At the Cardiopulmonary Rehabilitation Program at UHealth—the University of Miami Health System, program participants learn physical therapy exercises, Pilates, mindful breathing, meditation, and are encouraged to participate in yoga classes at UHealth or other locations in South Florida.
“When you have maximized everything you can do medically, integrative therapies like yoga, meditation, and breathing exercises accomplish things regular medicine cannot. The more challenging the patient, the more they benefit from yoga,” says Dr. Claudia Martinez Bermudez, a clinical and interventional cardiologist with the health system.
Patients have found that such exercise activities can lower or regulate blood pressure, cholesterol and body weight—sometimes better than medication.
The stretching, strengthening, breathing, and meditation involved in yoga have a powerful healing effect on the body. Holding different yoga poses requires a mindfulness that relaxes the body’s “fight or flight” response — the same response that restricts blood vessels, increases heart rate and the risk of blood clots.
As part of the program, Dr. Martinez Bermudez checks each patient’s blood pressure when they arrive at her office, when it is still elevated. She then asks them to take several deep breaths. “When I take their blood pressure again, 99 percent of the time, it has dropped. That’s how I convince them of the importance of deep breathing. Along with meditation, this overlaps in a positive way to help lower stress hormones, which in addition to lowering blood pressure, also decreases arrhythmia.”
Saying “yes” to yoga
Dr. Martinez Bermudez and Dr. Sabine Gempel, the program’s physical therapist, encourage heart patients interested in yoga and cardiac rehabilitation to start a conversation with their doctor.
According to Dr. Gempel, many patients aren’t aware that cardiac rehabilitation exists. “Nationally, the average referral rate is only 25 percent. It is so underutilized, though there is evidence that rehabilitation causes a 25 percent decrease in all-cause mortality.”
One of the first things Dr. Gempel teaches patients is the four pillars of rehabilitation:
1. Smoking cessation
2. Eating a whole foods, plant-based diet
3. Exercise
4. Stress management
“All styles of yoga are beneficial and can be made easier or harder to perform, but depending on your situation, some styles might be more appropriate. For example, chair yoga is a good option if you have poor balance. Bikram and ‘hot’ yoga can reduce your blood pressure as you sweat, so patients with low blood pressure should be cautious and stay hydrated. If you have had heart failure or an abdominal aortic aneurysm, avoid inversion poses because they increase blood flow back to the heart,” says Dr. Gempel.
Physical benefits aside, the psychosocial support found in yoga classes can alleviate depression, a common ailment among heart patients. “As patients exercise, they feel better, and their whole psychology changes,” says Dr. Martinez Bermudez. That simple yet profound change makes it easier to deal with whatever life presents – from health issues to traffic jams.
