Therapeutic role of yoga in hypertension

Table 1 Recommended yoga practice in hypertension

Yoga practice	Details of the yoga practice	Duration1
Shatkriya (Yogic cleansing practices)
Shatkriya	Trataka (concentrated gazing)	10 to 15 min
	Jala neti (nasal cleansing with warm saline water)	5 min (Once a week)
Sharir sanchalana (Warm-up practices)
Sharir sanchalana (Warm-up practices)	Toe bending, ankle bending, knee bending, half butterfly, finger bending, wrist bending, elbow bending, shoulder rotation, and neck movements in a seated position with synchronization of breathing	5 to 10 min
Surya namaskara (Sun salutations)
Surya namaskara (Sun salutations)	Series of dynamic yoga postures in a specific sequence with meditative awareness, practiced at slow-speed with breath synchronization	3–7 rounds as per capacity; The postures can be held for a short period, without straining[6]
Asana (Yoga postures) for relaxation
Shavasana (Corpse pose)	Shavasana with slow, rhythmic diaphragmatic breathing, awareness of the sensation at the nostrils, the temperature of the inhaled and exhaled air, relaxing the muscles, and feeling the heaviness of different parts of the body	5 to 30 min
Restorative Yoga (Conventional poses with props)	Supported and modified stretching to suit individual needs[11]; Shavasana (Corpse pose); Supta baddha konasana (Reclined bound angle pose); Upvistha konasana (Wide-angled seated forward bend); Balasana (Child's pose); Pashchimottanasana (Seated forward bend); Salamba kapotasana (Supported pigeon pose)	15 min[11]
Other Asana (Additional practices)
Standing postures	Tadasana (Palm tree pose); Tiryak tadasana (Swaying palm tree pose); Katichakrasana (Standing spinal twist); Ardhachakrasana (Standing backward bend)	Synchronizing the movements with the breathing cycle; The postures can be held for a short period, without straining
Seated postures	Vakrasana (Seated spinal twist); Gomukhasana (Cow face Pose); Ardha Ushtrasana (Half camel pose); Pashchimottanasana (Seated forward bend); Marjarasana (Cat stretch)
Prone postures	Bhujangasana (Cobra pose); Tiryak bhujangasana (Swaying cobra pose); Ardha Shalabhasana (Half locust pose)
Supine postures	Pavanmuktasana (Wind releasing pose); Eka and Dwipada uttaanpadasana (straight single and both legs raising)
Meditative Postures for Pranayama and Meditation
Meditative postures (Spine erect, shoulders relaxed, face softened)	Seated in a chair; Sukhasana (Comfort pose); Vajrasana (Thunderbolt pose); Ardha padmasana (Half lotus pose); Padmasana (Lotus pose)	During pranayama and meditation
Pranayama (Regulated breathing practices)
Deep abdominal breathing	Gentle deep inhalation and slow longer exhalation	5 min
Sukha pranayama (Easy comfortable breathing)	Conscious, slow and deep breathing with equal duration for inhalation and exhalation) at the rate of 6 breaths/min	5 min[16]
Anulom Vilom/Nadi shodhan pranayama (Alternate nostril breathing)	Gentle inhalation through the left nostril followed by exhalation through the right nostril. Next inhalation through the right nostril and exhalation through the left nostril	Upto 20 min[17]
Chandra nadi pranayama/Chandra bhedan pranayama (Left nostril breathing)	Unilateral left nostril breathing with inhalation and exhalation for an equal count of five; Variation: Inhalation through the left nostril followed by exhalation through the right nostril	27 rounds of 6 breaths/min[19]
Slow bhastrika pranayama (Bellows breath)	Deep inhalation and slow exhalation (Respiratory rate 6/min), imagine the open blue sky while breathing[18]	5 min[18]
Ujjayi pranayama (Ocean breath)	Slow inhalation and exhalation with a slight contraction around the glottis; Can be practiced in seated, supine, or standing position	10 min[15]
Bhramari pranayama (Humming bee breath)	Slow deep inhalation followed by exhalation with a humming sound	5 min[20]
Sheetali pranayama (Cooling breath)	Inhalation through curled tongue in the form of a tube, slow exhalation through the nose	9 rounds each[9]
Pranava pranayama/ AUM chanting	Slow and deep inhalation with complete yogic breathing followed by the audible vibratory resonance of a prolonged AUM chant; Can be practiced in a supine position	5 min[13]
Mudra (Subtle gestures)
Shanmukhi mudra (Closing the seven gates)	Closing the ears with the thumbs, placing the index fingers on the eyes, the middle fingers near the nostrils, the ring fingers, and the little fingers above and below the lips	Practiced during bhramari pranayama
Brahma mudra (Divine spiritual gesture)	Synchronizing neck movements with deep breathing and vibration sounds	3 to 9 rounds of this practice at each sitting
Apan Vayu Mudra (Mudra of the heart)	Placing the tip of the index finger at the base of the thumb and joining the tips of the middle finger, ring finger, and thumb, the little finger extended	15 min
Gyan mudra (Mudra of wisdom)	Joining the tips of the index finger and the thumb, other fingers extended	Practiced during pranayama and meditation; Up to 30 min a day
Meditation (Formal practice)
Concentration Meditation (Focus on a word, sound, prayer, mantra, or phrase)	Examples: AUM japa; Ajapa japa; Anahata (heart) chakra meditation with the mantra 'YAM'	10-15 min
Mindfulness meditation (Open awareness of the present moment with kindness, acceptance, and curiosity)	Examples: Body scan meditation (Awareness of body parts); Mindful breathing meditation (Breath awareness); Loving-kindness meditation (having unconditional compassion towards ourselves and all other beings)
Meditation (Informal/Integrated practice)
Mindfulness (Non-judgmental present-moment awareness during daily activities)	Examples: Mindful yoga (Yoga postures with awareness); Mindful Eating	Can be practiced anytime, anywhere in a day-to-day life
Yoga nidra (yogic sleep or effortless relaxation)
Yoga nidra	Relaxation practice that includes awareness of different body parts and breath, relaxation, auto-suggestions, and imagery	Up to 45 min[29]

¹The durations mentioned are not necessarily to be practiced during a single yoga session. A customized yoga sequence as per individual requirements is recommended.