Blood Pressure and Autonomic Changes From 12-Weeks of Yoga-Based Slow Breathing Exercises
Author: Alfredo Gamboa1, Hui Nian2, Emily C Smith1, Sachin Paranjape1, Robert Abraham3, Andre Diedrich1,4, Chase Bossart5, Gurjeet Birdee6
Affiliation:
1 Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
2 Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
3 Divisions of Cardiovascular Science, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
4 Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.
5 Yoga Well, Harbor, WA, USA.
6 Osher Center for Integrative Health, Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA.
Conference/Journal: Glob Adv Integr Med Health
Date published: 2025 Sep 25
Other:
Volume ID: 14 , Pages: 27536130251380265 , Special Notes: doi: 10.1177/27536130251380265. , Word Count: 288
Background:
Slow breathing exercises have been shown to reduce blood pressure and sympathetic tone acutely, though long-term effects are not well documented.
Objective:
Assess changes in blood pressure and autonomic measures from before and after 12 weeks of yoga-based slow breathing.
Methods:
We conducted a secondary analysis to assess changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and autonomic tone as measured by spectral analysis of heart rate variability after 12 weeks of yoga-based slow breathing among 99 healthy participants. Participants were randomized to 2 different slow breathing techniques, length of inhale = exhale (I = E) vs length of inhale<exhale (E>I), to examine if breath ratio produced differential effects.
Results:
The baseline average SBP and DBP was 105 ± 11 and 67 ± 8 mmHg respectively. Among the 11 participants with elevated blood pressure, SBP/DBP was 126 ± 11.0/80 ± 5 mmHg. SBP and DBP decreased significantly (-2.4 ± 7.3 and -1.6 ± 5.5 mmHg, respectively) at 12 weeks among all participants. Blood pressure among slow breathing participants with elevated baseline SBP >120 mmHg and/or DBP >80 mmHg reduced further (-10.3 ± 7.9 and -3.8 ± 5.5 mmHg, respectively). In our regression model, baseline SBP was associated with further decreases in SBP from baseline to 12 weeks. There were no significant differences in BP changes by breath ratio group. No significant changes were observed from baseline to 12 weeks in autonomic tone as measured with spectral analyses. Nor were there any observed correlations between changes in blood pressure and autonomic tone.
Conclusion:
12-weeks of slow breathing exercises were associated with clinically significant reduction of blood pressure in the absence of statistically significant changes in autonomic tone as measured by heart rate variability. Further research is warranted regarding the mechanisms and clinical efficacy of slow breathing on blood pressure regulation.
Keywords: breathwork; cardiovascular disease; yoga.
PMID: 41019836 PMCID: PMC12464420 DOI: 10.1177/27536130251380265
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