Yoga For Pulmonary Hypertension: What Mr Iyengar, The Yoga Doctors And The Research Say

Breathless on the stairs, tired by mid-morning, and living with pulmonary hypertension? You are not alone, and there is more you can do than you may have been told. This guide brings together what Mr BKS Iyengar, Dr Timothy McCall and the research say about yoga for pulmonary hypertension: gentle, supported poses, pranayama (yogic breathing), meditation and mindfulness, and how to practise them with care. Last updated: 8 November 2026.

By Chris Lalor, Certified Senior Iyengar Yoga Teacher and certified Yoga Therapist, Flametree Yoga Darwin.

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Does yoga help pulmonary hypertension? The short answer

Gentle, well-taught yoga and slow yogic breathing are well worth trying with pulmonary hypertension, adapted to you. In a randomised trial, adding yoga breathing training gave bigger gains in walking distance and lung function than the same care without it. Mindfulness training with rehabilitation lowered anxiety and depression and lifted fitness in another trial, and an Iyengar yoga pilot found less anxiety and fatigue. A Cochrane review found that supervised exercise and breathing programmes raised walking distance and quality of life, with no rise in serious problems. Yoga does not change the disease in the lung arteries. It works on what can change: the breath, posture, fitness within safe limits, sleep, worry and low mood.

The bottom line: five key moves for yoga with pulmonary hypertension

1. Find a gentle class that adapts the poses to you. Chairs, bolsters and the wall take the effort out, so you can work steadily without straining.
2. Learn a slow, smooth breath, with no breath holds. Yoga breathing training improved walking distance and lung function in a trial of people with pulmonary arterial hypertension.
3. Build steady attention. Mindfulness training lowered anxiety and depression in people with pulmonary hypertension. Holding a supported pose with attention builds the same skill.
4. Go regularly, and pace yourself. The trials ran twice a week for 6 to 15 weeks. Gains came with steady practice, never by pushing hard.
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.

One trial tested Iyengar yoga, the style we teach, as an early pilot. The others tested yoga breathing, mindfulness or rehabilitation programmes. In our view as certified Iyengar teachers, careful, well-taught yoga with props and a steady breath is likely to go further than the average. Why the kind of yoga matters.

Who was Mr BKS Iyengar? Iyengar yoga is the style we teach at Flametree. During the 20th century, Mr BKS Iyengar was the major teacher 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

• Overall evidence: Limited. Best study (single trial): In a randomised trial of 54 people with pulmonary arterial hypertension, adding yoga breathing training to osteopathic care for 8 weeks gave bigger gains in walking distance, breathing muscle strength and lung function than osteopathy alone (Naci 2021). Other trials in pulmonary hypertension are pilots, or mix mindfulness with exercise rehabilitation, so we rate this Limited. More support comes from related conditions: a review of 11 trials in COPD found yoga breathing raised walking distance and lung function.
• Mr BKS Iyengar: for heart conditions, a restful approach: lie over supports, open the chest, soften, breathe simply, and leave out headstand and raised arms.
• Dr Timothy McCall, an American medical doctor and yoga therapist who studied with Mr BKS Iyengar, author of Yoga as Medicine: pulmonary hypertension is no. 95 on his list of conditions helped by yoga.
• The research: an Iyengar yoga pilot, a yoga breathing trial, mindfulness trials, and reviews of supervised exercise and breathing programmes, listed below.
• Related guides: breathlessness, asthma and COPD, heart health, high blood pressure, circulation and fainting and fatigue.
• Take it further: our free ebook Breathwork’s Original Toolkit, the 2027 masterclass on sleep and energy, and classes in Darwin and online.

What is pulmonary hypertension?

Pulmonary hypertension is high blood pressure in the arteries that carry blood from the heart to the lungs. It is not the same as ordinary high blood pressure, which is measured in the arm. When the lung arteries are narrowed or stiff, the right side of the heart has to push harder to move blood through them. Over time that extra load strains the heart.

It has several causes. The most common is disease of the left side of the heart. Others are lung diseases such as COPD, old blood clots in the lungs, and pulmonary arterial hypertension (PAH), where the finest lung arteries themselves narrow. People most often notice breathlessness on effort, tiredness, light-headedness and swollen ankles. Worry and low mood are common too: a review found depression in 7.5% to 53% of people with PAH, and anxiety or panic in 19% to 51%.

There is no national Australian count. A study in Armadale, Western Australia, found pulmonary hypertension in at least 326 people in every 100,000. Across Australia that would be roughly 88,000 people, our own estimate. In Central Australia, a study found it far more often in Aboriginal and Torres Strait Islander people (723 per 100,000) than in other Australians (126 per 100,000), and at younger ages.

