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Pranayama at about six breaths per minute

Pranayama is the yoga practice of breath regulation, which the tradition explains as extending prana, vital energy. Slow forms of pranayama and other slow breathing at around six to ten breaths a minute have been tested in trials: meta-analyses of randomised trials in adults with high or high-normal blood pressure show modest falls in blood pressure and heart rate over weeks of practice, though the trials vary and carry risk of bias. Slow yogic breathing appears to act on cardiovascular and autonomic measures where fast techniques do not. Heart rate variability, stress and mood effects of slow breathing are covered in the slow-breathing entry.

  • Mind
  • Recovery

Evidence retrieved up to

What the research shows

A session of slow-paced breathing is followed by a small immediate fall in systolic blood pressure in adults without a diagnosed condition.

Low certaintyFurther research is likely to change this.
No known concerns at usual amountsBenefit

Who this is about

adults in nonclinical samples

Practical note

Graded low: a single meta-analysis of 31 studies with a wide confidence interval, and an immediate effect is indirect evidence for lasting change.

Vegan note

Not diet-related; applies equally to people following a vegan diet.

Sources

Reciting a yoga mantra paced at about six breaths a minute strengthens and synchronises cardiovascular rhythms and raises baroreflex sensitivity during recitation in healthy adults.

Very low certaintyThis is uncertain; treat it as a lead, not a finding.
No known concerns at usual amountsBenefit

Who this is about

healthy adults

Practical note

Graded very low: a single small comparative laboratory study (23 adults) of effects during recitation only; the same effect appeared with rosary prayer recited at the same pace.

Vegan note

Not diet-related; applies equally to people following a vegan diet.

Sources

Regular pranayama practice lowers resting heart rate in adults living with high blood pressure, with a smaller and less certain effect on blood pressure itself.

Moderate certaintyFurther research may change the size of the effect.
No known concerns at usual amountsBenefit

Who this is about

adults with high blood pressure

Practical note

Graded moderate: seven randomised trials (683 participants) agree closely on heart rate with no measurable heterogeneity; downgraded once for risk of bias and small trials.

Vegan note

Not diet-related; applies equally to people following a vegan diet.

Safety note

The review authors describe pranayama as an adjunct to usual care, not a replacement for it.

Sources

As part of a healthy lifestyle, regular slow breathing practice at ten breaths a minute or fewer, including pranayama, may help adults living well with high or high-normal blood pressure, with trials showing modest falls in systolic and diastolic blood pressure over several weeks.

Low certaintyFurther research is likely to change this.
No known concerns at usual amountsBenefit

Who this is about

adults with high or high-normal blood pressure

Practical note

Graded low: meta-analyses of randomised trials agree on the direction of effect (about 5-7 mmHg systolic and 3 mmHg diastolic), but heterogeneity was high, the trials carry risk of bias, and long-term effects are not established. Included trials used slow breathing for at least five minutes on three or more days a week for four weeks or more.

Vegan note

Not diet-related; applies equally to people following a vegan diet.

Safety note

Slow breathing was studied alongside, not instead of, usual care. Fast or forceful pranayama and long breath-holds are different practices; people who are pregnant or living with heart, lung or mental-health conditions are generally advised to check with a health professional before taking up breathwork.

Sources

What the tradition holds

Slow forms of yogic breathing are followed by favourable changes in cardiovascular and autonomic measures such as heart rate and blood pressure, while fast forms are not.

No known concerns at usual amountsBenefit

Who this is about

adults

The tradition's frame

Yoga

Yoga teaches pranayama as the regulation of breath to extend prana, the vital energy or life force, and treats the breath as the bridge between body and mind.

Practical note

The supporting review is narrative and notes that the mechanisms behind different pranayama techniques are not fully understood.

Vegan note

Not diet-related; applies equally to people following a vegan diet.

Safety note

Fast and forceful techniques such as kapalbhati and bhastrika are a different practice from slow pranayama and were not linked to the same effects.

Sources