Effect of pranayama the prevention and treatment of high blood pressure
Abstract
The objective of present study is to assess the effect of nadishodhan pranayama on hypertension. This research is done by employing simple random sampling to select 10 patients from MM Hall of Aligarh Muslim University (Aligarh). The single group pre-test, post-test experiment was conducted for 30 days with nadishodhan pranayama regularly in the morning. After statistical analysis, the result reveals that the nadishodhan pranayama one of the best tool to manage the blood pressure. This concludes that the yogic practices (nadishodhan pranayama) provides the individual with refreshing experiences and manage the hypertension to a great level and also the individual get rid of taking exhaustive colorful and toxic medicines.
KEY WORDS: Hypertension, Nadishodhan Pranayama.
INTRODUCTION
With increased awareness and interest in health and natural remedies, yogic techniques including pranayama are gaining importance and becoming increasingly acceptable to the scientific community. Pranayama literally means control of prana. Prana, in Indian philosophy, refers to all forms of energy in the universe. Life force is one part of this energy. Life force in an individual is symbolized by breathing. That is why pranayama is generally considered to mean regulated breathing. A yogi, through pranayama, can, at some stages, control other functions of his body and finally control manifestations of prana even outside his body (Bijlani, 2004). As a technique, pranayama can assume rather complex forms of breathing, but the essence of the practice is slow and deep breathing. Such breathing is economical because it reduces dead space ventilation. It also refreshes air throughout the lungs, in contrast with shallow breathing that refreshes air only at the base of the lungs (Bijlani, 2004). Pranayama breathing has been shown to alter autonomic activity. A study by Udupa et al. (1975) indicates that pranayama training produces a decrease in basal sympathetic tone. Raghu raj et al. (1998) have reported that Nadi-shodhana pranayama increases parasympathetic activity. Slow and deep breathing itself has a calming effect on the mind and helps an individual to de-stress (Sandeep et al., 2002). This calming effect may also exert profound physiological effects on pulmonary, cardiovascular, and mental functions of the brain. This study investigated the immediate effect of a type of slow pranayama called as ‘Nadishodhana’ on resting heart rate, blood pressure, peak expiratory flow rate, and simple problem-solving ability in young healthy subjects.
Health and holistic health is closely related, which gives importance to physical, mental, social, spiritual and sexual health as whole. Hypertension is directly connected with circulation, respiration and function of vital organs. Complementary therapy like pranayama is directly having effect on mental and physical health. So, Pranayama emphasis on promotion, prevention and curative measures and helps to maintain normal blood pressure. Alternative therapy in Nursing is also very much valuable aspect of health care system. It is mainly based on promotion, maintenance, prevention and rehabilitation of disease.
Blood pressure:
Blood pressure is the force of blood against the wall of arteries.
Arterial blood pressure reflects two factors:
I. How much the elastic arteries close to the heart can be stretched and
II. The volume of blood forced into them at any time. If the amounts of blood entering andleaving the elastic arteries in a given period were equal, arterial pressure would beconstant. Instead blood pressure rises and falls in a regular fashion in the elastic arteriesnear the heart, that is, it is obviously pulsatile.At the left ventricle contracts and expels blood into the aorta,it imparts kinetic energy to theblood, which stretches the elastic aorta as aortic pressure reaches its peak. Indeed, if the aorta wereopened during this period, blood would spurt upward 5 or 6 feet; this pressure peak called thesystolic pressure, average 120 mm Hg in healthy adults. Blood moves forward into the arterial bedbecause the pressure in aorta is higher than the pressure in the more distal vessels. During diastole,the aortic semi lunar valve closes, preventing blood from flowing back into the heart, and the wallsof the aorta (and other elastic arteries) recoil, maintaining adequate pressure on the reducing bloodvolume to keep the blood flowing forward into the smaller vessels. During this time, aortic pressure.
What is Pranayama?
Pranayama is the perfect control of the life-currents through control of breath and is the process by which we understand the secret of prana and manipulate it. You can hardly make any spiritual progress without the practice of pranayama. One who has grasped this prana has grasped the very core of cosmic life and activity. Through various exercises and training in pranayama the yogi tries to realize in this little body the whole of cosmic life and attain perfection.
