Courtney Wild

Final Research Project

INRODUCTION
High blood pressure is one of the most common conditions in the
United States today. One in three adults have high blood pressure and
only about half of those adults have their condition under control or
normalized. The US spends billions on health care services every year
to treat hypertension. Because of these spending habits, alternative
methods of therapy are currently being researched to help normalize
blood pressure values. Yoga is a popular exercise that focuses primarily
on practices of meditation and deep breathing. Previous studies have
shown that the practice of yoga can be beneficial for reducing longterm blood pressure values in adults with mild hypertension, especially
diastolic pressure. Few studies have been done showing the acute
effects of yoga on blood pressure. Therefore, my research question is
does yoga have an acute effect on the reduction in blood pressure in
mild hypertensive adults between the ages of 50-75. My null
hypothesis is that there will be no change in blood pressure values.
Likewise, my alternative hypothesis is that there will be a change in
blood pressure values.
LITERATURE REVIEW
In a study conducted by Moa Wolff, Kristina Sundquist, Sara Lonn,
and Patrick Midlov, researchers aimed to investigate the effect of yoga
on quality of life in adults diagnosed with hypertension. The subjects

in this study included 83 patients, majority women, located at a

medical center in Sweden with blood pressure levels between normal
and stage one hypertension. After inclusion in the study, patients were
selected to be in either a control group or one of two intervention
groups based on their systolic blood pressure. The first intervention
group participated in an hour-long yoga class once a week while the
second group participated in an at home yoga program for 15 minutes
a day. Blood pressure measurements were taken at baseline and
follow-up. The results of this study showed that there was not a
significant difference in systolic blood pressure but that there was a
significant improvement in diastolic blood pressure in the first
intervention group. This group also reported a greater quality of life.
Another study conducted by Marshall Hagins, Andrew Rundle,
Nathan Consedine, and Sat Khalsa on blood pressure in patients with
Pre-hypertension and Stage 1 hypertension showed similar results as
the study done by Wolff and other researchers. Patients in this study
were males and females between the ages of 21 and 70. Sixty-eight
participants were randomized to either a yoga group or an active
control group that participated in non-aerobic exercise. Both groups
also attended two 55-minute classes each week for the duration of the
12-week intervention. The results of this study showed no significant
changes in the control group. However, the yoga group showed

significant changes in both systolic and diastolic blood pressure with a

more significant difference in diastolic pressure at night.
Vogel and his researchers conducted using a multifactorial
approach at lower blood pressure. Participants in this study included
113 participants ages 22-75. Participants were randomized to one of
two groups, a DASH diet plus exercise group or a CALM-BP group.
Participants in both groups attended a weekly lecture to learn more
about their diet, the new DASH eating plan and the naturopathic whole
grain rice diet, CALM-BP. Both groups attended a 45-minute group walk
session to achieve and record their 60-75% maximal age
recommended heart rate. Only participants in the CALM-BP group
attended relaxation and stress management sessions consisting of
yoga and breathing techniques. The results of this study showed that
participants in the CALM-BP group significantly lowered their blood
pressure as well as their usage of antihypertensive medication.
A final study conducted by Montfrans, Karemaker, Wieling, and
Dunning investigated the long terms effects of blood pressure from
relaxation therapy in patients with mild or uncomplicated hypertension
in a nonclinical setting. Subjects in this study included 35 patients ages
20-60. At baseline, 24-hour ambulatory blood pressure was taken and
then patients were randomized to either a relaxation therapy group or
a control group. The relaxation therapy group, or yoga group, had a
therapist train them for one hour a week over the course of 8 weeks.

The control group practiced passive relaxation lead by a nurse with no

training. The results of this study show that relaxation was ineffective
in lowering 24-hour blood pressure. However, both groups showed a
slight decrease in systolic and diastolic blood pressure.
METHODS
I tested a group of 20 pre-hypertensive adults ages 50-75 at the
Green Hills YMCA. My method of recruiting subjects was on a volunteer
basis. Once participants were recruited, they signed up for a yoga class
time. I obtained my data by using a digital arm blood pressure monitor
to obtain values before the yoga class and after the yoga class. My
methods of measurement did not have a reliability coefficient so to
make sure data collection was accurate and consistent, I made sure
participants were at rest at least 10 minutes before the class began to
take blood pressure and as soon as the class was over to take blood
pressure. It also did not have a validity coefficient so to ensure validity;
I tested the digital arm multiple times before the study to make sure it
was assessing the intended construct. The yoga class was an hour long
and two different instructors led the class over the course of my study.
My dependent variable in this study was the blood pressure values.
Since my study was a pre and post test study, my independent
variable was time. I assessed and analyzed my data by running a
dependent t-test with a paired sample.
RESULTS AND DISCUSSION

