Yoga for HypertensionYoga for Hypertension
Enrique Saguil, MDEnrique Saguil, MD
““high blood pressure”high blood pressure”
““high blood”high blood”
““white coat response”white coat response”
““stress response”stress response”
““pressure issues”pressure issues”
““renal hypertension”renal hypertension”
““salt sensitive”salt sensitive”
““type A personality”type A personality”
““holds a lot of aggression”holds a lot of aggression”
““old fashion Italian”old fashion Italian”
““Newtonian” definitionNewtonian” definition
As per the JNC 7 (2003):As per the JNC 7 (2003):
Systolic <140mmHgSystolic <140mmHg
Diastolic < 90mmHgDiastolic < 90mmHg
With diabetes or chronic kidneyWith diabetes or chronic kidney
Systolic <130mmHgSystolic <130mmHg
Diastolic < 80mmHgDiastolic < 80mmHg
““Einstein-ean” definitionEinstein-ean” definition
Everything exists asEverything exists as energyenergy
Even an atom existsEven an atom exists asas energyenergy not a solid massnot a solid mass
…….thus, the human body is nothing but.thus, the human body is nothing but energyenergy!!
Hypertension is too muchHypertension is too much energyenergy in the wrong placein the wrong place
Back to bolts and nuts…
The “Plumbing” ScenarioThe “Plumbing” Scenario
Human vascular system isHuman vascular system is
A house is closedA house is closed
There is some flexibility toThere is some flexibility to
the systemthe system
There is no flexibility to theThere is no flexibility to the
If poor blood flow is gettingIf poor blood flow is getting
to an organ, heart beatsto an organ, heart beats
If water is not getting to aIf water is not getting to a
faucet, open the flood gatesfaucet, open the flood gates
Problems in the scenarioProblems in the scenario
Opening the flood gates for one faucet, they all getOpening the flood gates for one faucet, they all get
more water pressure (leaks/wear and tear)more water pressure (leaks/wear and tear)
The heart beating harder leads to hypertrophy ofThe heart beating harder leads to hypertrophy of
heart muscle tissue and the other organs getheart muscle tissue and the other organs get
slammed with high pressure (eye, brain, kidney)slammed with high pressure (eye, brain, kidney)
Blindness, stroke, renal failure, heart attack,Blindness, stroke, renal failure, heart attack,
pulmonary edema.pulmonary edema.
Leading causes of death USLeading causes of death US
Heart disease 631,636Heart disease 631,636
Cancer 559,888Cancer 559,888
Stroke 137,119Stroke 137,119
Chronic LRD 124,583Chronic LRD 124,583
Accidents 121,599Accidents 121,599
Diabetes 72,499Diabetes 72,499
CDC 2006CDC 2006
Hypertension is a Silent killerHypertension is a Silent killer
Pressure fronts in the blood vessel system andPressure fronts in the blood vessel system and
be tolerated with the elasticity of the bloodbe tolerated with the elasticity of the blood
Not for daily encounters with saber tooth tigersNot for daily encounters with saber tooth tigers
Rips, tears, ballooning, narrowing, an organ hasRips, tears, ballooning, narrowing, an organ has
to protect itself.to protect itself.
Tolerance until the organ suffers (dies)Tolerance until the organ suffers (dies)
What happensWhat happens
What makes the “closed” system react this way?What makes the “closed” system react this way?
The Stress ResponseThe Stress Response
Coined by Dr Walter B Cannon 1942Coined by Dr Walter B Cannon 1942
Harvard physiologist, “Vodoo Death”Harvard physiologist, “Vodoo Death”
Something has to arrive in the CNS atSomething has to arrive in the CNS at
the inappropriate time to cause thethe inappropriate time to cause the
“autonomic storm”.“autonomic storm”.
The Stress ResponseThe Stress Response
Fight or flight (sympathetic stimulation)Fight or flight (sympathetic stimulation)
Adrenaline, epinephrine, norepinephrine.Adrenaline, epinephrine, norepinephrine.
Fast heart rate, fast breathing, high pressure,Fast heart rate, fast breathing, high pressure,
Hyper-acute vision and hearingHyper-acute vision and hearing
Decreased pain perception (MVA)Decreased pain perception (MVA)
Diverting blood from gut to muscleDiverting blood from gut to muscle (don’t eat before(don’t eat before
No procreation (viva viagra!)No procreation (viva viagra!)