Why would yoga help? Not by opening the lung arteries. Medical care does that work. Yoga works on what sits around the disease: a breath that is quick and high in the chest, tight breathing muscles, a body that has stopped moving for fear of breathlessness, poor sleep, and the worry that comes with all of it.

How breathlessness, worry and inactivity feed each other

“In kumbhaka, you should not hold the breath, but the breath should hold you.”

What did Mr BKS Iyengar teach about the heart and the breath?

In short: rest the heart, open the chest, soften, and never strain the breath. We have not found anything Mr Iyengar wrote about pulmonary hypertension by name. Pulmonary hypertension strains the right side of the heart, so his teaching for heart conditions, and the cautions of two doctors who studied with him, are the ones we follow. This is known from long practice and teacher experience. Not yet tested is not the same as wrong.

• A restful approach. In Yoga: The Path to Holistic Health his sequences for the heart are restful: lying over supports, the legs resting up, supported forward bends, and complete rest to finish.
• Raised arms and headstand are left out. In The Tree of Yoga (pp. 98 to 100) he avoided them with a heart condition because of the strain they bring. This is what we teach at Flametree.
• Soften, do not tighten. He wanted the area around the heart to soften, not take on more tension.
• The breath is never forced. In Iyengar yoga, pranayama is learnt step by step, lying or seated with support, once the body can rest well. Holding the breath is not where anyone with a heart or lung condition starts.
• Two doctors who studied with him say the same. Dr Krishna Raman, a medical doctor in Chennai who trained under Mr Iyengar, says never to hold the breath, because it raises the pressure in the main artery (A Matter of Health, Q125). Dr J. T. Shah, a Mumbai surgeon who studied with Mr Iyengar, teaches breathing “without retention of breath” and says to avoid breath holding with problems of the heart or lungs (Therapeutic Yoga, pp. xix and 99).

“With problems, go down, stretch, but don’t strain.”

What Dr Timothy McCall says

In short: pulmonary hypertension is on his list. Dr Timothy McCall, an American medical doctor and yoga therapist who studied with Mr Iyengar and wrote Yoga as Medicine, published a list of 117 health conditions helped by yoga in June 2019. “Pulmonary Hypertension” is no. 95. Our encyclopaedia uses his list as its backbone and builds on it with newer research.

His reference list for no. 95 named two studies: the Iyengar yoga pilot by Santana and colleagues in Canada, and a case series by Awdish and colleagues in the United States that built a yoga programme adapted for pulmonary hypertension. Both are described below. Since 2019, a yoga breathing trial and several mindfulness trials have been published, and they are added here.

“The heart faces the floor in all the forward extensions and this gives rest and helps one recover from fatigue.”

What does the research say about yoga for pulmonary hypertension?

In short: the trials in pulmonary hypertension itself are early, but they point the same way. Yoga breathing added gains in a randomised trial. Mindfulness lowered anxiety and depression. An Iyengar yoga pilot eased anxiety and fatigue. Supervised exercise and breathing programmes raised walking distance without raising serious problems. Where the yoga was not Iyengar yoga, we say so. Why that matters.

Iyengar yoga trials

This study tested Iyengar yoga, the style we teach. The summary does not say whether the teachers were certified Iyengar teachers.

• Iyengar yoga eased anxiety and fatigue in people with lung and lung-artery disease. Santana and others, 2013, a pilot study in Canada: 25 people with pulmonary arterial hypertension or COPD, invited from lung transplant clinics, were offered 12 weeks of 2-hour Iyengar yoga classes twice a week. Anxiety and fatigue fell significantly, and walking, pain and emotional scores improved by amounts that matter. People wrote of slower out-breaths, more energy and better sleep. No comparison group. This is a study on Dr McCall’s list. Read the study.

Other yoga

These studies tested yoga, not Iyengar yoga in particular.

• A yoga programme adapted for pulmonary hypertension was safe, and eased anxiety and joint pain. Awdish and others, 2015, a case series of 3 people with pulmonary arterial hypertension: three home programmes (chair yoga, yoga with a chair for support, and a fuller practice), followed for 8 weeks by video. Health habits improved in all three and no one had a problem with the practice. This is a study on Dr McCall’s list. Read the study.
• Gentle movement, a restorative pose and body-awareness meditation eased symptoms. Von Visger and others, 2019: 14 adults with pulmonary hypertension had 6 weekly sessions of gentle movement, a restorative pose with guided body-awareness meditation, Reiki and essential oils. Pain, anxiety, fatigue and breathlessness were lower after each session, with moderate gains in symptom burden by the end. A mixed programme, with no comparison group. Read the study.

