Patient Care Neurology & Psychiatry - November 2007 - (Page 30)

I The Science of Healing sympathetic tone that enhanced HR variability and lowered BP They combined the slowed breathing with a . meditative technique that facilitated control over emotions. Most individuals who have high BP are not going to become yogis, but they can become empowered to use specific tools to retrain their ANS to reduce cardiac risk. Breathing exercises A motivated individual can lower BP at no cost by performing simple breathing exercises (see Table 1). Modalities to lower BP Modalities that may prove helpful include Biofeedback There are a number of devices on the market that train the body to enhance HR variability while lowering BP Web sites to visit include http://www. . resperate.com, http://www.heartmath.com, http://www. wilddivine.com, and http://www.stresseraser.com. Meditation classes Regular practice of mediation has been found to lower BP and increase HR variability.9,10 The following have been studied the most and/or involve the importance of the breath: transcendental meditation (focus on a word or mantra), mindfulness meditation (focus on the present moment), and kriya or Pranayama yoga (focus on enhancing energy through the breath). TABLE 1 Benefits beyond BP The recruitment of inner resources to facilitate health has added benefit beyond the treatment of any one symptom. Stimulating the relaxation response has been found to have a significant positive influence on heart health, immune function, pain, cognition, and sleep quality, to name a few.11-15 Teaching patients how to do this for themselves will address the health needs of the whole body and reduce dependence on external treatments. REFERENCES 1. Vakil RJ. Remarkable feat of endurance by a yogi priest. Lancet. 1950; 2(26):871. 2. Hoenig J. Medical research on yoga. Confin Psychiatr. 1968;11(2):69-89. 3. Camm AJ, Pratt CM, Schwartz PJ, et al. Mortality in patients after a recent myocardial infarction: a randomized, placebo-controlled trial of azimilide using heart rate variability for risk stratification. Circulation. 2004;109(8):990-996. 4. La Rovere MT, Pinna GD, Hohnloser SH, et al. Baroreflex sensitivity and heart rate variability in the identification of patients at risk for life-threatening arrhythmias: implications for clinical trials. Circulation. 2001;103(16):2072-2077. 5. Dekker JM, Crow RS, Folsom AR, et al. Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes: the ARIC study. Atherosclerosis Risk in Communities. Circulation. 2000;102(11):1239-1244. 6. Schein MH, Gavish B, Herz M, et al. Treating hypertension with a device that slows and regularises breathing: a randomised, double-blind controlled study. J Hum Hypertens. 2001;15(4):271-278. 7. Meles E, Giannattasio C, Failla M, et al. Nonpharmacologic treatment of hypertension by respiratory exercise in the home setting. Am J Hypertens. 2004; 17(4):370-374. 8. Bernardi L, Sleight P, Bandinelli G, et al. Effect of rosary prayer and yoga mantras on autonomic cardiovascular rhythms: comparative study. BMJ. 2001;323(7327):1446-1449. 9. Parati G, Steptoe A. Stress reduction and blood pressure control in hypertension: a role for transcendental meditation? J Hypertens. 2004;22(11):20572060. 10. Peng CK, Henry IC, Mietus JE, et al. Heart rate dynamics during three forms of meditation. Int J Cardiol. 2004;95(1):19-27. 11. Astin JA, Shapiro SL, Eisenberg DM, et al. Mind-body medicine: state of the science, implications for practice. J Am Board Fam Pract. 2003;16(2):131-147. 12. Davidson RJ, Kabat-Zinn J, Schumacher J, et al. Alterations in brain and immune function produced by mindfulness meditation. Psychosom Med. 2003;65(4):564-570. 13. Astin JA. Mind-body therapies for the management of pain. Clin J Pain. 2004;20(1):27-32. 14. Alexander CN, Langer EJ, Newman RI, et al. Transcendental meditation, mindfulness, and longevity: an experimental study with the elderly. J Pers Soc Psychol. 1989;57(6):950-964. 15. Jacobs GD, Benson H, Friedman R. Perceived benefits in a behavioral-medicine insomnia program: a clinical report. Am J Med. 1996;100(2):212-216. How to perform abdominal breathing exercises Place one hand on your chest and the other on your abdomen. When you take a deep breath, the hand on the abdomen should rise higher than the one on the chest. This ensures that the diaphragm is expanding, pulling air into the bases of the lungs. Take a slow deep breath in through your nose imagining that you are sucking in all the air in the room. Breathe in for a count of 4. Slowly exhale through your mouth for a count of 6. Repeat the cycle for a total of 10 deep breaths. Try to breathe 1 full breath every 10 seconds for a rate of 6 breaths a minute. At this rate, the body relaxes deeper and the heart rhythm is normalized. Repeat throughout the day—at stop lights, during TV commercials, and when experiencing a stressful situation. With practice, abdominal breathing will become natural. www.patientcareonline.com Visit our Web site for ® Click-through links to the Internet resources listed in these pages 30 PATIENT CARE NEUROLOGY & PSYCHIATRY www.patientcareonline.com http://www.resperate.com http://www.resperate.com http://www.heartmath.com http://www.wilddivine.com http://www.stresseraser.com http://www.wilddivine.com http://www.patientcareonline.com http://www.patientcareonline.com

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Patient Care Neurology & Psychiatry - November 2007 Contents Research Digest Medicine in the News The 15-Minute Visit Dementia workup and treatment: Do the drugs really work? Help for Your Patients Who Suffer from Specific Phobias Clinical Clips Case & Comment The Science of Healing Classified Advertising

Patient Care Neurology & Psychiatry - November 2007

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