Asanaverse

Blood Pressure

12 Week Yoga Program for Healthy Blood Pressure

The number has been creeping up for a few years. Nothing hurts, nothing feels different, and the advice was to lose a bit of weight and cut the salt. What was missing was something specific to actually do, three times a week, that has been measured.

Our yoga teachers built this twelve week program around the one part of it with a mechanism you can point at: slow breathing at around six breaths a minute, which makes the reflex that regulates your blood pressure more sensitive. Twelve weeks, alongside whatever your doctor has you on.

Three sessions a week plus a short one on the other days, four sequences, twelve weeks. Twelve is the median length across this research and the length of both of the best individual trials.

Length

12 weeks

Practices

84 in total

Rhythm

Three sessions a week plus a short one on the other days

Made for

Adults with elevated or stage 1 blood pressure, checked by a doctor

What the research says

The largest review of this question pooled 30 randomised trials with 2,283 people. Against control groups, yoga lowered systolic blood pressure by 7.95 mmHg and diastolic by 4.93, and heart rate by 4.4 beats a minute. A separate analysis of 34 trials with 3,125 people found the same direction and a similar size, and it also tells us what the effective programmes contained: alternate nostril breathing was the most common single technique, and Cobra and Savasana the most common poses.

The mechanism behind the breathing part is unusually well described. In a controlled study of people with hypertension, slowing the breath brought systolic pressure down from 149.7 to 141.1 mmHg and diastolic from 82.7 to 77.8, while baroreflex sensitivity, the reflex that adjusts your blood pressure moment to moment, nearly doubled from 5.8 to 10.3 milliseconds per mmHg. That is why every session here opens with six to eight minutes of breathing at around six breaths a minute.

A twelve week trial of Iyengar yoga in people with untreated elevated or stage 1 blood pressure measured with a 24 hour monitor rather than a clinic reading, and found systolic down 6 mmHg and diastolic down 5 within the yoga group. A second twelve week trial using the same 24 hour method found diastolic pressure down 3.9 mmHg over the day and 4.7 overnight in the yoga group, with no significant change in the group doing non-aerobic exercise instead.

See every study and guideline behind this program →

How the program works

3 phases, and you stay with the same practices for the whole of each one. That repetition is the plan rather than a shortage of ideas. A body changes when the same ask comes back often enough, and the trials this program follows repeated for weeks before they made anything harder.

Weeks 1 to 4MoveLearn the breathing rate that has a measurable effect, and get the practice into the week.Weeks 5 to 9BuildAdd standing practice, held at a level where the breathing never changes.Weeks 10 to 12IntegrateGet to something short you will still be doing in six months.

Each phase has one longer session three times a week and the same ten minute session on the other days. Open a session below to see every pose, its timing and the breathing that goes with it. Two things run through all twelve weeks: the breathing goes first, and if a pose changes how you are breathing, it is too much.

Who this is for

  • ·Your blood pressure is elevated or in the stage 1 range and a doctor has looked at it.
  • ·If you are on medication for it, you are staying on it. This runs alongside.
  • ·Your resting blood pressure is below 180 over 110.
  • ·You want something specific to do rather than only advice about salt and weight.
  • ·You can find twenty-five minutes three times a week and ten on the other days.

Before you start

This is an addition to your medical care and any blood pressure medication, not a replacement for either. Never hold your breath in any of it, and full inversions such as headstand and shoulderstand are not part of the program. The practice guide has the rest.

Read the full safety notes in the practice guide →

The practice

Two practices per phase. Open one to see every pose, its timing and the reason it sits where it does.

Move · Weeks 1 to 4

Six Breaths a Minute

Learn the breathing rate that has a measurable effect, and get the practice into the week.

Four weeks of building one thing: a breath that comes in over about five seconds and goes out over about five, with no pause at either end. That works out at around six breaths a minute, which is the rate the baroreflex research used. The poses in this phase are deliberately mild, because nothing here needs to be hard to work.

  1. 1.Easy Pose6 min
  2. 2.Staff Pose1 min
  3. 3.Seated Side Bend1 min each side
  4. 4.Bharadvaja's Twist1 min each side
  5. 5.Bridge Pose45 sec, twice
  6. 6.Legs Up the Wall4 min
  7. 7.Corpse Pose5 min
Open the full sequence →

Week by week

Week 1Find the rateIn for five, out for five. Count it out loud if that helps. The thing to avoid is pausing at the top or the bottom, which pushes blood pressure the wrong way.
Week 2Get a baseline that means somethingTake your blood pressure at the same time of day, sitting, twice, and use the second reading. Not straight after a session, when everyone looks good.
Week 3Same practice, no changesResist making it harder. Nothing in this program gets its effect from effort.
Week 4Do the short one on a bad dayThe point of the ten minute session is that it survives a week where nothing else does. Use it that way once and you will keep it.
← Back to the blood pressure practice guide

Build · Weeks 5 to 9

Standing, Without Speeding Up

Add standing practice, held at a level where the breathing never changes.

