Heart Health And Yoga: What Mr Iyengar, The Yoga Doctors And The Research Say

Had a heart scare, and now every flight of stairs makes you wonder? After a heart attack, with a heart that flutters, or after bypass surgery, it is hard to know what kind of exercise is right. The great yoga teachers and the medical doctors who worked with Mr BKS Iyengar point the same way: rest the heart, open the chest, and breathe smoothly, without strain. This guide brings together what each of them says about heart health, and what modern research has found. Last updated: 1 November 2026.

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Heart health and yoga: the short answer

Is yoga good for heart health? Yes. Yoga helps the heart. In people with heart disease, reviews of the trials found yoga lowered blood pressure, raised “good” HDL cholesterol and improved quality of life, stress, anxiety and depression. In heart failure, yoga improved fitness and walking distance. After a heart attack, yoga-based cardiac rehab gave people better self-rated health and got more of them back to their usual lives. Mr Iyengar’s own approach to the heart is a restful one: lying over supports, opening the chest, and smooth, simple breathing. If you are looking for how to improve heart health without pounding the pavement, this is it.

One thing to keep in mind as you read: most trials tested “yoga” of many styles, taught by teachers with very different training. The one Iyengar yoga study on the heart, using a programme Mr Iyengar developed for heart patients, found the calming nerve to the heart grew stronger, and in our view well-taught Iyengar yoga is likely to go further than the average. Why the kind of yoga matters.

The bottom line: five key moves for heart health

1. Go to a yoga class at your level, two or three times a week. The trials that helped ran for 8 to 12 weeks or longer, so give it time. A gentle or restorative class is a good place to begin.
2. Make the out-breath long and smooth, and never hold your breath in a pose. Slow pranayama (yoga breathing) calms the heart’s rhythm. Breath holds are left out for anyone with a heart condition.
3. Rest well. Supported, restful poses are the heart of Mr Iyengar’s approach. Rest is training too.
4. Work on the risk factors. Yoga brings down blood pressure, blood fats, weight and stress, and helps sleep. Eating well matters too, and yoga makes it easier to eat mindfully.
5. Start now. New to Flametree, or away 3 months or more? 2 free classes, then 10 at half price, in Darwin or LIVE online.

Iyengar yoga is the style we teach at Flametree. During the 20th century, Mr BKS Iyengar was the major person who codified traditional Indian yoga, through his seminal books and widespread teaching. He also pioneered the use of props, so poses can be adapted to almost any body. His style is sometimes called modern classical yoga. This guide is part of our encyclopaedia of yoga for health conditions.

This guide in short

• Mr BKS Iyengar: a restful approach for the heart. Lie over supports, open the chest, soften, and breathe simply. Headstand and raised arms are left out.
• Geeta S Iyengar: only the gentlest form of ocean breath for coronary heart disease, guided by a teacher.
• Dr Timothy McCall: heart disease is a lifestyle illness, and yoga works on the lifestyle: stress, blood pressure, blood fats, fitness and anger.
• Dr Krishna Raman: correct practice, smooth breath, and back bends done well.
• The research: 15 studies listed below, from heart failure and AFib to cardiac rehab after a heart attack or bypass surgery.
• For men: men have more than twice the heart attack rate of women, and do far less yoga.
• Take it further: a free ebook, our 2027 masterclass on calming the stress response, and classes in Darwin and online.

“Heart is the hub of life.”

What is heart disease?

Heart disease is a family of problems. About 580,000 Australian adults have had coronary heart disease, the most common one. The main kinds covered in this guide are:

• Coronary heart disease: the arteries that feed the heart muscle narrow and harden. Angina (chest pain on effort) and heart attack come from this.
• After a heart attack: part of the heart muscle went short of blood. Cardiac rehab (a recovery programme of exercise, education and support) usually follows.
• After bypass surgery: a new blood vessel is placed around a blocked artery.
• Atrial fibrillation (AFib): the upper chambers of the heart beat fast and out of rhythm. It can come and go.
• Heart failure: the heart pumps less strongly than it should, so people tire and get breathless.
• Implanted defibrillators (ICDs): a small device that shocks the heart back into rhythm.