Breath is a physical aspect or external manifestation of prana, the vital force, and thus pranayama begins with the regulation of the breath. Breath, like electricity, is gross prana, while prana itself is subtle. By controlling the breath, you can control the prana – just as you can control the other wheels by controlling or stopping the fly wheel of a diesel engine, and just as you can control the hairspring, cog wheels and the main spring of a watch by controlling the minute hand. Control of breath is achieved through manipulation of the lungs and the breathing process.
The lungs and the breathing process
The organs of respiration consist of two lungs, one on either side of the chest and the air passages that lead to them. The lungs are located in the upper thoracic cavity of the chest, one on each side of the median line, and are separated from each other by the heart, the greater blood vessels and the larger air tubes. The lungs are spongy, porous, and their tissues are very elastic, containing innumerable air-sacs or alveoli. Each lung consists of an apex and a base. The base is directed towards the diaphragm, the muscular septum, the dividing wall between chest and the abdomen.
Beginning pranayama
You can take up the practice of pranayama after you have gained steadiness in your asana, seat or sitting posture. If you can sit for three hours in one asana continuously at one stretch, you have gained mastery over the asana. If you are able to sit from half to one hour even, you can take up the practice of pranayama.
An ardent enthusiastic student, with zeal, cheerfulness and tenacity, can acquire siddhi, perfection, within six months; while a happy-go-lucky practitioner with drowsiness and laziness will find no improvement ever after eight or ten years.
Plod on. Persevere with patience, faith, confidence, expectation, interest and attention. You are bound to succeed. Nil desperado – never despair.
Inhalation, exhalation and retention
Pranayama has three components: the external breath, the internal breath and the steady state in between the two. When the breath is expired, it is rechaka, the first kind of pranayama. When the breath is drawn in, it is the second, termed pooraka. When the breath is suspended, it is the third kind, called kumbhaka, or retention of breath.
Kumbhaka increases the life-span of an individual. It augments the inner spiritual force, vigour and vitality. If you retain the breath for one minute, this one minute is added to your span of life. By taking the breath to the brahmarandhra, the fontanelle at the top of the head (said to be the connecting point between the spirit and the body) and keeping it there, the yogi can defeat the lord of death, Yama, and conquer death.
In the practice of pranayama, rechaka, pooraka and kumbhaka, are controlled and regulated by space, time and number.
The space of the breath
‘Space’ refers to whether the breath is inside or outside of the body, the length of the breath, and if the prana is held in some particular part of the body. During both inhalation and exhalation, the distance to which the breath extends inside or outside the body varies. This variation accords with the tattwa which is pervading at the time of practice. The length of the breath is respectively 12, 16, 4, 8, 0 angulas, finger-breadths, according to whether the tattwa – prithvi, apas, tejas, vayu or akasha (earth, water, fire, air, ether or space) is predominant at that time.
The ‘place’ or ‘space’ of exhalation lies within 12 angulas of the tip of the nose. This can be measured using a piece of reed or cotton. The place of inhalation ranges from the head down to the soles of the feet and can be felt through a sensation similar to the touch of an ant. The place of kumbhaka consists of the places of both exhalation and inhalation combined, because the breath can be retained at either or both of these places.
The time of breath
The duration of the inhalation, exhalation or retention is generally counted in matras (approximately a second). But here the ‘time’ also refers to how long the prana should be fixed in a particular centre or part. There are three types of pranayama categorized by duration: adhama or inferior, madhyama middle and uttama superior. Vachaspati describes them thus, “Measured by 36 matras, is the first attempt, udghata, which is mild. Twice that is the second, which is middling. Thrice that is the third, which is intense. This is the pranayama as measured by number.”
Adhama pranayama consists of a count of 12 matras, madhyama consists of 24 matras and the uttama occupies a time of 32 matras. This count is for pooraka in each case.
The ratio between pooraka, kumbhaka and rechaka is 1:4:2. So, if you inhale for a period of 12 matras you will have to maintain kumbhaka for a period of 48 matras and then the time for rechaka will be 24 matras. This count is for adhama pranayama, but the same rule applies to the other two varieties.
Extending the matra needs to be done gradually, first practiseadhama for a month, then madhyama for three months, and finally begin uttama.