The results of this study showed that there was an acute

significant change in blood pressure among participants pre yoga
class and post yoga class. The P-value in this study, .001, is less then
0.05 and therefore means that the variances are significantly different.
This P-value helps state that the data is consistent and the null
hypothesis was rejected. The mean and standard deviation for pre and
post scores were quite similar but varied slightly. Pre scores had a
mean of 99.85 and a standard deviation of 2.66 while the post scores
had a mean of 98.1 and a standard deviation of 2.86. Though there
was a significant change in blood pressure values from pre to post
there was no known pattern as to which pressure changed more and
why, systolic and diastolic. Overall, the results of this study showed
that there was a significant difference in blood pressure from pre yoga
class and post yoga class. (p<.05).
One limitation to this study included lack of control. All
participants did not take the same class with the same breathing
techniques and movements and therefore each class would have
different results. Multiple factors such as instructor, time of day, and
choreography could not be controlled for and may have played a role
in the accuracy of the results. Another limitation was not knowing
medical history. Some participants may have been on blood pressure
medication and some may not have been. Since the study duration
was very short, the opportunity to recruit participants that met all

criteria that a larger study would ask for was just not realistic. For
future research, I would suggest a larger sample size but with the same
age range. Very few studies on yoga and hypertension focus on a small
age range of older adults so more research is needed. The need for
control in this topic of research is very important and future research
should aim for much more control of arms. I would also encourage
continued research on the acute effects, instead of long term effects,
of yoga and hypertension since data is scarce. In conclusion, older
adult with pre-hypertension who participate in yoga will have an acute
decrease in blood pressure values.

SPREADSHEET DATA FILE

Values of MAP in mmHg
PRE

POST
97
101
101

95
96
99

103
103
97
100
102
98
103
101
94
100
100
102
97
97
98
104
99

103
101
96
98
102
96
100
100
92
100
97
101
95
96
96
101
98

SAS RESULTS

t Test

The TTEST Procedure

Difference: Pre - Post
N

Mean

Std Dev

Std Err

Minimum

Maximum

20

1.7500

1.2085

0.2702

5.0000

Mean

1.7500

95% CL Mean

1.1844

Std Dev

2.3156

1.2085

95% CL Std Dev

0.9191

1.7651

DF

t Value

Pr > |t|

19

6.48

<.0001

Generated by the SAS System ('Local', W32_7PRO) on April 17, 2015 at 11:20:48 AM

Summary Statistics
Results

The MEANS Procedure

Variable
Pre
Post

Mean
99.8500000
98.1000000

Std Dev
2.6611236
2.8635642

Minimum
94.0000000
92.0000000

Maximum
104.0000000
103.0000000

N
20
20

Generated by the SAS System ('Local', W32_7PRO) on April 17, 2015 at 11:47:05 AM

REFERENCES FOR LITERATURE

1) Wolff, M., Sundquist, K., Lonn, S. L., Midlov, P. (2013). Impact of
yoga on
blood pressure and quality of life in patients with hypertension a controlled trial in primary care, matched for systolic blood
pressure. BMC Cardiovascular Disorders, 13(211).
doi:10.1186/1471-2261-13-111.
2) Hagins, M., Rundle, A., Consedine, N. S., & Khalsa, S. B. S. (2014). A
randomized
controlled trial comparing the effects of yoga to an active control
on ambulatory blood pressure in individuals with Pre- and Stage
1 Hypertension. Journal of Clinical Hypertension,16(1), 5462.
3) Ziv,A.,Vogel,O.,Keret,D.,Pintov,S.,Bodenstein,E.,Wolkomir,K.,...Efrati,S.
(2013).ComprehensiveApproachtoLowerBloodPressure(CALMBP):A
randomizedcontrolledtrialofamultifactoriallifestyleintervention.Journalof
HumanHypertension,27,594600.
4) Montfrans,G.A.,Karemaker,J.M.,Wieling,W.,&Dunning,A.J.(1990).

Relaxationtherapyandcontinuousambulatorybloodpressureinmild
hypertension:Acontrolledstudy.BritishMedicalJournal,300(6736),13681372.