International Journal of Medical Science Research and Practice

UNIT OF AXIS JOURNALS

International Peer Reviewed Medical Journal Committed for Excellence
Print ISSN: 2349-3178 Online ISSN: 2349-3186

Original Research

Effect of Bhramari Pranayama and Yoga Nidra on

cardiovascular hyper-reactivity to cold pressor test
Ritu Bajpai, Chanda Rajak, Sanjeev Rampalliwar

Department of Physiology, Shyam Shah Medical College, Rewa, Madhya Praesh, India

ABSTRACT
Aim: The aim of this study was to investigate whether regular practice of Bhramari Pranayama and Yoga Nidra for
3 months can reduce cardiovascular hyper-reactivity to the cold pressor test in young healthy medical students.
Background: A number of studies support the beneficial effect of Bhramari Pranayama and Yoga Nidra in hypertension.
No study has been done to evaluate combined effect of pranayama and meditation in hyper-reactors to cold pressor test.
Materials and Methods: A total of 94 young medical students were selected who performed Bhramari Pranayama and
Yoga Nidra for duration of 3 months. Cold pressor test was done on each student before and after yoga. Results: There
was 79% reduction in hyper-reactivity to cold pressor test as number of hyper-reactors reduced from 32 before the study
to 7 after 3 months of yoga. Systolic rise of blood pressure to cold pressor test reduced from 20.1 ± 3.5 mm Hg to
15.2 ± 3.7 mm Hg (P < 0.001) and diastolic rise reduced from 13.81 ± 3.4 mm Hg to 10.37 ± 2.62 mm Hg (P < 0.001)
in hyper-reactors. Mean systolic blood pressure in all the 94 subjects reduced from 119.87 ± 12.01 mm Hg to 117.68
± 11.89 mm Hg whereas mean diastolic blood pressure reduced from 77.08 ± 9.3 mm Hg to 75.11 ± 9.07 mm Hg
(P < 0.001). Conclusion: Bhramari Pranayama and Yoga Nidra together can significantly alleviate stress induced
changes in cardiovascular parameters.

Keywords: Bhramari, Cold pressor test, Hyper-reactors, Yoga Nidra

INTRODUCTION MATERIALS AND METHODS

Stress-induced hypertension is a major cause of The present study was carried out in the Department
cardiovascular mortality and morbidity in modern times. of Physiology, Shyam Shah Medical College Rewa
World Health Organization (WHO) global burden of (Madhya Pradesh), India. Total 94 medical students
disease survey estimates that stress-related disorders, aged 17-27 years participated in the study after obtaining
will be the second leading cause of disability by the year clearance from an ethical committee of the institute and
2020.1 after taking written informed consent. They performed
Bhramari Pranayama and Yoga Nidra under expert
Yoga is one of the most precious inheritances of Indian
supervision for the duration of 3 months. Each subject
civilization. There is evident literature support on the
served as its own control. Subjects excluded from the study
beneficial effect of pranayama. Studies show that Bhramari
were those suffering from respiratory or cardiac diseases
Pranayama induces parasympathetic dominance on the
or those on some sort of respiratory medication. Cold
cardiovascular system reducing systolic and diastolic
pressor test was done before and after yoga, and systolic
pressures and heart rate.2
and diastolic hyper-reactivity of blood pressure measured.
Yoga Nidra is probably the best known technique to induce Statistical analysis was done by MS Excel 2010 software.
complete physical, mental, and emotional relaxation.3
Very few studies have been done on combined effect of
pranayama with meditation on blood pressure4 and none RESULTS
by performing cold pressor test and seeing effect on hyper- Of 94 students, 32 (18 females and 14 males) were
rectors. Our study does the same. found to be hyper-reactors to cold pressor test before

Corresponding Author:
Dr. Ritu Bajpai, Department of Physiology, Shyam Shah Medical College, Rewa, Madhya Pradesh, India. E-mail: [email protected]
© 2015 International Journal of Medical Science Research and Practice available on www.ijmsrp.com

International Journal of Medical Science Research and Practice • Vol 2 • Issue 1 • 2015 24
 Bajpai, et al.: Bhramari Pranayama and Yoga Nidra effect on cardiovascular hyper-reactivity

yoga. Most of the students were systolic hyper-reactors Systolic rise of blood pressure to cold pressor test
(Table 1). reduced from 20.1 ± 3.5 mm Hg to 15.2 ± 3.7 mm Hg and
diastolic rise reduced from 13.81 ± 3.4 mm Hg to 10.37 ±
Systolic rise of blood pressure to cold pressor test and
2.62 mm Hg in hyper-reactors.
diastolic rise was measured in all the subjects. Mean systolic
and diastolic blood pressure in all the 94 subjects was also Mean systolic blood pressure in all the 94 subjects reduced
measured (Table 2). from 119.87 ± 12.01 mm Hg to 117.68 ± 11.89 mm Hg
whereas mean diastolic blood pressure reduced from 77.08
There was 79% reduction in hyper-reactivity to cold pressor
test as number of hyper-reactors reduced from 32 before the ± 9.3 mm Hg to 75.11 ± 9.07 mm Hg. The difference in the
study to 7 after 3 months of yoga (Table 3). mean values of all the above parameters was found to be
statistically significant with a P < 0.001 (Table 4).