Five weeks with standing poses in them, and one rule that governs all of it: if your breathing speeds up or you find yourself holding it, the pose is too much and you come out. That sounds cautious and it is actually the useful instruction, because it turns every pose into a self-adjusting dose.

Week by week

Week 5Learn the standing shapesShorter holds this week, more attention to where your weight is. Come up slowly out of the forward fold: standing up fast is what makes people light headed.
Week 6Use the breath as the gaugeIn every standing pose, check whether you could still hold a conversation. If not, come out a little. That is the whole intensity system.
Week 7Full holdsLonger in each pose rather than deeper in any of them. Depth is not what this program is for.
Week 8Check the number againSame time of day, same conditions as week two. One reading proves nothing, so look at a few across the week.
Week 9Notice what you actually keptMost people are doing the ten minute session more often than the long one by now. That is the right way round.
← Back to the blood pressure practice guide

Integrate · Weeks 10 to 12

The Version That Survives

Get to something short you will still be doing in six months.

The most useful thing in this research is a warning about what comes next. In the longest trial, people moved from supervised classes to community ones, the effects got smaller rather than larger, and the yoga group had the highest dropout of the three. What you keep after twelve weeks matters more than what you did during them, so these last three weeks are about making it small enough to survive.

Week by week

Week 10Shrink it on purposeGoing from thirty-five minutes to fifteen feels like giving something up. It is the opposite: it is what makes the practice still exist next spring.
Week 11Breathe without the propsDrop the hands from the alternate nostril breathing and just do in for five, out for five. That version works in a car park, a waiting room or a meeting.
Week 12Decide what staysPick the two sessions you will actually do. Everything else is available when you want it, and nothing is lost by not doing it.
← Back to the blood pressure practice guide

The 16 poses in this program

Every pose has its own page with alignment, common mistakes and the energetic effect. Look one up when a shape does not make sense in your body.

Easy PoseStaff PoseSeated Side BendBharadvaja's TwistBridge PoseLegs Up the WallCorpse PoseCat PoseCow PoseMountain PoseMountain Pose with Side BendStanding Forward BendTriangle PoseWarrior IIExtended Side Angle PoseHigh Cobra Pose
Go to the Asana Lab →

The guide behind this program

Why these poses and not others

The Blood Pressure practice guide explains what each pose does and why it belongs to this goal. It also carries the safety notes and every study this program is built on. Read it if you want the reasoning rather than the plan.

Read the guide →

Frequently Asked Questions

Will this replace my blood pressure medication?

No, and no study has ever tested that. In 17 of the 30 trials in the largest review, participants were already on medication and yoga was added on top. There is no trial comparing yoga against blood pressure treatment, so nobody can tell you what would happen if you stopped.

How much does it actually lower blood pressure?

Across 30 trials with 2,283 people, about 8 mmHg systolic and 5 diastolic against control groups. That is a meaningful amount and it is in the same range reported for other lifestyle changes. It is an average across a very varied set of trials, so treat it as what is possible rather than what is promised.

Why does the breathing matter so much here?

Because it has the clearest mechanism of anything in this program. Slowing the breath to around six a minute makes the baroreflex more sensitive, which is the reflex that adjusts your blood pressure continuously. In the study that measured it directly, that sensitivity nearly doubled and blood pressure fell while it happened.

Can I do headstand or shoulderstand?

Not in this program. Full inversions raise blood pressure while you are in them, and they are generally not recommended with hypertension. Legs up the wall is a different matter, it is gentle, it appears throughout the protocols in this research, and it is in every session here.

Is yoga better than walking or other exercise for this?

There is no good evidence that it is better. Compared against other active programmes rather than against doing nothing, the differences are small and not consistent. The reason to choose this one is that you will do it, and that the breathing component adds something the walking does not.

What if my blood pressure is very high?

If your resting reading is 180 over 110 or above, that is the threshold at which exercise programmes generally should not be started without medical guidance, and this belongs in a conversation with your doctor rather than as a self-directed program. The same goes for a reading over 140 over 90 that nobody has assessed yet.

Creator of this program

Manish Rana

Manish Rana

Founder of Asanaverse.de. Manish writes about yoga, Ayurveda and meditation, and owes his deep connection to yoga to his Indian roots. With over 1,000 hours of Yoga Alliance Teacher Training, he shares his knowledge with the community.

More about Manish →
Registered Experienced Yoga Teacher, E-RYT 500

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