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MODULATION OF STRESS INDUCED BY ISOMETRIC HANDGRIP TEST IN HYPERTENSIVE PATIENTS FOLLOWING YOGIC RELAXATION TRAINING


Vijayalakshmi P.*, Madanmohan, Bhavanani A. B., Asmita Patil and Kumar Babu P.

Department of Physiology and Staff & Students’ Health Center, 
Jawaharlal Institute of Post-graduate Medical Education and Research,
Pondicherry – 605 006  

Abstract: 13 essential hypertensive patients aged 41 to 60 years were given yoga training for 60 min daily, Monday through Saturday, for a total duration of 4 weeks. Blood pressure and heart rate (HR) were measured with non-invasive semi-automatic blood pressure monitor. Measurements were recorded before the training and at weekly intervals during the 4 week training period. Results of our study show a significant (P<0.001) reduction in resting HR and rate-pressure-product (RPP) after 2 weeks of yoga training. Systolic pressure (SP), diastolic pressure (DP) (P<0.001) and mean pressure (MP) (P<0.05) showed a significant reduction at 3 weeks of training period. After 4 weeks of training, there was further fall in SP, DP, pulse pressure (PP) (P<0.05), MP (P<0.001), HR and RPP. Isometric handgrip test before yoga training produced a significant rise in SP and MP and insignificant rise in DP, HR and RPP. After yoga training, there was a significant rise in all these parameters. Our results show that yoga training optimizes the sympathetic response to stressful stimuli like isometric handgrip test and restores the autonomic regulatory reflex mechanisms in hypertensive patients.

Key words: yoga training, blood pressure, heart rate, rate-pressure-product, isometric handgrip  


Modern man has become a victim of daily stress and stress related disorders like essential hypertension, angina, insomnia and impotency. Being holistic in their approach, yogic techniques are ideal for improving one's ability to withstand stressful stimuli. There is evidence that yoga is effective for prevention as well as management of bronchial asthma (1), stress due to exams (2), anxiety and depression (3), stress in hypertensive patients (4) and in the cure/control of essential hypertension (5). Yoga is also known to improve the subjective well being (3, 6). Non pharmacological control of essential hypertension with relaxation methodologies in the form of yoga (7, 8, 9), transcendental meditation (10) and progressive muscular relaxation (11) has become more popular recently, though these techniques have been practiced in the past (12). Most of these techniques produce long-lasting changes in the blood pressure (BP) and heart rate (HR) if they are practiced regularly (8, 12). Earlier studies by Selvamurthy et al (5) have shown that some yogic postural exercises can control essential hypertension. Many references are available on non pharmacological control of essential hypertension (11, 13, 14) and a number of workers have used shavasan and other yogic techniques for the control of essential hypertension (7, 15, 16). 

Rate-pressure-product (RPP) is a reliable index of myocardial oxygen consumption and cardiac work and it correlates well with the myocardial oxygen consumption of normal subjects as well as patients with angina pectoris (17). Yogasans may influence RPP by altering pre-load and or after-load. However, there is paucity of literature on the effect of yogasans on RPP in essential hypertension. In view of this, the present work was planned to study the effect of yoga training on BP, HR and RPP. Since vascular reactivity response can readily be detected by isometric stress (18), we extended our work to study the cardiovascular response to stress with isometric hand-grip (IHG) test before and after yoga training.

 
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