Good for survival (occasionally)Good for survival (occasionally)
Not good at other timesNot good at other times
The Relaxation ResponseThe Relaxation Response
Coined by Herb BensonCoined by Herb Benson
Decrease stress hormonesDecrease stress hormones
Studied Tibetan MonksStudied Tibetan Monks
Lower HR, RR, BP,Lower HR, RR, BP, Temp
The Love ResponseThe Love Response
When Parasympathetic >When Parasympathetic >
Sympathetic Response…Sympathetic Response…
Civilization prospersCivilization prospers
Relationship growRelationship grow
Humans feel goodHumans feel good
Digestion is efficientDigestion is efficient
Thinking is creativeThinking is creative
Sex is goodSex is good
Disease is controlledDisease is controlled
People find theirPeople find their
When Para is > SympaWhen Para is > Sympa
The “Conventional MD’s” say:The “Conventional MD’s” say:
PsoriasisPsoriasis Psychosomatic Medicine 60: 625-632, 1998Psychosomatic Medicine 60: 625-632, 1998
Cytokine Production in Breast and Prostate CACytokine Production in Breast and Prostate CA PsychosomaticPsychosomatic
Medicine 65: 571-581, 2003Medicine 65: 571-581, 2003
Immune FunctionImmune Function Psychosomatic Medicine 65:564-570, 2003Psychosomatic Medicine 65:564-570, 2003
IBSIBS BehavBehav ResRes TherTher. 2002 May ;40 (5):541-6. 2002 May ;40 (5):541-6
Cortisol Response in YogaCortisol Response in Yoga P3-196P3-196
The Influence of Classical Yoga Practices on Plasma Cortisol Levels.The Influence of Classical Yoga Practices on Plasma Cortisol Levels.
Justin Mager*1, Vijayendra Pratap2, Barbara Levitt2, John Hanifin1, George Brainard1. 1Ctr for Integrative Med, Jefferson MedJustin Mager*1, Vijayendra Pratap2, Barbara Levitt2, John Hanifin1, George Brainard1. 1Ctr for Integrative Med, Jefferson Med
Coll, Philadelphia, PA; 2Yoga Res Soc, Philadelphia, PA.Coll, Philadelphia, PA; 2Yoga Res Soc, Philadelphia, PA.
What is Conventional Medicine AnyWhat is Conventional Medicine Any
Allopathic MedicineAllopathic Medicine
AntonieAntonie van Leeuwenhoekvan Leeuwenhoek in 1676in 1676
Joseph ListerJoseph Lister in 1865 antisepsisin 1865 antisepsis
Charles DarwinCharles Darwin in 1859 species categoriesin 1859 species categories
WatsonWatson andand CrickCrick in 1953 DNAin 1953 DNA
Robert KochRobert Koch in 1905 bacteriologyin 1905 bacteriology
Barack Hussein Obama IIBarack Hussein Obama II 20102010
Allopathic EvolutionAllopathic Evolution CFSCFS Hahnemann 1842Hahnemann 1842
In the US some schools date back 300 yearsIn the US some schools date back 300 years
Trends changed when the microscope wasTrends changed when the microscope was
Washing hands, pasteurization, public health,Washing hands, pasteurization, public health,
nutrition, pharmacology, Roentgennutrition, pharmacology, Roentgen
EBM, EMR, Wikipedia, DNA, HealthcareEBM, EMR, Wikipedia, DNA, Healthcare
reform, FDA, USDA, pharmaceutical industry,reform, FDA, USDA, pharmaceutical industry,
health insurance industryhealth insurance industry
Ayur = lifeAyur = life
Veda = science of knowledgeVeda = science of knowledge
5000 year old system of healing5000 year old system of healing
Health is a balance between environment, body,Health is a balance between environment, body,
mind and spiritmind and spirit
Tibetan medicine, TCM and Greek medicineTibetan medicine, TCM and Greek medicine
have roots in ayurvedahave roots in ayurveda
Comes fromComes from AyurvedaAyurveda
A lifestyle not an exerciseA lifestyle not an exercise
Hot commodity in commercial salesHot commodity in commercial sales
18 million Americans practice18 million Americans practice
Predominantly female but attracting malesPredominantly female but attracting males
Like jogging in the 60s and aerobics in the 70sLike jogging in the 60s and aerobics in the 70s
1990 study by Ornish used yoga (+) to reduce1990 study by Ornish used yoga (+) to reduce
heart disease.heart disease.
