery bypass grafting. with this treatment one will have to change his life style to prevent growing of new clot, and to protect from heart attack. When the heart muscle gets hurt by heart attack they are dying and there is no way back from this condition. So one can continue live if only few of the heart muscle died but then he will not be able to have all the normal functions of life. If a patient get the correct treatment, with a change of life style and yoga one can live quite healthy life without much complication.

So how we can prevent hypertension, IHD, and other heart disease?

Diet is one of the important things in management heart disease. When we are eating diet rich in saturated fats and cholesterol (mostly that comes from animal fats, dairy, sugar, eggs) there is a process of fatty deposit in the blood vessels that with time grows and create a clot that narrow the passage of the blood flow. So by controlling our diet with minimum saturated fats, less sugar and a lot of fibers that will help in the process of digesting fats and sugar we can reduce this factor and keeping our blood vessels open completely. In yoga we can find the yogic diet in the concept of "mittahar". The yogic food should be satvic (creating lightness), not over stimulating like spices and not too heavy to digest like animals meet. It should be fresh food that increases the life and vitality. Yogic concept of diet also takes care of how to prepare the food and how to eat the food. Food should be prepared with love and awareness because part of the energy that we are eating comes from the person that cooked the food. The second thing, when we eat we need to have a calm mind and not to be disturbed by anything else. Because when we are angry or under stress the digestive juices are not stimulating because our mind is in a different place and then if we will be eating this food it will not get digested properly and it will be like a toxin material to the body. If we have this kind of habit these toxins will accumulate in the blood and might create clot in the blood vessels. Another important thing that will help in preventing heart disease is physical exercises, when we are doing physical exercises our heart and blood vessels are working under high blood pressure, and when we relax it comes to normal and reduce the blood pressure to lower than before. It means that the blood vessels are having the contraction and relaxation and by this they can keep their elasticity and it will stop them from the process of degenerating and hardening. That's why we must keep our body active all life. Stress management is one of the most important things to control heart disease. As it explained before, stress causes hyper activity of the sympathetic nerves system and the system doesn't get time to rest and we always have high blood pressure. As we learned before high blood pressure or hypertension is one of the main causes to create the process of thickening of the blood vessels walls and creating clot and this can lead to ischemic heart disease or even heart attack.

So how do we control the stress?

Here comes yoga. Yoga is a science that teaches us how to live happy and peacefully and to be satisfied from our life. When we learn the yoga philosophy we understand that all the problems that manifested in the physical body comes from the disturbed mind. So what we need to do is to learn how to control the mind, or in another words to learn how to direct the negative flow of thoughts that we have in our mind to a flow of positive thoughts. Sage patanjali defined it as "citta vritti nirodha". patanjali gave us different technique of calming our mind and canalizing the energy.

Here are few examples:

- Omkar chanting - Rapid exhalation series (kapalbhati) - Holding the breath- kumbhaka - To create friendliness in the mind - To think about happy things - To create compassion to all the people, to the ones that in pain and in happiness - To be happy for other people and not to be jealous - To try to see well in all the people and not the negative things

These simple practices will help someone under stress to direct his mind to a positive view. The yoga texts tell us that there is a very strong connection between our breath and mind. When we are under disturbed emotion we can see that our breathing is fast, and when we are in peace the breath is very deep and slow. So by doing breathing exercise we can control our mind, this is the practice of pranayama.

Pranayama practices for heart disease:

Different pranayama can be practice but without kumbhaka (holding of the breath) because this may increase the pressure on the heart. Nadishudana pranayama- will help to create balance in our mind and will relax the stress. Sitali and sitkari pranayama- will help to cool down our body, when we are having high blood pressure the body is over working so we have over heat in the body, so cooling pranayama will help in lower the high blood pressure and the body temperature. Bhramari pranayama and omkar chanting- the creation of vibration from the sound of a humming bee or from the omkar works very well on relaxing our brain cells, and this can help in releasing stress. Mild Kapalbhati- it is a cleansing process and not pranayama, but it is very useful in cleaning our blood, because of the exchanges of gases due to forceful exhalation and passive inhalation, while using the abdominal muscles in pushing the air out. In heart patient one should be careful not to do too much stroke and not to give too much pressure, but even if this practice is been done softly it will be very useful.