High blood pressure is a major cause of heart disease, and it has its own guide: yoga and high blood pressure.

What did Mr BKS Iyengar teach about the heart?

In short: rest the heart, open the chest, soften the muscles around it, and never strain.

In Yoga: The Path to Holistic Health, Mr Iyengar gives the heart and circulation its own chapter (pp. 264 to 275). He sets out a yoga approach for blocked arteries (p. 271), angina (p. 272) and recovery from a heart attack (p. 275). Every one of them is restful: lying over supports, the legs resting up, some supported forward bends, and finishing in complete rest. In The Tree of Yoga (pp. 98 to 100) he goes further. In our words:

• Raised arms and headstand are left out. With a heart condition, and after a heart attack, he avoided them because of the strain they bring. This is what we teach at Flametree.
• Soften, do not tighten. The muscles at the back of the heart region need to soften, not take on more tension.
• Supported poses do the work. He names a supported bridge pose, legs-up-the-wall poses, bolsters, the resting pose and simple breathing.
• Yoga, not jogging. In his view jogging makes the heart race and can irritate it, while a well-supported yoga back bend does not leave you gasping.
• Breath and blood are “two gates”. He saw breathing and circulation as two gates of health, and poses as a way to bring blood where it is needed. Health, in his view, is a by-product of yoga, and it comes slowly but steadily (The Tree of Yoga, pp. 86 to 88).

In Light on Yoga, his first book, Mr Iyengar’s appendix on ailments has four heart entries, and they are the gentlest in the whole list. For coronary thrombosis (p. 420) and for heart trouble in general (p. 424) he gives no poses at all: only gentle breathing lying down, without holding the breath and without strain, with meditation and long rest, ideally with a competent teacher. For a dilated heart (p. 421) he gives breathing without breath holds, and for palpitations (p. 429) a few quiet poses, with breath holds left out for the first two to three months.

We do not publish his sequences. A sequence needs a teacher who can see you and adapt each pose, which is what a class is for.

Geeta S Iyengar, his daughter, gives the same care in Yoga: A Gem for Women. Her hint on heart disease (p. 85) is to take a teacher’s advice; she lists the poses she safely used with heart patients. For coronary heart disease she gives only the first, gentlest form of ocean breath (Ujjayi I, a long, smooth out-breath lying down) (p. 308). At Flametree we follow her lead on pranayama.

“The heart faces the floor in all the forward extensions and this gives rest.”

What does Dr Timothy McCall say about heart disease?

In short: heart disease grows out of how we live, and yoga works on the way we live.

Dr McCall is a US medical doctor and yoga therapist, author of Yoga as Medicine and former medical editor of Yoga Journal. His book gives heart disease a full chapter. His June 2019 list of conditions helped by yoga has six heart entries: atrial fibrillation (no. 6), congestive heart failure (no. 21), heart disease (no. 39), after coronary bypass surgery (no. 81), after a heart attack (no. 82) and implanted defibrillators (no. 83). His views, in our words:

• Yoga works on the risk factors. He writes that yoga can lower stress, improve cholesterol, lower blood pressure, build fitness and reduce anger and frustration.
• Look at the whole programme. Five of his heart disease references are Dr Dean Ornish’s lifestyle programme: yoga poses, breathing, meditation, walking, group support and a low-fat vegetarian diet. In its US Medicare project, about 2,000 people with heart disease saw their top blood pressure fall from an average of 150 to about 136 in 12 weeks. That result belongs to the whole programme, with yoga as one part, not to yoga alone.
• A story from his book. A man he calls Ron, with angina, did a week-long lifestyle programme and then a daily home yoga practice. After about two months his angina came seldom enough that a planned second procedure to open an artery was put off. Ron began with the poses, and took three years to come to the breathing and meditation, which turned out to matter more to him than he expected. He could breathe deeply in traffic and let it go.
• Sleep counts. He notes that poor sleep raises the risk of a heart attack. Our guide to yoga and sleep covers this.