Number of pranayama
‘Number’ refers to the number of times the pranayama is performed, and thus is long or short according to the period of time it is practised. Just as water, thrown on a hot pan shrivels upon all sides as it is being dried up, so also air, moving in or out ceases its action by a strong effort of restraint in kumbhaka, and stays within. The yogic student should slowly take the number of pranayamas up to 80 in one sitting. He should have four sittings: in the morning, noon, evening and midnight, and should practise thus 320 pranayamas in all.
The fourth stage
After gradual mastery over these preliminary three kinds of pranayama, the fourth kind arises, where the breath is restrained by directing it to an external or internal object, “Bahyabhyantaravishayakshepichaturthah” (Yoga Sutras 11:50). This stage involves fixing the prana in the various padmas, lotuses, of the chakras, and taking it slowly, and slowly, step by step, and stage by stage to the last lotus in the head, where perfect samadhi takes place. This is internal. In this fourth variety, one reaches different states of perfection, as it is being performed over time. After one stage is mastered, the next stage is taken up and practised.
TYPES OF PRANAYAMA
Some major types of pranayama yoga are as follows:
NadiSodhana
Shitali Pranayama
Ujjayi Pranayama
Kapalabhati Pranayama
Digra Pranayama
Bhastrika Pranayama
Bahya Pranayama
Bhramari Pranayama
Udgit pranayama
Anuloma&Viloma Pranayama
Agnisar Kriya
NadiSodhana:
Following steps instruct on how to perform the nadisodhana pranayama:
Sit down in a comfortable place assuming a cross legged position.
Now use your thumb (right hand) to close the right side of your nose. Inhale deeply using the left nostril.
Now close the left nostril and exhale using the right one.
In the same way, now with the left nostril still closed, inhale using the right nostril and exhale with the left one.
You can continue doing this exercise for around 10 - 15 times.
Blood pressure (BP)
Is the pressure of circulating blood on the walls of blood vessels. Used without further specification, "blood pressure" usually refers to the pressure in large arteries of the systemic circulation. Blood pressure is usually expressed in terms of the systolic pressure (maximum during one heart beat) over diastolic pressure (minimum in between two heart beats) and is measured in millimeters of mercury (mmHg), above the surrounding atmospheric pressure (considered to be zero for convenience).
Blood pressure is one of the vital signs, along with respiratory rate, heart rate, oxygen saturation, and body temperature. Normal resting blood pressure in an adult is approximately 120 millimetres of mercury (16 kPa) systolic, and 80 millimeters of mercury (11 kPa) diastolic, abbreviated "120/80 mmHg".
Traditionally, blood pressure was measured non-invasively using a tube sphygmomanometer, which instrument is still generally considered to be the gold standard of accuracy.[1] More recently other semi-automated methods have become common, largely due to concerns about potential mercury toxicity,[2] although cost and ease of use have also influenced this trend.[1] Early alternatives to mercury-tube sphygmomanometers were often inaccurate, but modern validated devices have similar accuracy to mercury devices.
How is blood pressure measured?
Blood pressure is measured in millimeters of mercury (mmHg) and is given as two figures:
Systolic pressure – the pressure when your heart pushes blood out
Diastolic pressure – the pressure when your heart rests between beats
For example, if your blood pressure is "140 over 90" or 140/90mmHg, it means you have a systolic pressure of 140mmHg and a diastolic pressure of 90mmHg.
As a general guide:
Ideal blood pressure is considered to be between 90/60mmHg and 120/80mmHg
High blood pressure is considered to be 140/90mmHg or higher
Low blood pressure is considered to be 90/60mmHg or lower
High blood pressure
High blood pressure is often related to unhealthy lifestyle habits, such as smoking, drinking too much alcohol, being overweight and not exercising enough.
Left untreated, high blood pressure can increase your risk of developing a number of serious long-term health conditions, such as coronary heart disease and kidney disease.
Low blood pressure
Low blood pressure is less common. Some medications can cause low blood pressure as a side effect. It can also be caused by a number of underlying conditions, including heart failure and dehydration.
The effect of nadishodan pranayama on blood pressure
Drops to its lowest level(approximately 70 to 80 mm Hg in healthy adults), called the diastolic
Blood pressure varies from person to person and by ages. Ingeneral:
Normal blood pressure is less than 130 mm Hg systolic and less than 85 mm Hg diastolic.
Optimal blood pressure is less than 120 mm Hg systolic and less than 80 mm Hg diastolic.
Hypertension is generally defined as a blood pressure greaterthan 140/90.