Table 1: Distribution of hyper-reactors as systolic/

diastolic before Yoga DISCUSSION
Category Number Male Female Total Our study found that hyper-reactivity to the cold pressor
and subjects subjects subjects test reduced by doing regular Bhramari Pranayama
percentage (14) (18) (32) and Yoga Nidra for 3 months. Furthermore, there was a
Systolic Number 8 9 17 reduction in mean systolic and diastolic blood pressure
hyper-reactors Percentage 25 28 53 which was statistically significant. The reason for this can be
Diastolic Number 4 4 8 parasympathetic dominance on autonomic activity which has
hyper-reactors Percentage 12.5 12.5 25 been given in numerous studies.
Hyper-reactors Number 2 5 7
to both Percentage 6.4 15.6 22 Many studies have showed a beneficial effect of pranayama
on blood pressure.4-6 Pal et al. have explained this is due to
increased parasympathetic activity.7 Pramanik et al. found
Table 2: Basal blood pressure and effect of cold in male volunteers systolic blood pressure decreased from
116 mm Hg to 111 mm Hg and in female counterpart systolic
stress on basal blood pressure with their mean
blood pressure decreased from 109 mm Hg to 104 mm Hg
value and standard deviation
following Bhramari Pranayama.2
Subjects BP Basal BP Rise in BP due
(mmHg) to cold stress Deepa et al.3 showed a significant reduction of supine
(mmHg) systolic blood pressure from (151.33 ± 14.1) mm of Hg
Mean SD Mean SD to (132.4 ± 18.1) mm of Hg. The supine diastolic pressure
value value showed decrease after Yoga Nidra practice from (90.67
± 9.0) mm of Hg to (76.93 ± 9.6) mm of Hg. Their study
All Subjects Systolic 119.87 6.01 13 5.86
found that in Yoga Nidra an attempt is made to activate the
Diastolic 77.08 4.65 9.29 4.35
parasympathetic system, and slowly a new balance between
Hypo-reactors (62) Systolic 121.29 6.202 9.39 2.796
the sympathetic and parasympathetic systems is achieved
Diastolic 78.58 4.29 6.97 2.584
Hyper-reactors (32) Systolic 117.125 4.47 20.125 3.533
by inducing complete physical, emotional and mental
Diastolic 74.187 3.88 13.812 3.441 relaxation. In their study one patient in the study group, the
Systolic Systolic 117.33 4.46 21.83 1.724 electrocardiogram showed improvement in left ventricular
hyper-reactors (17) Diastolic 74.08 3.89 12.833 3.411 function following a significant reduction in systemic blood
Diastolic Systolic 116 4.32 18.93 4.725 pressure. The decreased systolic pressure can be attributed
hyper-reactors (8) Diastolic 74 3.65 16.8 0.98 to the relaxation of mind produced as a result of Yoga Nidra,
Both systolic Systolic 115.43 4.101 23.43 1.761 which reduces stress and discharge of sympathetic nervous
and diastolic Diastolic 73.43 3.332 16.857 0.9897 system. A decrease in diastolic pressure is most likely to be
hyper-reactors (7) due to relaxation techniques that the patient has gradually
BP: Blood pressure, SD: Standard deviation learnt which finally resulted in peripheral vasodilation.

Table 3: Change in hyper-reactivity to cold pressor test after 3 months of Yoga

Category Hyper-reactors to Subjects became Subjects remained Hyper-reactors to
CPT before Yoga hypo-reactors after Yoga hyper-reactors after Yoga CPT before Yoga
All hyper-reactors No. of subjects 32 25 07
Percentage 34 26.6 7.4
Systolic hyper-reactors No. of subjects 17 13 04
Percentage 18 13.8 4.2
Diastolic hyper-reactors No. of subjects 08 06 02
Percentage 8.5 6.4 2.1
Hyper-reactor to both No. of subjects 07 06 01
Percentage 7.4 6.4 1

25 International Journal of Medical Science Research and Practice • Vol 2 • Issue 1 • 2015
 Bajpai, et al.: Bhramari Pranayama and Yoga Nidra effect on cardiovascular hyper-reactivity

