Study: Adding Yoga to a Regular Exercise Routine May Help Improve Cardiovascular Health

Adding yoga to a regular exercise routine may provide better heart health benefits and overall well-being, compared to stretching, new research shows.

In a pilot study, published in December in the Canadian Journal of Cardiology, researchers found that adding just 15 minutes of yoga to an exercise routine before 30 minutes of aerobic activity improved both systolic blood pressure and resting heart rate, compared to 15 minutes of stretching, in adults with diagnosed hypertension.

“This study provides evidence for an additional non-pharmacologic therapy option for cardiovascular risk reduction and blood pressure control in patients with high blood pressure, in the setting of a primary prevention exercise program,” lead investigator Paul Poirer, MD, PhD, a professor in the Faculty of Pharmacy at Laval University in Quebec, Canada, said in a press release.

"As observed in several studies, we recommend that patients try to find exercise and stress relief for the management of hypertension and cardiovascular disease in whatever form they find most appealing," added Dr. Poirer. "Our study shows that structured yoga practices can be a healthier addition to aerobic exercise than simply muscle stretching."

Yoga Compared to Stretching for Heart Health

For the study, Dr. Poirer and his team of researchers sought to find out whether the addition of yoga to an exercise routine could reduce cardiovascular risk.

Researchers recruited 60 people for an exercise training program for the study. They'd all been previously diagnosed with high blood pressure and metabolic syndrome, a catch-all term for a group of conditions that together raise your risk of coronary heart disease, diabetes and stroke. 

Participants were split into two groups: one that performed 15 minutes of yoga before a 30-minute cardiovascular routine five times a week, the other that did 15 minutes of stretching before cardio. Researchers measured participants' blood pressure, glucose, and lipid levels, as well as their Framingham and Reynolds risk scores. At baseline, there were no differences between groups.

After a three-month regimen, both groups saw a decrease in resting systolic and diastolic blood pressure, mean arterial blood pressure, and heart rate—but participants in the yoga group saw an even greater reduction in systolic blood pressure (10 mmHg vs. 4 mmHg), resting heart rate, and 10-year cardiovascular risk.

“This is only a pilot study," Dr. Poirer told Health, "but if additional studies show that yoga changes morbidity and mortality, it is something that should be done in cardiac rehabilitation.” He added that, while the benefits of yoga are widely known outside of North America, studies like this have the potential to shift the way people in this part of the world view the exercise.

"Yoga decreases your parasympathetic drive, it relaxes your stress response, and increases your relaxation response, which is good for heart health," said Dr. Poirer. "We need to have an open mind."

Allowing the Body and Mind to Work Together

Though the exact mechanism behind why yoga shows benefit for hypertensive patients over just stretching is unknown, researchers said it has to do with more than the physical aspect of stretching—yoga engages both the body and the mind.

Deep breathing exercises paired with poses that stretch the muscles help quell the fight-or-flight stress response, and engage the rest and digest relaxation response, according to Tamanna Singh, MD, co-director of the Sports Cardiology Center at the Cleveland Clinic.

“You're essentially exercising the ability to calm your body by decreasing your stress which leads to decreasing your heart rate and blood pressure, improving your heart rate variability, and ultimately improving cardiovascular risk,” Dr. Singh, who was not involved in the new research, told Health.

The awareness yoga cultivates can also have rippling effects on other healthy habits. 

When practicing awareness and mindfulness, “you tend to become more intentional about what you put into your body, for example, your nutrition, and how else you move your body, as well as your relationships,” said Dr. Singh.

Poirier notes that there are many different types of yoga, and the benefits you get from different kinds may vary. For example, a cardio-based practice will have the added benefit of aerobic exercise or weight training. These types of yoga can still provide the benefits around mindfulness, said Singh. 

There’s also evidence that the benefits of yoga extend beyond mindfulness, blood pressure, and heart rate. 

Previous research has found that yoga may also reduce so-called “bad” low density lipoproteins (LDL) cholesterol levels. LDL cholesterol builds up on the arterial walls, making them hard and narrow, which is a significant risk factor for heart disease. 

A small study published in 2019, in the International Journal of Preventive Medicine, followed 24 women who did yoga three times a week for 26 weeks. They found that while the practice didn’t appear to have an effect on heart-protecting high density lipoproteins (HDL) cholesterol, it did significantly lower total cholesterol and LDL cholesterol.

If you're looking to add a yoga practice to your exercise routine, Dr. Singh recommends giving yourself time to adjust and the freedom to make mistakes.

"Give yourself [time] to commit, whether it's buying a pack of classes or committing with a friend," said Dr. Singh. "If you miss a session or a day, it's not the end of the world; don't beat yourself up about it. Reset your intention, recommit, and just go to another class. You'll never regret it."