RANGE OF HYPERTENSION
At 50 years -140/90
At 60 years -160/95
At 70 years - 170/100
(Ross &Willsons, 2004)
Causes of high blood pressure
1. Hereditary
Hypertension may be hereditary which means that the genetic factor increases the risk of hypertension. If there is family history of high blood pressure, then it is advisable to have regular health check up to detect hypertension at an early stage. The inherited form of hypertension falls under the primary high blood pressure category, which accounts for about 95 percent of the cases. This condition may lead to other health issues at a young age.
2. Excessive body weight
Excessive body weight is among the leading causes of hypertension. Unhealthy lifestyle, increased insulin levels, poor diet cause obesity, which is linked to high blood pressure and other conditions like heart attack and diabetes. It is important to maintain a healthy body weight to prevent hypertension.
3. Age
The blood pressure increases naturally as you grow old. The risk of developing high blood pressure increases in elderly people. Consumption of fatty foods, excessive drinking and smoking and sedentary life, ups the risk of hypertension with age.
4. Excessive salt
Excessive intake of salt also increases the blood pressure. If you are having processed or packed food, always check for the salt content as usually these products have high levels of salt. According to the American Heart Association, intake of excessive amount of salt will up the risk of cardiovascular diseases and high blood pressure.
5. Gender
Yes, the gender is also important. Males have greater possibilities of developing hypertension as compared to females. It is important to improve your diet and lifestyle to keep hypertension at bay.
6. Sedentary lifestyle
Spending hours sitting is not healthy and it is often associated with high blood pressure. Long term sedentary life, which lacks exercise or any other type of physical activity, can lead to increase in body weight and stress on the heart
Drinking alcohol and smoking cigarette excessively will put undue stress on the arteries and your heart. It is important to find a balance and have a healthy lifestyle. Smoking excessively is connected to heart disease as this bad habit can clog the arteries.
8. Stress
From problems at home to office politics, there are several reasons for stressful life. It is another big contributor to hypertension. You must try to calm you mind and relax
9. Contraceptive pills
Contraceptive pills or birth-control pills increases the risk of hypertension. If a woman consumes oral contraceptive pills then it is important to monitor the blood pressure regularly.
10. Sleep apnea
Sleep apnea or Obstructive Sleep Apnea (OSA) is a disorder in which a person has interrupted breathing or shallow breaths during sleep. It causes sudden decrease in blood oxygen levels and this may lead to increase in the blood pressure at night. The blood pressure may stay elevated during the day.
Hypertension Survey Facts
The National Council on Aging (NCOA) conducted a national survey of more than 1,500
Americans over the age of 50 to gauge the awareness of high blood pressure, including its risks andcauses. This group is considered to be at great risk for complications from uncontrolled high bloodpressure.46% of those surveyed incorrectly believed that the main cause of high blood pressure is stress.
Nadishodhana Pranayama’ training (Bhargava et al., 1988)
After an initial recording, all subjects were put through Nadi-shodhana pranayama for 20 minutes. They were asked to assume ‘Sukhasana’ (the comfortable posture) and regulate thealteration of breathing as follows:
Subbalakshmi et al.
1. Open the right hand and bend index and middle fingers against the palm. The thumb was
used for closing the right nostril while the fourth and fifth fingers were used for the left nostril.
2. Place the right thumb against the ale at the end of the nostril to close it and similarly
press the fourth and fifth fingertips against the left nostril.
3. Start the exercise in the ‘Sukhasana posture’, with relaxed attitude and concentration as below.
4. Exhale slowly and deeply without closing the nostrils but being ready to do so.
5. Inhale slowly and quietly through the left nostril while closing the right.
6. At the end of the inhalation close both nostrils and hold the breath for a while (not
more than 1-2 seconds).
7. Keep the left nostril closed and exhale through the right as quietly as possible.
8. After exhaling completely, inhale slowly and quietly through the right nostril.
9. Close both nostril and wait for a while, then open the left nostril and exhale slowly and
Silently.
10. Inhale through the same nostril and continue.
OBJECTIVE OF THE STUDY
To examine the effect of pranayama high blood pressure.
To examine the immediate effect of Nadisodhana pranayama.