Definition in Sanskrit = yolk or unionDefinition in Sanskrit = yolk or union
-of mind-body / spirit-collective-of mind-body / spirit-collective
Yoga postures or asana formulated to help moveYoga postures or asana formulated to help move
Yoga breathing or pranayama formulated toYoga breathing or pranayama formulated to
move breath /life forcemove breath /life force
more on it’s definition………………..more on it’s definition………………..
Lived in the 3Lived in the 3rdrd
century before Christcentury before Christ
Compiled “sutras”/ “threads” of informationCompiled “sutras”/ “threads” of information
Each sutra is a “knot” of informationEach sutra is a “knot” of information
The writing is called The Yoga SutrasThe writing is called The Yoga Sutras
Yoga was a way of life before patangali wroteYoga was a way of life before patangali wrote
his format makes easier understanding of andhis format makes easier understanding of and
esoteric conceptesoteric concept
The Eight Limbs of YogaThe Eight Limbs of Yoga PatangaliPatangali
1 Law of life (yama)1 Law of life (yama)
2 The rules of living (niyama)2 The rules of living (niyama)
3 Posture (asana)3 Posture (asana)
4 Breathing exercises (pranayama)4 Breathing exercises (pranayama)
5 Retirement senses (pratyahara)5 Retirement senses (pratyahara)
6 Focusing of attention (dharana)6 Focusing of attention (dharana)
7 Meditation (dhyana)7 Meditation (dhyana)
8 The settled mind (samadhi)8 The settled mind (samadhi)
Old languageOld language
Difficult to convey the meaningDifficult to convey the meaning
Not to be taken in a “step-wise approach”Not to be taken in a “step-wise approach”
““Limbs” all develop simultaneouslyLimbs” all develop simultaneously
Postures and Breathing exercises togetherPostures and Breathing exercises together
known asknown as Hatha YogaHatha Yoga
Hatha YogaHatha Yoga is preparation for the heart of yogais preparation for the heart of yoga
- meditation- meditation
Bastrika Pranayama Break!Bastrika Pranayama Break!
Please bring your seatbacks forward and remain seated !
Pranayama Break!!!Pranayama Break!!!
Andrew WeilAndrew Weil
Salute the Sun Break!Salute the Sun Break!
Hand to footHand to foot
8 limbs8 limbs
Hand to footHand to foot
Salutation -hands to heart and back to business!Salutation -hands to heart and back to business!
Energy pathways = einstein-eanEnergy pathways = einstein-ean
When the highways are moving, the city is happyWhen the highways are moving, the city is happy
When the 90 and 53 is bottlenecked,When the 90 and 53 is bottlenecked,
tempers flare, people become late, road ragetempers flare, people become late, road rage
……..the city is unhappy...the city is unhappy.
Helps to unblock the highway or nadi’s andHelps to unblock the highway or nadi’s and
move energy making the city/body happy.move energy making the city/body happy.
Helps “still” the mind and bring blissHelps “still” the mind and bring bliss
Helps secrete the love hormones.Helps secrete the love hormones.
Helps decrease the stress hormones.Helps decrease the stress hormones.
Helps improve breathing and oxygenate theHelps improve breathing and oxygenate the
Why stretch nadi’sWhy stretch nadi’s
Stretching nadi’s lets energy flow.Stretching nadi’s lets energy flow.
Energy flowing through the nadi’s, flows through theEnergy flowing through the nadi’s, flows through the
Reflexology? (lazy man energy moving)Reflexology? (lazy man energy moving)
Postures (asana) unblock and flowPostures (asana) unblock and flow
Unblocked flow = healthUnblocked flow = health
When anahata flows hbp goes.
The heart chakra is responsible
for love and compassion.