The teacher behind his chapter. His expert is Nischala Joy Devi, who helped Dr Ornish design the yoga in his heart trial and taught it. Her rule is that less is more: most people, she says, push past their limit, so do less than you think you can, and come back to deep relaxation several times in a session, not only at the end. McCall also reports, as his claim, that the Ornish trial found blockages in the arteries grew smaller on average over five years while the comparison group’s grew larger, and that a trial at the Yoga Institute in Mumbai found smaller blockages in 70% of the yoga group against 28% of the comparison group. Both were whole lifestyle programmes, so the result is not yoga’s alone, and he is careful to say the Iyengar idea that supported chest openers help the heart has not been tested. His cautions match ours: never hold the breath, leave out fast breathing such as Kapalabhati and Bhastrika, use supported inversions only, and go carefully with arm balances, full backbends and long standing holds.

“When the chest opens, the mind opens, and we feel emotionally radiant, and stability comes.”

What does Dr Krishna Raman say about yoga and the heart?

In short: correct practice, smooth breathing, and back bends done well.

Dr Raman is a Chennai physician who trained in yoga under Mr Iyengar and used Iyengar yoga with patients for many years. He writes about the heart in his question-and-answer book on yoga and medical science, and in a long article on yoga and the heart. His views, in our words:

• Never hold the breath in a pose. He says holding the breath raises the pressure in the main artery and can bring on headache, palpitations and dizziness (Q125).
• Back bends need to be done well. In his view, correct, supported back bends relieve angina, and badly done ones make it worse (Q475).
• Lift the shoulders in shoulderstand. Done flat on the floor, he says, it squeezes the heart and lungs. A lift under the shoulders, as in every Iyengar class, avoids this (Q475).
• Yoga sits alongside good food. Poses may help cholesterol and the heart, he says, but they do not replace a good diet, and one back bend a day is not enough on its own (Q318 to Q321).
• After bypass surgery: he calls yoga necessary, while being clear that no one can promise an artery will stay open (Q318 to Q321).
• Angina: he describes a graded programme, built up step by step under a teacher’s eye (Q325).
• Where he and Mr Iyengar differ. Dr Raman writes about one heart failure patient who later used headstand, with props, after recovering. That is his own case and his own view. At Flametree we follow Mr Iyengar’s caution in The Tree of Yoga: no headstand and no raised arms with a heart condition.

“The chest expansion gives a feeling of happiness and joy.”

Other yoga voices on heart health

• The evidence for yoga earns four stars both for heart risk factors and for heart disease itself. Her tips: come up from poses slowly, because blood pressure can dip, and go easy on hot or fast yoga. She also reports that yoga after a heart attack is cheap to run: one teacher could cover a whole hospital’s needs. Mary Flaherty, Does Yoga Work?, a careful review of the yoga research (pp. 56 to 80).
• A review of 37 trials found small gains in weight, blood pressure, cholesterol and heart rate after about 12 weeks, with classes of about an hour, two or three times a week. Harvard Medical School, An Introduction to Yoga (p. 8).
• Frozen shoulders after bypass surgery got moving again with yoga. A man whose shoulders froze three weeks after emergency heart bypass surgery in 2010 was pain free and moving after about two years of yoga and physiotherapy together. His story, from Mary Flaherty’s book, is in our shoulder mobility article.
• Dr Loren Fishman’s books focus on joints, spine and bones, and say little about the heart.

“Deep breath does not mean puffing the chest.”

What does the research show about yoga and heart health?

In short: reviews of the trials show yoga lowers blood pressure and blood fats and lifts quality of life in heart disease, improves fitness in heart failure, and helps recovery after a heart attack or bypass. Most of these studies tested yoga in general, of many styles. The Iyengar yoga study is listed on its own below. Why the difference matters.

