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Yoga for High Blood Pressure: A Gentle Routine

When the heart pumps blood through the arteries, the blood puts pressure on the artery walls.

This is referred to as blood pressure.

High blood pressure is when the force of this pressure is consistently too high. 

Understanding blood pressure, knowing how to measure it, and understanding how blood pressure works in conjunction with yoga is a must for teachers who plan to help those with hypertension on their yoga journey. 

Understanding Blood Pressure Basics

Hypertension is often referred to as a silent killer. There are no symptoms to let you know you have it - the only way to find out if your blood pressure is too high is to measure it.  

Two numbers are used to measure blood pressure:

  • Systolic blood pressure - measures the pressure in your arteries when your heart beats. This is the first number measured in a blood pressure reading. 
  • Diastolic blood pressure - measures the pressure in your arteries while your heart is resting between beats. This is the second number measured in a blood pressure reading. 

A normal blood pressure range is below 120/80 mmHg.

High Blood Pressure is All Too Common

High blood pressure, also known as hypertension, affects nearly half of adults in the US - that’s roughly 116 million people! 

Here’s some stats from the CDC:

  • Having hypertension puts you at risk for heart disease and stroke, which are leading causes of death in the United States.
  • In 2019, more than half a million deaths in the United States had hypertension as a primary or contributing cause.
  • Nearly half of adults in the United States (47%, or 116 million) have hypertension, defined as a systolic blood pressure greater than 130 mmHg or a diastolic blood pressure greater than 80 mmHg or are taking medication for hypertension.3
  • Only about 1 in 4 adults (24%) with hypertension have their condition under control.
  • About half of adults (45%) with uncontrolled hypertension have a blood pressure of 140/90 mmHg or higher. This includes 37 million U.S. adults. 
  • About 34 million adults who are recommended to take medication may need it to be prescribed and to start taking it. Almost two out of three of this group (19 million) have a blood pressure of 140/90 mmHg or higher.
  • High blood pressure was a primary or contributing cause of death for 516,955 people in the United States in 2019.
  • High blood pressure costs the United States about $131 billion each year, averaged over 12 years from 2003 to 2014.

Ways to Prevent or Manage Hypertension

For many people, high blood pressure can be managed or prevented by making lifestyle changes.

The problem usually develops over time due to lifestyle choices like smoking, not eating a balanced diet, and not getting enough exercise.

Diabetes, obesity, kidney disease, and some health conditions can also contribute to high blood pressure. 

Here are a few ways to manage or prevent high blood pressure:

  • Move your body! The CDC recommends at least 30 minutes of exercise a day, five days a week. That’s 150 minutes of movement.
  • Stop smoking
  • Eat a balanced diet that limits sodium, and alcohol. 
  • Maintain a healthy weight
  • Manage stress

Luckily, a regular yoga practice can help with at least two of these - exercising, & managing stress!

Stress: It’s what gets your blood boiling - or rather, elevates your blood pressure. 

Living a fast paced, high stress lifestyle can be the culprit of high blood pressure. 

“Essential hypertension” is defined as high blood pressure without a clearly identifiable cause. This type of hypertension is not only the most common, affecting the majority of those who experience hypertension, but it is linked to a high stress lifestyle as well as lifestyle choices like poor diet, & lack of exercise.

What to Avoid to Curb Hypertension 

A regular yoga practice is helpful for those with hypertension because as discussed above - it helps to manage stress and is also a form of exercise. While most yoga is helpful, there are some things you may want to avoid. 

Contraindicated Poses for Hypertension 

  • Deep backbends like Wheel.
  • Anything that compresses the diaphragm such as Bow Pose. This can elevate blood pressure. 
  • Some standing poses with arms overhead, such as Warrior 1 and Triangle Pose as this raises the heart rate. 
    • These poses can be modified by keeping hands on the hips
  • Unsupported inversions like Headstand, Forearm Stand, and Handstand. 

Helpful Poses for Hypertension 

  • Gentle forward folds like Paschimottanasana, especially with support under the head.
  • Mild backbends that do not compress the diaphragm, like Bridge Pose.
  • Pranayama, especially cooling or balancing pranayama such as Nadi Shodhana, Box Breath, and Sheetali. 
  • Supported inversions such as Legs up the Wall. 

Teaching Tips to Help You With Your High Blood Pressure Students 

When working with students with hypertension, encourage your students to be mindful of their breath & how they’re feeling throughout practice.

