Heart disease or Cardio Vascular Disease (CVD) is a phrase used for a variety of conditions that affect the heart’s structure and function. There are several diseases under the heart disease umbrella which include:
Coronary heart disease (CHD) – is caused by the build-up of plaque in the heart’s arteries. It is also called ischemic heart disease (IHD) or Atherosclerosis or Coronary Artery Disease (CAD). This is a hardening of the arteries.
- Heart attack (Myocardial Infarction)
- Heart failure
- Arrhythmias – abnormal heart rhythm
- Aneurysm – a bulge caused by the weakening of the heart muscle or arteries
- Rheumatic heart disease – caused by rheumatic fever, and mainly affecting the heart valves
- Congenital heart disease – defects or malformations in the heart or blood vessels that occur before birth.
- Cardiomyopathy – this condition causes the heart’s muscles to harden or become weak.
- Myocarditis – Inflammation and infiltration of myocardium with necrosis and degeneration
- Pericarditis – Inflammation of the pericardium
- Valvular Diseases – related to valves of the heart
According to World Health Organization, Cardiovascular diseases (CVDs) are the leading cause of death globally, taking an estimated 17.9 million lives each year.
Heart Research Australia also confirms that heart disease is Australia’s leading single cause of death, with 18,590 deaths attributed to heart disease in Australia in 2017. Heart disease kills one Australian every 28 minutes.
To support these statistics, the Centers For Disease Control and Prevention (CDC), USA, trusted source, says that approximately every 40 seconds an American will have a heart attack. In the United States, 1 in every 4 deaths in is the result of heart disease.
Causes and Risk Factors
According to The World Health Organization, the most important behavioural risk factors of heart disease and stroke are: Unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. Most cardiovascular diseases can be prevented by addressing above mentioned behavioural risk factors.
In this context Yoga, Ayurveda and Natural Therapies can play an important role in preventing as well as management of cardiovascular disease (CVDs).
Ayurveda and Yoga
Yoga and Ayurveda are two inter-related branches of the same tradition. Together, Ayurveda and Yoga form a complete approach for optimal health, vitality and higher awareness.
Each of them has its unique place and function, but each overlaps into the other on many levels.
This combination of Yoga and Ayurveda also provides the basis for a real dialogue with modern medicine addressing not only specific therapies but also the real causes of disease and how to maintain health and well-being in society.
Ayurveda in a modern context:
From the last few decades, there is a global concern on raising trends of chronic and non-communicable disease (NCD), an epidemic of lifestyle-related diseases like diabetes, obesity, heart diseases, typically a result of stress, improper diet and irregular or sedentary lifestyle.
Ayurvedic lifestyle supports physical, mental as well as social health. These lead to improvement in the disease process, disease symptoms and improvement in the quality of life, helping in the prevention and management of diseases.
Ayurveda in a modern context:
Pursuing the healthy living style mentioned in Ayurveda is in the form of daily, and seasonal routines, good food habits and appropriate physical exercise as mentioned in the ayurvedic texts is the best way for prevention of any disease.
There has been plenty of research done now indicating the value of Ayurveda and lifestyle management for heart disease, including for reducing stress and hypertension which are major contributors for any disease.
Yoga therapy in modern context:
There has been plenty of research done now indicating the value of yoga and lifestyle therapies for heart disease, including for reducing stress and hypertension which are major contributors for any disease.
Yoga also improves heart health by increasing circulation and blood flow. Practicing yoga and ayurveda appropriately can help lower blood pressure, cholesterol, and blood glucose levels, as well as the heart rate. They can all add up to a lower risk of hypertension, stroke, and heart disease.
The heart has always been the symbol of life and love, of joy and happiness, of courage and faith.
In ancient writings, the heart is considered as the seat of sensation and consciousness. It is considered the seat of emotions.
Reducing the burden of emotional stress, bringing some joy and peace in the heart are important considerations for anyone, including for patients with heart disease.
What are they saying:
Hugh Calkins, M.D., director of the Cardiac Arrhythmia Service at Johns Hopkins, says “A large number of studies show that yoga benefits many aspects of cardiovascular health. There’s been a major shift in the last five years or so in the number of cardiologists and other professionals recognizing that these benefits are real.”
Dr. Gloria Yeh, an associate professor of medicine at Harvard Medical School says, “Yoga is unique because it incorporates physical activity, breathing, and meditation,” As she explains, each of these elements positively affects cardiovascular risk factors, so combining them was bound to show a benefit.
What Ayurveda and Yoga Offer for Heart Disease:
Relaxation, Meditation, Yoga nidra:
Stress by itself can cause heart disease and is one of the important risk factors for many health conditions, including heart disease. Looking after emotional heart and reducing stress is an important consideration in any yoga therapy protocol.