Table 4: Changes in BP in mm Hg during cold CONFLICTS OF INTEREST

pressor test in hyper-reactors before and after
Nil
3 months Yoga
Parameters Before After 3 months of
Yoga Yoga FUNDING
BP (mm Hg) Mean value SD Mean value SD
Nil
Basal BP
Systolic 117.12 4.470 114.18 4.103
Diastolic 74.18 3.884 71.37 2.570 REFERENCES
BP after hand dip in
4°C water for 1 min. 1. Murray CJ, Lopez AD. The Global Burden of Disease:
Systolic 137.12 5.383 129.5 5.172 A Comprehensive Assessment of Mortality and Disability from
Diseases, Injuries and Risk Factors in 1990 and Projected
Diastolic 87.69 3.909 81.75 3.562
to 2020. Report on Behalf of the WHO and World Bank.
Rise in BP
Cambridge: Harvard University Press; 1996.
Systolic 20.125 3.533 15.19 3.669 2. Pramanik T, Pudasaini B, Prajapati R. Immediate effect of a
Diastolic 13.812 3.441 10.375 2.619 slow pace breathing exercise Bhramari pranayama on blood
BP: Blood pressure, SD: Standard deviation pressure and heart rate. Nepal Med Coll J 2010;12:154-7.
3. Deepa T, Sethu G, Thirrunavukkarasu N. Effect of yoga and
meditation on mild to moderate essential hypertensives. J Clin
Meditation ensures better peripheral circulation was reported Diagn Res 2012;6:21-6.
by Bhargava et al.8 and blood flow to the tissues reported by 4. Malik S, Shah M, Hasan S, Bilal M. The physiological
Gopal et al.9 responses of yogic breathing techniques: A case-control study.
J Exerc Physiol Online 2011;14:74-9.
Several EEG studies have shown sleep like changes during 5. Rampalliwar S, Rajak C, Arjariya R, Poonia M, Bajpai R. The
meditation with increased alpha activity in the beginning and effect of Bhramari pranayama on pregnant women having
theta activity towards the end of meditation practice.10-12 cardiovascular hyper-reactivity to cold pressor test. Natl J
Physiol Pharm Pharmacol 2013;3:137-41.
Recent EEG studies on Yoga Nidra showed similar results 6. Singh S, Gaurav V, Parkash V. Effects of a 6-week nadi-
with alpha wave patterns with theta wave patterns occurring shodhana pranayama training on cardio-pulmonary parameters.
at later stages.13 Alpha rhythm in meditation and Yoga Nidra J Phys Educ Sports Manage 2011;2:44-7.
is an expected finding under these circumstances. But 7. Pal GK, Velkumary S, Madanmohan. Effect of short-term
the appearance of theta waves may indicate deep cortex practice of breathing exercises on autonomic functions in
induced relaxation in an awakened subject. normal human volunteers. Indian J Med Res 2004;120:115-21.
8. Bhargava R, Gogate MG, Mascarenhas JF. Autonomic
Harinath et al.14 have shown a positive effect of hatha responses to breath holding and its variations following
yoga and meditation together on cardio-respiratory pranayama. Indian J Physiol Pharmacol 1988;32:257-64.
performance. Our study is the first to show a beneficial effect 9. Gopal KS, Bhatnagar OP, Subramanian N, Nishith SD. Effect
of pranayama and meditation when practiced together on of yogasanas and pranayamas on blood pressure, pulse rate
and some respiratory functions. Indian J Physiol Pharmacol
cardiovascular hyperreactivity to stress.
1973;17:273-6.
10. Anand B, Chhina GS, Singh B. Some aspects of
electroencephalographic studies inyogis. Electroencephalogr
CONCLUSION Clin Neurophysiol 1961;13:452-6.
We can conclude that Bhramari Pranayama and Yoga Nidra 11. Wallace KW, Benson H. The physiology of meditation. Sci Am
1972;226:84-6.
if practiced together can significantly alleviate the stress
12. Younger J, Adriance W, Berger RJ. Sleep during
induced changes in cardio-respiratory parameters. Yoga is
transcendental meditation. Percept Mot Skills 1975;40:953-4.
an easy and cost effective way to reduce damaging effects 13. Lou HC, Kjaer TW, Friberg L, Wildschiodtz G, Holm S,
of stress and if incorporated in our lifestyle yoga can reward Nowak M. A 15O-H2O PET study of meditation and the resting
us with a long, healthy and disease-free life. state of normal consciousness. Hum Brain Mapp 1999;7:98-105.
14. Harinath K, Malhotra AS, Pal K, Prasad R, Kumar R,
Kain TC, et al. Effects of hatha yoga and omkar meditation
ACKNOWLEDGMENTS on cardiorespiratory performance, psychologic profile, and
melatonin secretion. J Altern Complement Med 2004;10:261-8.
Department of Physiology, Shyam Shah Medical College,
Rewa.
How to cite this article: Bajpai R, Rajak C, Rampalliwar S. Effect of Bhramari
Pranayama and Yoga Nidra on cardiovascular hyper-reactivity to cold pressor
test. Inter J Medical Sci Res Prac 2015;2(1):24-26.
PEER REVIEW
Received: 03 Oct 2014; Accepted: 25 Nov 2014; Published: 31 Mar 2015
Not commissioned. Externally peer reviewed.

International Journal of Medical Science Research and Practice • Vol 2 • Issue 1 • 2015 26