Reviews of the trials

• In people with heart disease, yoga lowered blood pressure, raised HDL (“good”) cholesterol, nudged other blood fats the right way, and improved quality of life, stress, anxiety and depression. Kalra 2022, a review of 16 randomised trials, 11 pooled. Read the study.
• Yoga lowered body mass index, blood pressure, LDL and total cholesterol, triglycerides and heart rate, and raised HDL, compared with no exercise. It did as well as other exercise. Chu 2014, a review of 37 randomised trials of heart risk factors. Read the study. Note: “as well as exercise” is yoga in general, of many styles. Iyengar yoga has not yet been tested against exercise on its own. Why it matters.
• Yoga added to cardiac rehab clearly improved quality of life, with gains in stress, anxiety and depression, and blood pressure and blood fats leaning the right way. Chandrababu 2026, a review of 11 papers and 4,489 people with coronary heart disease, including people after bypass surgery. Read the study.
• After a heart attack, yoga-based rehab improved self-rated health, wellbeing and return to daily activities, and mindfulness eased anxiety and stress and helped blood pressure control. One study found fewer major heart events. Bianchi 2026, a review of 10 studies. Read the study.
• In heart failure, yoga improved peak fitness, six-minute walk distance and quality of life, and lowered a blood marker of strain on the heart. No serious problems were reported. Dutta 2023, a review of 11 trials and 552 people. Read the study.

After a heart attack: cardiac rehab and recovery

• Yoga-based cardiac rehab gave better self-rated health at 12 weeks and got more people back to their pre-attack activities. Major heart events were 6.7% with yoga and 7.4% with advice alone; the trial was not built to show a difference that small, so it is not counted as one. Prabhakaran 2020 (Yoga-CaRe), a trial of 3,959 people in 24 Indian hospitals. Read the study.
• Yoga strengthened the body’s automatic blood pressure steadying reflex and made blood pressure swing less, on top of the best medicines. Thirteen hospital yoga sessions. Christa 2023, a trial of 80 people after a heart attack. Read the study.

Note: one UK trial, reported in Mary Flaherty’s Does Yoga Work?, found no extra benefit when yoga was added to a normal cardiac rehab programme. That was yoga in general, not Iyengar yoga, taught by teachers with six or more years of training. Why it matters.

After bypass surgery

• Men whose hearts pumped weakly before surgery improved more with yoga than with physiotherapy-based rehab, and yoga also improved blood fats and mood and lowered stress, anxiety and depression. Followed for a year. Raghuram 2014, a trial of 250 men aged 35 to 65 having bypass surgery. Read the study.

Heart failure

• Yoga added to medical care improved how well the heart pumped, and a blood marker of heart strain fell further than with care alone. Twelve weeks. Krishna 2014, a trial of 130 people with heart failure. Read the study.
• Exercise time and fitness rose with yoga and fell without it, and markers of inflammation dropped. Eight weeks. Pullen 2008, a pilot trial of 19 people with heart failure. Read the study.
• Yoga did as well as water exercise for quality of life and fitness, and the yoga group also had better health ratings and less depression. Twelve weeks, twice a week. Hagglund 2017, a trial of 40 people with heart failure. Read the study. Note: this was yoga in general, not Iyengar yoga.

Atrial fibrillation (AFib)

• AFib episodes with symptoms fell from 3.8 to 2.1, and anxiety, depression, heart rate and blood pressure all came down. Three months of watching without yoga, then three months of yoga twice a week. Lakkireddy 2013 (YOGA My Heart), a before-and-after study of 49 people with AFib that comes and goes, with no separate comparison group. Read the study.

Coronary heart disease and implanted defibrillators

• Body mass index, waist, blood pressure and heart rate all fell with yoga. Thirty-five to 40 minutes a day, five days a week, for 18 months. Pal 2013, a trial of 258 people with coronary heart disease in India. Read the study.
• Fear of shocks fell with yoga and rose without it, and in an early look people had 32% fewer rhythm events that needed the device to step in. Eight weeks of adapted yoga. Toise 2014, a trial of 46 people with implanted defibrillators. Read the study.

Iyengar yoga studies

This study tested Iyengar yoga specifically, taught by trained Iyengar teachers, using a programme Mr Iyengar developed for heart patients.

• The calming nerve to the heart (vagal tone) grew significantly stronger during Iyengar yoga. Eleven experienced Iyengar students, four of them certified teachers, wore 24-hour heart monitors during the yoga programme and during a relaxation programme. Khattab 2007. Read the study. These were healthy people, so it shows how the programme acts on the heart’s rhythm. A trial of it in heart patients is still to come.