Review of Literature
Hypertension is persistent elevation of systolic blood pressure above 140 mmHg and diastolic blood pressure 90 mmHg. Hypertension is a silent killer. High blood pressure results due to consumption of fat which result in obesity, tobacco chewing, smoking, mental stress and family history of hypertension. High blood pressure remains lifelong problem and by getting a regular medical checkup and taking some medication and medical treatment it can be kept under control. Hypertension is categorized into three groups according to their measurement of blood pressure as, normal 110-130/70-80 mmHg, mild-130-140/80-90 mmHg, moderate-140-160/90-100 mmHg, severe hypertension-160above/100-above mmHg.
American association of Hypertension (2004-06), study done shows that 29% of Americans had hypertension (systolic blood pressure >140 mm Hg or diastolic blood pressure > 90 mm hg) in 2010, representing a 4% increase from 1991. The prevalence of hypertension has increased, especially in African-Americans and in the elderly, and is associated with substantially increased risks of stroke and cardiovascular disease. More recent data shows that even patients with high blood pressure (systolic BP 130 – 139 mm hg or diastolic BP 85 – 89 mmHg.
Study analyzed by Camisasca p. et.al among the 1204 patients recruited between mean age group of 52.8 to 75.8, only 399 patients (33.1%) had a blood pressure lower than 140/90 mmHg and remaining 805 patients where having blood pressure more than 140/90 mmHg with the associated low, medium, high risk factors.
Dr. Kalgutkar L. and Mr. Menon , stated that a growing popularity of alternative medicine has created a demand for clear and comprehensive information on many therapies available hence the setting of Indian council of social[15]science research (ICSSR) and Indian council of medical research (ICMR) has started the thinking process to bring people oriented to alternative medicine and to bring health care to forefront hence 73rd and 74th amendments of constitution are trying to make it possible to have alternative medicine in health care.
Bhavanani (2011) Hypertension is one of the most common health disorders, and yogahas been shown to be an effective adjunct therapy in its management. Earlier studies havereported blood pressure (BP) lowering effects of slow, deep breathing after 3 weeks and 3months of training and beneficial immediate effects of slow, deep breathing in reducingpremature ventricular complexes and lowering blood pressure. None of these immediate studiesused the concept of pranayama, involving conscious internal awareness of the whole breathingprocess. This study was undertaken to determine the immediate cardiovascular effects of sukhapranayama in hypertensive patients. Methods: Twenty-three hypertensive patients attending theYoga OPD at JIPMER were recruited for the study and instructed to perform sukhapranayama for 5 minutes at the rate of 6 breaths/min. This pranayama involves conscious, slowand deep breathing with equal duration for inhalation and exhalation. Heart rate (HR) and BPwere recorded before and immediately after the intervention. Results: Post-intervention statisticalanalysis revealed a significant (p<.05) reduction in HR and a highly significant (p<.001)reduction in systolic pressure, pulse pressure, mean arterial pressure, rate-pressure product, anddouble product with an insignificant fall in diastolic pressure. Discussion: It is concludedthat sukha pranayama at the rate of 6 breaths/minute can reduce HR and BP in hypertensivepatients within 5 minutes of practice. This may be due to a normalization of autonomiccardiovascular rhythms as a result of increased vagal modulation and/or decreased sympatheticactivity and improved bar reflex sensitivity. Further studies are required to understand possiblemechanisms underlying this beneficial immediate effect and to determine how long such abeneficial effect persists.
Sinha et al. (2002) Studied suggested that Energy Cost and Cardiorespiratory ChangesDuring the Practice of Surya Namaskar. Surya Namaskar (SN), a group of Yogic exerciseconsists of a set of twelve postures which is practiced by some of the yoga practitioners. Thepresent study was undertaken to observe critically the energy cost and different cardiorespiratory changes during the practice of SN. Twenty-one male volunteers from the IndianArmy practiced selected Yogic exercises for six days in a week for three months duration. TheYogic practice schedule consisted of Hatha Yogic Asanas (28 min), Pranayama (10.5 min) andMeditation (5 min). In the Yogic practice schedule 1st they practiced Kapalbhathi (breathingmaneuvers) for 2 min then Yogamudra (yogic postural exercise) for 2 min, after that they tookrest until oxygen consumption and heart rate (HR) came to resting value. Subsequently subjectsperformed SN for 3 min 40 seconds on an average. After three months of training at thebeginning of the fourth month subjects performed entire Yogic practice schedule in thelaboratory as they practiced during their training session and experiments were carried out. Theirpulmonary ventilation, carbon dioxide output, Oxygen consumption, HR and other cardiorespiratory parameters were measured during the actual practice of SN. Oxygen consumptionwas highest in the eighth posture (1.22 ± 0.073 1 min–1) and lowest in the first posture(0.35 ± 0.02 1 min–1). Total energy cost throughout the practice of SN was 13.91 kcal and at anaverage of 3.79 kcal/min. During its practice highest HR was 101 ± 13.5 B.Pd. As an aerobicexercise SN seemed to be ideal as it involves both static stretching and slow dynamic componentof exercise with optimal stress on the cardio respiratory system.