In that context, including shavasana, yoga nidra and meditation are key parts of the protocol.
Some studies aim to show that three factors are significantly associated with the use of chanting in health and wellness: (a) stimulated quality of life, (b) enhanced mood, and (c) general well-being. They have shown that mantra chanting has measurable and positive physiological and psychological outcomes that support health and wellness.
There is plenty of research that indicates the value of mantra chanting including AUM chanting.
At another level, Yoga and Ayurveda talk about Soul (atma) which is more subtle than the mind and so cannot be fully comprehended by the mind. In that sense any research cannot fully explain the benefits of chanting, but it has been found very valuable in physical, emotional, and Spiritual growth and wellbeing.
Chanting or contemplation or even listening of the sacred sound of AUM helps a heart patient recover.
Chanting of Anahat Chakra beej mantra, or mental recitation of mantra “Yam” can also be used for people with heart disease.
Asanas, Bandhas and Pranayama
In general, any asanas that don’t bring strain or discomfort can be done and have some benefit for the heart, with understanding of some underlying principles.
We need to take care that there is no forcing or straining, relaxed breath, focused yet calm mind and attitude at the time of yoga practice.
Being overenthusiastic and rushing or doing strong yoga postures may potentially lead to injury.
In general, the postures that extend the spine and expand the chest benefit the patients with heart disease.
It is well known that many heart attacks occur when a person is bending forward which compresses the chest, forcing the abdomen and diaphragm against it, decreasing the space for the heart and lungs, restricting their movement, reducing blood flow and oxygenation to heart and lungs both, which can precipitate a heart attack if heart is already weak, or the person is obese.
Inverted poses are generally contraindicated for people with high BP and some other disease.
Some modified variations may be done gently with use of props depending on the condition of the patient.
Surya namaskar, sarwangasana, halasana, shirshasana & its variations. Fast breathing, right nostril breathing, agnisar dhauti , bhastrika pranayama, Any pranayama with kumbhak. vaman dhouti, shankha prakshalana (Laghoo / Purna) cleansing practices. These are all contraindicated for people with heart disease.
The shatkarmas can be good and useful for prevention but contra indicated if someone has heart disease.
Jal neti or Tratak can be done.
- Simple and gentle supine postures with gentle breathing, no forcing, or straining, with some hamstring stretches kind of postures can help loosen and warm the muscles in lower extremities, hips and lower spine while improving circulation.
- Abdominal postures or prone position postures can also create abdominal pressure, on chest or heart, they also require caution and gentleness. It is better to be conservative and do them gently, and without holding breath, especially people who have had a heart surgery, have high BP or any condition with weakened heart.
- Standing poses can be sometimes hard, especially for older people who have heart disease if they have poor balance. They need to be introduced gently, depending on patient’s condition and age and comorbidities etc.
- Practicing pranayama is limited to only gentle inhalation and exhalation exercises for heart patients. Left nostril breathing, anulom vilom, deep breathing, ujjayi pranayama without kumbhak, bhramari pranayama without kumbhak are good pranayamas for people with heart disease.
- Some Useful Asanas: Tadagasana, Vajrasana series, Pavanmuktasana, Ardha Chakrasana, Anantasana, Bhujangasana, Dhunurasana, Katichakrasana, Tadasana – Tiryak Tadasana.
- Bandhas and breath retention are contraindicated because bandhas and breath retention boost blood pressure and so are not good for the heart. For heart patients only deep breathing is suggested.
Ayurvedic herbs and treatments
- Ayurvedic snehana massage, with hrud basti and shirodhara treatments can be very useful in de-stressing.
- Hrud basti, especially with arjun oil or ashwagandha oil can be very useful in strengthening the physical heart.
- Ayurvedic herb, Arjun is very useful typically for a patient with heart disease. Another good herb can be ashwagandha. These or other herbs need to be taken only after consulting a practitioner.
Hridaya mudra (heart gesture) or apana vayu mudra is a good mudra for people with heart disease.
- Foods To Favour Normal food with less fats & carbohydrates and with high fibres. In general, a sattvic diet will be recommended. Another word to consider is “mitahara” – moderation in food intake, typically plant based, low fat diet.
- Foods To Avoid – Non-vegetarian food, milk & milk products, oily & spicy foods, refined and processed foods, fast food, preserved food, too much salt.
Interesting Research Publications
Here are some sample publications confirming through findings about yoga for heart disease. Many more can be seen through google scholar and other websites.
From this we can see that Ayurveda, Yoga and Natural Therapies can play an important role in preventing as well as management of cardiovascular disease (CVDs).
Here is a link to the Video Ayurveda and Yoga for Heart Disease.