Standard “warm up’s”Standard “warm up’s”
Only hit major muscleOnly hit major muscle
Usually opposing groupsUsually opposing groups
Less than 5 minutes…Less than 5 minutes…
……then onto body buildingthen onto body building
movements or straight tomovements or straight to
Problem with standard exerciseProblem with standard exercise
There’s a “high” with bodybuilding movementsThere’s a “high” with bodybuilding movements
enkephalin’s and endorphin’s secreted (short).enkephalin’s and endorphin’s secreted (short).
No energy flow using the energy models and just theNo energy flow using the energy models and just the
opposite with muscle stiffness .opposite with muscle stiffness .
There’s a “high” with running, (short) but the rhythmThere’s a “high” with running, (short) but the rhythm
and breathwork with running also bring out aand breathwork with running also bring out a
“calming” effect (long).“calming” effect (long).
No energy flow using the energy models.No energy flow using the energy models.
E. Saguil, MDE. Saguil, MD
The benefits of yoga over standard:The benefits of yoga over standard:
No short high, there is and endorphin responseNo short high, there is and endorphin response
but included with mind stilling – long, all day forbut included with mind stilling – long, all day for
continued tolerance to further stressors.continued tolerance to further stressors.
By stretching the nadi’s/chakra’s, energy movesBy stretching the nadi’s/chakra’s, energy moves
from the root to the crown and into thefrom the root to the crown and into the
universe/consciouness, the spirit stays healthy,universe/consciouness, the spirit stays healthy,
body also follows and maintains health.body also follows and maintains health.
More benefits of yogaMore benefits of yoga
Due to mind “stillness”, oxytocin flows and theDue to mind “stillness”, oxytocin flows and the
inflammatory response lessens.inflammatory response lessens.
Interactions that are presented from theInteractions that are presented from the
environment becomes less provoking for theenvironment becomes less provoking for the
stress response.stress response.
The breathwork or pranayama takes 4 phases ofThe breathwork or pranayama takes 4 phases of
breath and makes 26 different techniques-morebreath and makes 26 different techniques-more
efficient lungs=more efficient heart.efficient lungs=more efficient heart.
The Hook:The Hook:
Control theControl the stress responsestress response and you controland you control
thethe hypertensive responsehypertensive response
Control theControl the relaxation responserelaxation response and youand you
control thecontrol the stress responsestress response
Live inLive in blissbliss and you control theand you control the relaxationrelaxation
Add the practice ofAdd the practice of yogayoga and you can findand you can find blissbliss
The Saguil ApproachThe Saguil Approach
Any new lifestyle will be difficult to assimilateAny new lifestyle will be difficult to assimilate
““RPM” and as “bed time prayer”RPM” and as “bed time prayer”
4-7-8 breathing bid can expand to an activity4-7-8 breathing bid can expand to an activity
Catch any exercise form and addCatch any exercise form and add AsanasAsanas
Dovetail yoga routines with PT/Dietary/PostopDovetail yoga routines with PT/Dietary/Postop
Encourage a month trial in a local studio.Encourage a month trial in a local studio.
““When you can take the pebbles from myWhen you can take the pebbles from my
hand it will be time for you to leave” ….?hand it will be time for you to leave” ….?
The scientific teaching ofThe scientific teaching of Hatha YogaHatha Yoga is like ais like a
Those who wish to reach the higher realms ofThose who wish to reach the higher realms of
thethe Royal WayRoyal Way climb up it.climb up it.
Goraksha Samhitain the relationship between hatha and raja yogaGoraksha Samhitain the relationship between hatha and raja yoga
The Yoga’sThe Yoga’s
ViVigorousgorous- Power Yoga, Jivamukti Yoga, White- Power Yoga, Jivamukti Yoga, White
Lotus Yoga, and Ashtanga YogaLotus Yoga, and Ashtanga Yoga
FlowFlow- Vinyasa-style practices- Vinyasa-style practices
HotHot- Bikram Yoga- Bikram Yoga
RestorativeRestorative- Yin Yoga and Svaroopa Yoga- Yin Yoga and Svaroopa Yoga
Attention to detail-Attention to detail- Iyengar, Anusara, andIyengar, Anusara, and
Kripalu YogaKripalu Yoga
Deepak Chopra-Deepak Chopra- 7 Spiritual Laws of Yoga7 Spiritual Laws of Yoga