We Indians usually pay attention to our health only when something goes wrong, and we give very little thought to the chronic stress and emotional strain that quietly shape cardiovascular risk. What’s more, yoga is often dismissed as too gentle, too spiritual, or too rooted in tradition to be relevant in an era of statins, wearable health trackers, and advanced cardiac care. Yet a growing body of scientific evidence suggests it may have a meaningful role to play in cardiovascular health.
Many studies suggest that cardiovascular diseases are the leading causes of death in India, accounting for 62 per cent of all deaths. What is alarming is how early it begins, not in old age, but in the productive middle years of life. The most common risk factors, such as hypertension, dyslipidemia, insulin resistance, obesity and chronic stress are the lived reality of millions of Indians navigating sedentary jobs, fragmented sleep, ultra-processed diets, and unrelenting pressure. Considering all this, the question is not just about whether we need more solutions, rather, it is about whether the one that has existed for 5,000 deserves a look.
The science behind the stillness
Yoga is often confused with stretching. When researchers studied the impact of yoga on patients with hypertension and metabolic syndrome, the findings were striking. Adding structured yoga, as opposed to conventional stretching, to a regular aerobic regimen reduced systolic blood pressure by 10 mmHg, compared to just 4 mmHg with stretching alone. It also reduced resting heart rate and ten-year cardiovascular risk scores. These are clinically meaningful numbers.
Yoga activates the parasympathetic nervous system, counteracting the chronic sympathetic overdrive that modern lifestyles impose on the body. This triggers measurable physiological changes, such as reduced serum cortisol and catecholamines (stress hormones), improved endothelial function (which means your blood vessels are working better and more flexibly because they have a steady supply of a natural dilatory gas called nitric oxide) decreased systemic inflammation and better insulin sensitivity.
Mindfulness-based meditation has even been shown to modulate gene expression associated with pro-inflammatory cytokines, which are small proteins released by immune cells that act as your body’s emergency alarm system. These can be a problem if they remain switched on for too long. Yoga changes not just how we feel but also changes how our cells behave.
Stress: The hidden risk factor
To appreciate why yoga matters for the heart, we must first acknowledge what conventional risk calculators have long underweighted — psychological stress. A landmark global study found that individuals with high stress levels and depression were 2.14 times more likely to suffer a heart attack than those without such histories. Stress drives elevated cortisol, promotes arterial inflammation, disrupts sleep and activates clotting pathways. It is, in every measurable sense, a cardiovascular toxin.
Herein lies yoga’s singular advantage over conventional exercise. A brisk walk improves cardiac output, a gym session builds muscle, but neither reliably quiets the mind. Yoga, through the integration of asana, pranayama, and dhyana, addresses the body and the nervous system simultaneously. This is the very reason yoga surpasses mechanical exercise in reducing the total burden of cardiovascular risk.
From prevention to rehabilitation
The benefits of yoga span the entire cardiovascular continuum, as for healthy individuals, regular yoga practice reduces the risk of hypertension, insulin resistance and dyslipidemia. The asanas improve muscular insulin sensitivity, pranayama lowers blood pressure, and meditation moderates the neurohormonal stress response that silently accelerates atherosclerosis.
For those already living with heart disease, yoga is a valuable adjunct to medical therapy. A study presented at the European Society of Cardiology congress demonstrated that heart failure patients who practised yoga alongside their medications reported feeling better, showed improved functional capacity and demonstrated stronger cardiac performance than those on medication alone.
In cardiac rehabilitation, the structured recovery programme recommended after a heart attack or surgery, yoga fits naturally. The breath awareness it cultivates is directly relevant to the exertion demands of the recovery-phase exercise. The mindfulness it builds encourages better medication adherence, healthier eating, and restorative sleep and all these are independently associated with improved outcomes.
Choosing your practice wisely
Not every style of yoga suits every person. Hatha and restorative yoga, with their gentle pace and emphasis on breath, are ideal for those beginning their cardiac wellness journey. More vigorous forms may suit healthy individuals seeking to complement their aerobic routine. Patients with advanced heart disease or recent cardiac events should consult their cardiologist before beginning any yoga regimen.
Intervention, potent drugs and precise procedures have their irreplaceable place, but the most powerful interventions in cardiovascular medicine have always been behavioural and simple, such as stopping smoking, eating well, sleeping soundly, moving daily and managing stress. Yoga addresses almost all of these simultaneously, with an unmatched safety profile and a growing body of evidence behind it.
For a country as burdened by heart disease as India, and a population as culturally proximate to yoga as ours, the case for integrating this practice into mainstream cardiac care has never been stronger.
(Dr Trehan is cardiovascular surgeon and CMD, Medanta)
Growing scientific evidence suggests yoga can play a significant role in cardiovascular prevention by helping lower blood pressure, ease chronic stress, improve insulin sensitivity and reduce inflammation linked to heart disease. (Representative image) 
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