Gnanabakthan and Elangovan (2012) studied to investigate the effects of the selectedYogic practices of Swami Satyananda Saraswati (Group A) and Swami Kuvalayananda (Group-B) on Police men with Health fitness components, Physiological and Psychologically. Tofacilitate the study, 90 Police men were selected from Tamil Nadu Police Academy at vandalur,Chennai were selected as subjects and their aged between 30 to 45 years. In this study yogicpractices were given to experimental group for the period of Twelve weeks in progression. Thepre-test was taken from the subjects before administering the training. The subjects wereinvolved with their respective training for a period of Twelve weeks. At the end of the Twelfthweek training post-test were taken. After the experimental period of Twelve weeks post testscores were obtained from all the three groups. The scores on Health fitness components,Physiological and Psychological variables were considered as the effect of varied training ofyogic practices on Police men .The mean differences were tested for significance using Analysisof Covariance (ANCOVA) among three groups on selected Health fitness components,Physiological and Psychological variables on Police men. To find out the paired meandifferences, scheffe’s post hoc test was used.
Shashikala et al. (2011) Yoga is an ancient science, which originated inIndia. Pranayama has been assigned a very important role in yogic system of exercises. It isknown that regular practice of breathing exercises (pranayama) increases parasympathetic tone,decreases sympathetic activity, and improves cardiovascular functions. Different types ofbreathing exercises alter autonomic balance for good by either decrease in sympathetic orincrease in parasympathetic activity. Mukh Bhastrika (yogic bellows), a typeof pranayama breathing when practiced alone, has demonstrated increase in sympathetic activityand load on heart, but when practiced along with other types of pranayama has showedimproved cardiac performance.
Madhanmohan et al. (2004) studied the effects of yoga training on cardiovascular response to exercise and the time course of recovery after the exercise. Cardiovascular responseto exercise was determined by Harvard step test using a platform of 45 cm height. The subjectswere asked to step up and down the platform at a rate of 30/min for a total duration of 5 min oruntil fatigue, whichever was earlier. Heart rate (HR) and blood pressure response to exercisewere measured in supine position before exercise and at 1, 2, 3, 4, 5, 7 and 10 minutes after theexercise. Rate-pressure product [RPP = (HR × SP)/100] and double product (Do P = HR × MP),which are indices of work done by the heart were also calculated. Exercise produced a significantincrease in HR, systolic pressure, RPP & DOP and a significant decrease in diastolic pressure.After two months of yoga training, exercise induced changes in these parameters weresignificantly reduced. It is concluded that after yoga training a given level of exercise leads to amilder cardiovascular response, suggesting better exercise tolerance.
Manjunath and Tells (2001) Introduced the Effects of Sirsasana (Headstand) Practice onAutonomic and Respiratory Variables. The present study had two aims: (1) To assess heart ratevariability (HRV) along with non-specific autonomic measures (used in earlier studies), beforeand after two minutes of the head stand. (2) To compare changes in two categories of subjects,i.e., those who practiced the headstand in a traditional way (without any support) and those whoused the support of the wall (a present-day adaptation). The subjects were forty male volunteers(age range 19 to 36 years), with twenty subjects under each category. The following changeswere significant after the practice, compared to values at baseline. Both categories had anincrease in the power of the low frequency component (LF) and a decrease in the high frequencycomponent (HF) of the HRV spectrum, increased LF/HF ratio, and decreased heart rate. (ii)Subjects who practiced the headstand with the support of a wall showed reduced fingerplethysmogram amplitude suggesting increased sympathetic vasomotor tone. (3) Practicing the headstand without support was associated with an increase in the skin conductance level,suggestive of increased sympathetic sudomotor tone. Hence, both categories showed similarchanges in the HRV components though changes in sympathetic vasomotor and sudomotoractivity were different. These changes suggest sympathetic activation, irrespective of the methodof practice.