From a related condition, heart failure:

• Yoga raised exercise time and lowered markers of inflammation. Pullen and others, 2008, a randomised trial of 19 people with heart failure: 8 weeks of yoga added to medical care. Exercise time rose 18% with yoga and fell 7.5% without it. Not pulmonary hypertension. Read the study.

Breathing and pranayama

We list breathing practices only, not trials of breathing devices such as inspiratory muscle trainers.

• Adding yoga breathing training gave bigger gains in walking distance, breathing strength and lung function. Naci and others, 2021, a randomised trial in Turkey of 54 people with pulmonary arterial hypertension: osteopathic manipulation alone, the same with yoga breathing training added, or no extra care, twice a week for 8 weeks. Both active groups improved, but the group with yoga breathing improved more. The group with no extra care got worse in walking distance and lung function. Read the study.
• Supervised exercise and breathing training raised walking distance by 111 metres. Mereles and others, 2006, a randomised trial in Germany of 30 people with severe pulmonary hypertension: 15 weeks of exercise and breathing training against usual care. Quality of life, fitness and functional class improved, and the training was well tolerated. Not yoga. Read the study.
• Supervised exercise programmes raised walking distance and quality of life, with no rise in serious problems. Morris and others, 2023, a Cochrane review of 14 randomised trials: walking distance about 49 metres further (11 trials, 418 people), and better physical and mental quality of life. Serious problems were no more common with exercise. Some programmes included breathing training. Not yoga. Read the study.

• Yoga breathing raised walking distance and lung function in COPD, a related lung condition. Cramer and others, 2019, a review of 11 randomised trials with 586 people with COPD: about 26 metres further in six minutes and better lung function. The gains came from breathing-focused yoga, not from poses alone. Not pulmonary hypertension. Read the study.
• Breathing training showed the biggest gain in walking distance, but the evidence was thin. Hua and others, 2026, a network review of 16 trials with 644 people with pulmonary hypertension. The authors rated the certainty low, and the breathing training group may include device training. Read the study.

No trial has yet tested a full pranayama course, Iyengar or other, in pulmonary hypertension. Not yet studied is not the same as not working.

Meditation and mindfulness

• Mindfulness with rehabilitation lowered anxiety and depression, and lifted fitness. Qian and others, 2026, a randomised trial in China of 50 people with stable pulmonary arterial hypertension: 6 weeks of mindfulness-based stress reduction (MBSR) with cardiopulmonary rehabilitation, against health education and usual care. Peak fitness, oxygen delivery and lung artery measures improved, and anxiety and depression scores were lower. The effect of the mindfulness cannot be separated from the exercise. Read the study.

• Online mindfulness lowered depression and improved quality of life and sleep. Von Visger and others, 2024, a pilot randomised trial of 16 adults with pulmonary hypertension: 8 weekly sessions of mindful breathing, gentle movement, a restorative pose and body awareness, online and by app. Depression, quality of life and sleep difficulty improved over time. Attendance at the online sessions was 93%. Read the study.
• An online mindfulness programme improved quality of life and resilience. Takita and others, 2026, a single-group study in Japan of 12 people with pulmonary hypertension: 8 weekly online sessions. Quality of life and resilience rose; anxiety and depression leaned the same way. No comparison group. Read the study.
• People who came to mindfulness classes found them helpful, but travel was hard. Tulloh and others, 2018, a pilot randomised trial in the UK of 34 people with pulmonary arterial hypertension: those who attended group MBSR found it helpful for their symptoms, but attendance was low because of travel. The authors suggested online delivery. Read the study.

Not every result was clear. Most of these studies were pilots, several had no comparison group, and the largest trial mixed mindfulness with exercise. What they show is that people with pulmonary hypertension could do these practices, came back, and felt better for them.

“The brick itself opens the chest. Be passive. The brick does the rest of the job.”

Yoga, pranayama and mindfulness: how they work together

Several of the studies above tested mindfulness courses or breathing training, not yoga poses. That still counts for our classes. Mindfulness is steady, present attention, and yoga poses and pranayama (yogic breathing) are old routes to that same state. So the mindfulness and breathing trials in pulmonary hypertension also show what a good yoga and pranayama class can build. No trial separates which part does the work.

We suggest coming to both a yoga class and a pranayama class. Mr Iyengar taught that asana (poses), pranayama and meditation are not divided, and in our experience the two together do more than either alone. See every class time. We trace the history and the links in Yoga And Mindfulness: Why The Mindfulness Research Points Back To Yoga And The Breath.

How this comes together in a Flametree class

Everything above points the same way, and it is how we teach yoga in Darwin and online. Flametree classes adapt poses with chairs and props, so the work stays steady and within your limits.

