Yoga Improves Blood Pressure, Lowers Heart Rate in Patients with Atrial Fibrillation

A Swedish trial found that weekly yoga was associated with higher quality of life, lower blood pressure and slower heart rates in patients with paroxysmal atrial fibrillation (AFib).

Investigators randomized 40 patients to standard treatment and another 40 patients to standard treatment combined with hour-long yoga classes, attended once a week for 12 weeks. They then took baseline measurements of blood pressure, heart rate and quality of life as measured by 2 validated questionnaires, the EuroQoL-5D (EQ-5D) Visual Analogue Scale (VAS) and the Short-Form Health Survey (SF-36).

Yoga group members reported significant improvements during the study period on both the EQ-5D VAS scale (mean 70; interquartile range [IQR], 20-95 vs. mean, 80; IQR 50-100; p < 0.001) and the mental component of the SF-36 (mean, 42.1; IQR, 17.6-53.3 vs. mean, 50.6; IQR, 24.0-55.2; p < 0.001). Control group members scores on the same questionnaires remained virtually unchanged.

Neither group experienced significant changes on the physical component of the SF-36 scale, though the yoga group’s scores did improve, on average, by more than 3 points during the study period (p = 0.091).

The findings were similar when investigators compared baseline and final data on heart rate and blood pressure. The mean number of heartbeats per minute among yoga group members fell from 64 (± a standard deviation of 13) to 61 (±13), but the reduction was not significant (p = 0.183). Mean systolic blood pressure also fell an insignificant amount (137 mm Hg [± 16 mm Hg] vs. 132 mm Hg [±17 mm Hg]; p = 0.069). The only significant change was in the yoga group’s mean diastolic blood pressure (84 mm Hg [±9 mm Hg] vs. 77 mm Hg [±10 mm Hg]; p < 0.001).

That said, the investigators saw evidence that yoga might have produced improvements in heart rate and both types of blood pressure. At baseline, there were no significant differences between the yoga group and the control group in any of the 3 measurements. By the end of the study, the yoga group had significantly slower heart rates (p=0.024) as well as significantly lower systolic (p=0.033) and diastolic (p<0.001) blood pressures.

“Yoga with light movements and deep breathing may lead to improved quality of life, lower blood pressure and lower heart rate in patients with paroxysmal AFib compared to a control group,” the study authors wrote in the European Journal of Cardiovascular Nursing. “Yoga could be a complementary treatment method to standard therapy.”

The investigators characterized their work as a pilot study but still believe it to be the largest randomized trial to evaluate the effect of yoga on cardiac arrhythmia.

The size and duration of the trial were not large enough to draw any conclusions about yoga’s impact on health outcomes, but the investigators wrote that its possible effects on both blood pressure and heart rate could improve outcomes.

“Hypertension is an important risk factor for atrial fibrillation related complications… Decreasing blood pressure may lead to a reduced risk for bleeding in treatment with anticoagulants,” they wrote. “At the same time, high heart rates are relatively common and may lead to pronounced symptoms and eventually development of a tachycardiomyopathy.”