Shashidhar et al (2011) Pranayama has a very important role in the yogic system ofexercises and it has been said to be much more important than yogasanas for keeping soundhealth. The practice of Mukh Bhastrika, a type of pranayama, is known to improve humanperformance. The studies which have been conducted till date were on the effect of the short-term practice of Mukh Bhastrika, other types of pranayama and yoga in general. The ReactionTime (RT) is a means of determining the sensory motor association and the performance.
Parshad et al (2011) Studied Sixty-four healthy medical students (57 females and 7males), mean age 21.3 ±2.6 years, attending a Special Study Module 'Role of Dhyana Yoga inStress Management', participated in this study. Systolic (SYS) and Diastolic (DIA) bloodpressure, Heart Rate (HR), Stroke Volume (SV), Cardiac output (CO), Total PeripheralResistance (TPR), Interbeat Interval (IBI), Left Ventricular Ejection Time (LVET), ArterialCompliance (Cwk) and Ascending Aorta Impedance (Zao) were measured before and after sixweeks of yogic exercises. Various exercises included asanas (Postures), pranayama (Breathing),and dhyana (Meditation). Data were analyzed using Stat for Windows. Two-tailed paired t-testrevealed that practice of yoga caused significant increases in HR (p < 0.05), SV (p < 0.01), CO(p < 0.001) and Cwk (p < 0.01) and decreases in TPR (p < 0.001), IBI (p < 0.05) and Zao (p <0.001) after practicing yoga for 6 weeks as compared to before yoga practice. No significantdifferences were, however, observed in SYS, DIA, Mean arterial blood pressure (MAP) andLVET.
Santa Ella et al. (2011) Studied 76 healthy elderly subjects were enrolled in a randomizedcontrol trial in Brazil and 29 completed the study (age 68±6 years, 34% males, body mass index25±3 kg/m2). Subjects were randomized into a 4-month training program (2 classes/week plushome exercises) of either stretching (control, n=14) or respiratory exercises (yoga, n=15). Yogarespiratory exercises (Bhastrika) consisted of rapid forced expirations followed by inspirationthrough the right nostril, aspiratory apneas with generation of intrathoracic negative pressure,and expiration through the left nostril. Pulmonary function, maximum expiratory and inspiratorypressures (Pemex and PImax, respectively), heart rate variability and blood pressure variability forspontaneous bar reflex determination were determined at baseline and after 4 months. Subjects inboth groups had similar demographic parameters. Physiological variables did not change after4 months in the control group. However, in the yoga group, there were significant increases inPemex (34%, p<0.0001) and PImax (26%, p<0.0001) and a significant decrease in the lowfrequency component (a marker of cardiac sympathetic modulation) and low frequency/highfrequency ratio (marker of sympathovagal balance) of heart rate variability (40%, p<0.001).Spontaneous bar reflex did not change, and quality of life only marginally increased in the yogagroup.Pramanik et al. (2009) Heart rate and blood pressure of volunteers (n = 39, age = 25-40years) was recorded following standard procedure. First, subjects had to sit comfortably in aneasy and steady posture (Sukasana) on a fairly soft seat placed on the floor keeping head, neck,and trunk erect, eyes closed, and the other muscles reasonably loose. The subject is directed toinhale through both nostrils slowly up to the maximum for about 4 seconds and then exhaleslowly up to the maximum through both nostrils for about 6 seconds. The breathing must not abdominal. These steps complete one cycle of slow pace Bhastrika pranayama (respiratory rate6/min). During the practice the subject is asked not to think much about the inhalation andexhalation time, but rather was requested to imagine the open blue sky. The pranayama wasconducted in a cool, well-ventilated room (18-20 degrees C). After 5 minutes of this breathingpractice, the blood pressure and heart rate again were recorded in the aforesaid manner using thesame instrument. The other group (n = 10) took part in another study where their blood pressureand heart rate were recorded following half an hour of oral intake of hyoscine-N-butyl bromide20 mg. Then they practiced the breathing exercise as stated above, and the abovementionedparameters were recorded again to study the effect of parasympathetic blockade on the samepranayama. It was noted that after slow Bhastrika pranayama breathing (respiratory rate 6/min)for 5 minutes, both the systolic and diastolic blood pressure decreased significantly with a slightfall in heart rate. No significant alteration in both blood pressure and heart rate was observed involunteers who performed the same breathing exercise for the same duration following oralintake of hyoscine-N-butyl bromide. Vagal cardiac and pulmonary mechanisms are linked, andimprovement in one vagal limb might spill over into the other. Bar receptor sensitivity can beenhanced significantly by slow breathing (supported by a small reduction in the heart rateobserved during slow breathing and by reduction in both systolic and diastolic pressure). Slowpace Bhastrika pranayama (respiratory rate 6/min) exercise thus shows a strong tendency toimproving the autonomic nervous system through enhanced activation of the parasympathetic system
METHEDOLOGY
3.1) Research Design:
In the present study, the single group pre-test and post-test design was used.