If at any time they feel dizzy or hot, remind them to rest - give them resting pose options, such as Virasana, Paschimottanasana, or Sukhasana.

 For some students, resting in Child’s Pose may feel okay, but because the head is still lower than the heart, Child’s Pose will not lower their blood pressure. Anytime the head is below the heart, blood pressure rises. 

Use support!

Utilize props in your classes & encourage your students to do so as well.

In poses like Uttanasana, and Prasarita Padottanasana, students with hypertension can place their hands on blocks to maintain the head in line or almost in line with the heart in order to avoid raising their blood pressure. 

Sequencing Tips for Teaching Students with High Blood Pressure

Warm Up Section:

  • Warm up slowly with seated postures like Baddha Konasana, Gomukhasana, & Paschimottanasana. 
  • Add in some mild abdominal exercises with the head down such as Pelvic Tilts, & Twisted Root Abdominals.
    • Pelvic Tilts:
      • Begin supine with knees bent & feet on the mat.
      • Inhale into low belly.
      • Exhale, press low back into the mat & hug belly to spine.
      • Inhale, relax back to a neutral spine.
      • Repeat for 3 - 5 rounds.
    • Twisted Root Abdominals
      • Begin supine with knees bent. Cross right knee over left as if going into Eagle Legs or Gomukhasana legs. Lift feet off mat. Place hands on right thigh.
      • Inhale into low belly.
      • Pause breath, press low back into the mat.
      • Exhale, squeeze thighs, press hands into thigh & thighs back into hands to create resistance & hug belly to spine. The goal is to feel some shakes. 
      • Inhale, relax back to a neutral spine.
      • Repeat for 3 - 5 rounds.
  • Bridge Pose
  • Cat/Cow 
    • Practice 3 - 5 rounds of Cat/Cow. 
  • Downward Facing Dog
    • Stay for a few breaths. Encourage students to come down to knees in Virasana if they become dizzy or hot.

Sun Salutations:

  • Move through 3 - 7 Sun Salutations of your choice. 
  • Sun B builds heat quickly, so Sun A or Classic Sun Salutations may be a better option for students with hypertension. 
  • Utilize blocks in forward folds to keep the head level with the heart as needed. When the head drops below the heart, blood pressure rises. Students may be okay for a breath or two with the head lower than the heart, but give the option in case this is too intense for students.

Flow Section:

Sequence your flow section as usual. Offer students modifications in standing poses with arms raised over the head - such as Warrior 1, Triangle Pose, and Tree pose - students can keep their hands at hips instead.

Example flow section:

Vignette 1

  • Low Lunge
  • Half Split
  • Lizard Lunge
    • Chaturanga
    • Updog
    • Downdog
    • Repeat other side

Vignette 2

  • Warrior 2
  • Reverse Warrior
  • Triangle Pose with hand at hip
    • Chaturanga
    • Updog
    • Downdog
    • Repeat other side

Vignette 3

  • Warrior 1 with hands at sacrum
    • Use hands at sacrum to lengthen & decompress the lower back. Lift ribs away from hips.
  • Pyramid Pose with hands on blocks
    • Keep a long spine & relaxed neck. 
  • Prasarita Padottanasana with hands on blocks
    • Chaturanga
    • Updog
    • Downdog
    • Repeat other side

Warm Down Section

Use cooling forward fold poses like Janu Sirsasana, and Paschimottanasana. Add supported inversions like Legs up the Wall, and Supported Halasana (Plow Pose).

Example Warm Down Section:

  • Janu Sirsasana with a bolster bridge for support under the head.
  • Legs up the Wall either against a wall or with hips elevated on a block.
  • Happy Baby
  • Supine Twist
  • Savasana - allow plenty of time in Savasana. 6-10 minutes is recommended.
Adriana Lee
Adriana's yoga journey began at a young age and continues to inspire her every day by healing mind, body and spirit through the breath. She received her 200 Hour RYT through Frog Lotus Yoga's center, Suryalila, in Adalusia, Spain. She also trained an additional 50 hours with Heba Saab at Body Heat Hot Yoga in Las Vegas, NV. She continued training with Heba by assisting and acting as a mentor to her 200 Hour trainees. She trained with Cameron Shayne in Miami and received a 50 Hour certification in the Budokon Yoga system. She is also a certified Pilates instructor and a Reiki Level 2 practitioner. Her yoga practice has brought sweetness and authenticity into her life and her intention is to share that sweetness and help her students strive to be their own authentic selves.
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