Meditation and mindfulness

• Twelve weeks of Yoga Nidra, a guided yoga meditation, improved sleep in people with coronary artery disease. Sleep efficiency was 82 percent with Yoga Nidra against 64 percent with usual care, and people slept longer, fell asleep faster, and also reported less stress and low mood and a better quality of life. Sharma 2026, a randomised trial of 144 people with stable coronary artery disease and poor sleep, 35 minutes a session. Read the study.

After a heart attack, mindfulness programmes eased anxiety and stress, helped blood pressure control and improved quality of life (Bianchi 2026, above). Mindfulness is a loose word: who taught what, and how, is often not clear. The steady attention of a yoga pose and of pranayama trains the same thing.

Breathing practice (pranayama)

No trial in our list tested pranayama on its own for heart disease. Breathing was part of most of the yoga programmes above, though the papers rarely say which techniques were taught, or how. Not yet studied is not the same as not working. In healthy people, slow breathing raises heart rate variability (the healthy beat-to-beat flex of the heart), as our article on how to improve HRV explains. The pranayama we teach (staircase, ocean, alternate nostril and humming) is slow, nasal and taught step by step. Forceful breaths such as breath of fire and the bellows breath wait for people with heart disease. Why the kind of breathing matters.

For men: heart disease and yoga

In short: heart disease hits men harder, men do much less yoga, and yoga is a practical way in.

• Men have 2.3 times the heart attack rate of women. Two in every three of the 56,700 heart attacks and similar events in Australia in 2020 were in men, and men’s death rate from coronary heart disease is about twice women’s. Australian Institute of Health and Welfare. See the figures.
• Yoga after bypass surgery was tested in men, and it helped. The Raghuram trial above was 250 men.
• Half as many men as women meditate, but the men who do find it helps. In a US survey of 34,342 adults, 5.2% of men and 10.3% of women meditated, and 90% of the men said it helped. Upchurch and Johnson 2018. Read the study.
• Many men see yoga as “not for blokes”. Classes with other men were what might bring them in. Cagas 2020, interviews with 21 men in Queensland. Read the study.

What men can do about it. Yoga is something you do, not something you talk about, and you feel it in the body first: a slower breath, looser shoulders, a quieter head. Start with a beginner or gentle class. Bring a mate or come alone, but give it 12 weeks. About a third of the people in our classes are men. For the prostate and men’s pelvic pain, see our prostate health and men’s health guide.

“The spine is horizontal and parallel to the ground so that the heart is rested.”

How does this come together in a Flametree class?

Everything above points the same way, and it is how we teach in Darwin and online. Looking for something to go alongside cardiac rehab in Darwin? This is what a class with us looks like.

• Props in every class: bolsters, blankets, blocks, chairs and the wall, so the chest opens and the heart rests.
• Classes adapted to the people in them. No one-size-fits-all. Tell your teacher about your heart, and the poses are changed for you.
• No headstand and no raised arms with a heart condition, following Mr Iyengar. Supported poses take their place.
• Come up slowly, and never hold the breath in a pose.
• A practice for every kind of day: our gentle yoga and restorative yoga classes are the place to start.
• Breath and calm: every class ends in rest, and our pranayama classes go further.

Read more on the heart and the breath

• Stroke recovery and yoga: the full guide
• Yoga and high blood pressure: the full guide
• Circulation and yoga: varicose veins, cold hands and feet, low blood pressure
• How to improve HRV: slow breathing, the out-breath and yoga
• Shoulder mobility: a bypass patient’s frozen shoulders, and five supported moves
• Vagus nerve exercises: six slow ones
• Yoga for stress and burnout
• Yoga for asthma, COPD and breathlessness
• Weight, stress eating and cortisol belly

“The brick itself opens the chest. Be passive.”

Take it further

• Classes, in Darwin or LIVE online: new, or away 3 months or more? 2 free classes, then 10 at half price. Already practising yoga? See the non-beginner half price pass. See every class time.
• Masterclass: the calming poses and pranayama that bring the stress response down run through our 2027 Sunday Arvo Masterclass on anxiety, upsets and anger with Chris Lalor, Certified Senior Iyengar Yoga Teacher and certified Yoga Therapist. Come for the poses, the sequences and the pranayama that put this into action. Bookings open soon.
• Retreats: a week of daily, adapted yoga and pranayama in Bali. See the retreats.