Asana practice for heart disease:

A patient that suffer from hypertension and is healthy and active should do some simple exercise like walking and weight lifting to avoid farther hardening of the blood vessels that why all simple asanas can be given to him in slow way and with full awareness to not increase the blood pressure. The only asanas one should avoid without guidance from an expert are inverted poses like viparit karni, sarvangasana and sirsasana, because they can create a lot of pressure on the heart. When a person is having uncontrolled high blood pressure, ischemic heart disease or any other complication in the heart, he should follow very simple asana practice that are creating movement in all the body joint to avoid hardening and inflammation in the joint and to keep the muscles active. What is important to remember is that asana is practice of different steady postures of the body with full awareness and without going beyond ones limitation. After each asana one take relaxing pose to bring the heart rate to normal and to relax the muscles. If we practice in this way there will not be any complication and danger in the practice of asanas for heart patients. The different between asanas practices to exercise is that in exercise we increase the heart rate and not using any aware connection between the body and mind, and yoga asana are steady and stable posture that doesn't increasing the blood pressure and helping in activation of the parasympathetic nerves system, that this is what lack in hypertension patient. Researches has shown that people who practice yoga asanas for few month reduce their blood pressure and can go into a relax state (shavasana) very fast after the practice. Swami kuvalyananda ji was doing experiment on blood pressure during the practice of asanas. In the initial part when someone enter to the asana the blood pressure go's little up like in exercises but after maintaining the pose for few minutes the blood pressure go's down to normal and even lower from the normal. He also checked it on inverted poses like sarvangasana and sirsasana and he saw that even then blood pressure go's down to normal because of the vasomotor center is responsible for the regulation of the caliber of blood vessels. This center doesn't let different pose to create more pressure on a particular organ that will create damage to the organ, it regulate the pressure in all body as per to the need. So by this he was proving that by practicing asana for long time we can help in reduce the blood pressure and it will be very effective for people who suffer from heart disease.

Relaxation practices for heart disease:

Shavasana Deep breathing Yoga nidra Observance of the natural breath Meditation

All this practices will help one to take a break from the busy and stressful life and to calm down the heart rate and the mind. Another yogic practice that one can and should follow is the yama and niyama.

These are the social codes of behavior= yama and the self-code of behavior= niyama:

Yama: Ahimsa= non violence Satya= truthfulness Asteya= non stealing Brahmacarya= celibacy Aparigraha= non possessiveness

Niyama: Saucat=cleanliness Santosa= contentment Tapa= austerity Svadhyaya= self-study Isvarapranidhana= surrendering to God

When we are following them we have less tension, worries and stress in our life, this happens automatically, because we are following the rules of nature. We can see very similar codes of behavior all over the world in different countries, religions and tradition. It means that human beings knew always what is wright and what is wrong to follow. And when we are following the wrong way of life and nature we are suffering from stress in our own mind and this creates tension in our own gross body that gets manifest as different disease like hypertension and ischemic heart disease. Different experiment on groups of hypertension and ischemic heart disease patient practicing yoga practices and shavasana meditation has shown statistically significant reduction in blood pressure levels, reduction in drug dosages and improvement in the "sense of well-being".

Reference:

Yoga for hypertension and heart diseases/ dr r. nagarathna, dr h.r nagendra, svyasa. Heart care workshop, 2007/ mr.ravi m. dixit, kaivalyadhama. Yoga mimasa 25- simple assessment of relaxation after asanas. Yoga mimasa 26- Preparatory and Preliminary Yoga Techniques for the Rehabilitation of Patients after Acute Myocardial Infarction with Mild Arterial Hypertension/ dr. m.v bhole. Yoga mimasa 24- effect of shavasana meditation on essential hypertension/ mr.p.p.poddar, mr.k.m.gangwal, mr.s.d.vinod, mr.m.n.palsane. Yoga mimamsa 24- yogic therapy as a complement in ischemic heart diseases treatment/ dr.pedro de vicente monjo. Yoga mimamsa 2- yogic poses and blood pressure/ swami kuvalayananda ji. Yoga mimamsa 2- blood pressure experiment on sarvangasana, matsyasana and sirshasana/ swami kuvalyananda ji.

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