3.2) Sampling:
The sample of 10 patients of hypertension were taken for the present studyfrom MM Hall of AMU, Aligarh. The SimpleRandom sampling has been used for collecting the sample.
3.3) Tool used:
In the present study the Sphygmomanometer (Home blood pressure monitor) and stethoscope was used.
3.4) Statistical analyses
All the values obtained before and after performing ‘Nadi-shodhana Pranayama’, rest and
quiet breathing was expressed as mean ± SD. The Student paired t’ test was used to compare
parameters within groups. P value of less than 0.05 indicates a significant difference.
results and discussions
Systolic blood pressure
table 4.1
The statistical analysis of systolic blood pressure level after one month of pranayama practices shows highly significant difference between pre and post of blood pressure i.e. pre-Systolic blood pressure from 154.53 mmHg (SD 2.98) post-test 149.2 mmHg (SD 2.55) paired t-test for systolic blood pressure before and after pranayama shows *p value 0.00, which very less than 0.01, therefore the effect of pranayama on systolic blood pressure of old age subjects is highly significant.
Diastolic blood pressure
table 4.2
The statistical analysis of diastolic blood pressure level after one month of pranayama practices shows highly significant difference between pre and post of blood pressure i.e. pre-diastolic blood pressure from 154.53 mmHg (SD 1.43) post-test 142.2 mmHg (SD 1.59) paired t-test for diastolic blood pressure before and after pranayama shows *p value 0.00, which very less than 0.01, therefore the effect of pranayama on diastolic blood pressure of old age subjects is highly significant. The mean of post-test was greater than the mean of pre-test of the adolescent boys. Thus, the result is highly significant at 0.01 level: the result table indicates that the directional hypothesis viz, “There will be immediate effect of Nadisodhana pranayama in controlling high pressure. Following researches supports the fact that the regular practice of Nadishodhan Pranayama with consciousness and awareness effectively reduce the hypertension.
Nadishodhan pranayama is a useful technique to reduce elevated blood pressure and Hypertension. Nadishodhan pranayama shows significant effect on hypertensive patients. (Uduppa, K.N., 1986)
This study shows that nadishodhan pranayama relaxes the body and mind. It is very effective technique for relaxing the mind. Mind and body are correlated with each other. So, if the mind relaxes and tension freer then body also be relaxing and tensionless. If the muscles are relaxed then elevated blood pressure be reducing.
Thus, we can say nadishodan pranayama is useful to reduce elevated/high blood pressure. Hypertension and anxiety can be relaxed easily from meditation. Meditation is more effective then relaxation technique. (Broota, Verma and S., 1995).
Yoga nidra and Nadishodhan Pranayama is a systematic method of including complete physical, mental and emotional relaxation. Yoga nidra is highly effective technique to reduce elevated (high) blood pressure. Shraavana also include in the yoga nidra practice. Nadishodhan Pranayama and Shavasana shows beneficial effect of in mild hypertensives who were not taking medication. (Datey, et al., 1969).
A study reported that shavashana shows a beneficial effect in hypertension in one-year fallow-up control study. (Patel, 1973).
Conclusion
The result of this study confirmed the high blood pressure, among hypertensive patients. In conclusion it is thought that the current interventions (Pranayama,) will assist in decreasing the blood pressure, pulse rate and symptoms among the hypertensive patients. Furthermore, it is also thought that it can add to the literature and increase understanding of individual‟ on prevention of hypertension and its complications.
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