Other conditions are in our encyclopaedia of yoga for health conditions.

Heart health and yoga: questions people ask

Is yoga good for heart health?

Yes. In people with heart disease, a 2022 review of 16 randomised trials found yoga lowered blood pressure, raised good HDL cholesterol and improved quality of life, stress, anxiety and depression. A review of 37 trials found yoga also lowered weight, cholesterol and resting heart rate. Mr Iyengar’s approach for the heart is restful and supported, with smooth, simple breathing.

Can I do yoga after a heart attack?

Yes, and yoga after a heart attack has been studied in large numbers. In a trial of 3,959 people in India, yoga-based cardiac rehab gave better self-rated health and got more people back to their usual activities. Mr Iyengar’s course for heart attack recovery is a restful one: lying over supports, the legs resting up, and finishing in complete rest. Tell your teacher about your heart. Always follow the directions of any doctor you are consulting.

Is yoga a good part of cardiac rehab?

Yes. A 2026 review of 11 papers and 4,489 people with coronary heart disease found that adding yoga to cardiac rehab clearly improved quality of life, with gains in stress, anxiety and depression. After bypass surgery, a trial of 250 men found yoga did better than physiotherapy-based rehab for people whose hearts pumped weakly.

Does yoga help AFib?

It looks promising. In a 2013 study of 49 people with atrial fibrillation that comes and goes, episodes with symptoms fell from 3.8 to 2.1 after three months of yoga twice a week, and anxiety, depression, heart rate and blood pressure came down. That study compared people with themselves before yoga, with no separate comparison group.

Can yoga help heart failure?

Yes. A 2023 review of 11 trials and 552 people with heart failure found yoga improved fitness, six-minute walk distance and quality of life, and lowered a blood marker of strain on the heart, with no serious problems reported. Supported, restful poses and smooth breathing suit a tired heart.

Why does Iyengar yoga leave out headstand with a heart condition?

Mr BKS Iyengar taught in The Tree of Yoga that headstand and raised arms are avoided with heart conditions and after a heart attack, because of the strain they bring. That is what we teach at Flametree. Supported poses, such as a supported bridge and legs up the wall, take their place. Dr Krishna Raman describes one heart failure patient who later used headstand with props; that is his own case and view.

Why not hold the breath in yoga poses with a heart problem?

Dr Krishna Raman, a physician who trained with Mr Iyengar, says holding the breath in a pose raises the pressure in the main artery and can bring on palpitations and dizziness. Geeta S Iyengar gives only the gentlest ocean breath, a long smooth out-breath lying down, for coronary heart disease. At Flametree, breath holds are left out for anyone with a heart condition.

Where can I do yoga for heart health in Darwin or online?

Flametree Yoga Studio teaches Iyengar yoga at Woolner and Coolalinga in Darwin, and LIVE online across Australia, with bolsters, blankets, blocks and chairs in every class. Gentle and restorative classes are a good place to start. New, or away 3 months or more? You get 2 free classes, then 10 at half price.

Where this comes from: BKS Iyengar, Yoga: The Path to Holistic Health (Dorling Kindersley), the Heart and Circulation chapter; The Tree of Yoga, The Aim and the By-product and The Art of Prudence; Light on Yoga, Appendix II, pp. 420 to 429. Geeta S Iyengar, Yoga: A Gem for Women, hints on heart disease and Ujjayi. BKS Iyengar and Geeta S Iyengar, Basic Guidelines for Teachers of Yoga. Timothy McCall MD, Yoga as Medicine (Bantam), the heart disease and high blood pressure chapters, and his June 2019 list of health conditions helped by yoga. Krishna Raman MD and S. Suresh MD, Yoga and Medical Science: FAQ. Mary Flaherty, Does Yoga Work?, chapter 5. Harvard Medical School, An Introduction to Yoga. Australian Institute of Health and Welfare, coronary heart disease figures. Studies as linked above. Everything is summarised in our own words.

This page is general information, not medical advice. Flametree Yoga Studio, Darwin and LIVE online.