• Tell your teacher about your condition. Tell us you have pulmonary hypertension, how far you can walk or climb before you get breathless, and how you are on the day. Classes are adapted to the people in them.
• Supported poses: lying over bolsters to open the chest, seated poses on a chair, supported forward bends with the head resting. The props do the holding.
• Nothing forced: no breath holds, no headstand, no raised-arm poses, and no pushing to the point of gasping. For any other pose, tell your teacher about your condition. Come up from lying slowly.
• Steady attention: holding a supported pose gives a busy mind one job to do. That is the same skill the mindfulness trials taught.
• Rest and breath to finish: every class ends with supported rest, and our pranayama classes teach the slow breath step by step, lying or seated.

Always follow the directions of any doctor you are consulting.

See the timetable and book a class. Online classes can be done from home, which helps on days when travel would leave you breathless, the barrier people described in the mindfulness trials.

Read more on the heart, lungs and breath

• Yoga for asthma, COPD and breathlessness: the breathing practices in more depth
• Heart health and yoga: heart failure, cardiac rehab and Mr Iyengar’s teaching for the heart
• High blood pressure and yoga: the ordinary kind of high blood pressure, measured in the arm
• Circulation, fainting and low blood pressure: coming up slowly and steady circulation
• Chronic fatigue and tiredness: pacing, rest and restorative poses
• Anxiety, upsets and anger: the calming breath for worry

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 the timetable and book.
• Masterclasses: Yoga for sleep and energy, Sunday 10 January 2027, one of our 2027 masterclasses with Chris Lalor, where you learn the supported rest poses and the long, soft out-breath that restore a tired body. See the 2027 masterclasses.

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

Yoga for pulmonary hypertension: questions people ask

Is yoga safe with pulmonary hypertension?

In the studies so far, no one in the yoga case series had a problem with the practice, and a Cochrane review found supervised exercise programmes did not raise serious problems. In our classes breath holds, headstand, raised-arm poses and pushing to the point of gasping are left out, following Mr Iyengar, Dr Raman and Dr Shah on heart and lung conditions. Tell your teacher about your condition.

Can breathing exercises help pulmonary hypertension?

Yes, in the trials so far. In a randomised trial of 54 people with pulmonary arterial hypertension, adding yoga breathing training to osteopathic care gave bigger gains in walking distance, breathing muscle strength and lung function. A review of 11 trials in COPD, a related lung condition, found breathing-focused yoga raised walking distance and lung function. The breath is kept slow and smooth, and never held. Read the breathlessness guide.

What exercise is good for pulmonary hypertension?

A Cochrane review of 14 trials found that supervised exercise programmes raised walking distance by about 49 metres and improved quality of life, with no rise in serious problems. Gentle, supported yoga fits the same pattern: steady, paced and never pushed to gasping. Always follow the directions of any doctor you are consulting.

Should I hold my breath in yoga with pulmonary hypertension?

No. Dr Krishna Raman, who trained under Mr Iyengar, says holding the breath raises the pressure in the main artery, and Dr J. T. Shah says to avoid breath holding with heart or lung problems. Mr Iyengar himself taught that the breath should never be forced. At Flametree, breath holds are left out for anyone with a heart or lung condition.

“The diaphragm is the window of the self. The more tension you have, the more the window of the diaphragm gets closed.”

Can I do upside-down poses with pulmonary hypertension?

Headstand is left out. Mr Iyengar left out headstand and raised arms for heart conditions because of the strain they bring, and pulmonary hypertension strains the heart. For any other upside-down pose, tell your teacher about your condition. Supported lying poses, chest openers over bolsters and supported forward bends give rest without strain. Read the heart health guide.

Does mindfulness help anxiety with pulmonary hypertension?

It may. Mindfulness with rehabilitation lowered anxiety and depression in a trial of 50 people with pulmonary arterial hypertension, and an online mindfulness programme lowered depression and improved sleep in a pilot trial. Worry and low mood are common with pulmonary hypertension, so steady attention and a slow breath are well worth learning.

Can yoga cure pulmonary hypertension?

No. Yoga does not change the narrowed lung arteries. What it can do is ease breathlessness and worry, improve the breath, posture and fitness within safe limits, and help sleep and mood. In the trials, people walked further, felt less anxious and less tired.

How often should I do yoga with pulmonary hypertension?

The trials ran twice a week for 6 to 15 weeks, and gains came with regular practice. Aim for one or two gentle classes a week, a little slow breathing most days, and full rest at the end of each practice. Pace yourself and keep going.

Can I do yoga for pulmonary hypertension in Darwin or online?

Yes. Flametree Yoga teaches Iyengar yoga in Woolner and Coolalinga in Darwin, and LIVE online, so you can practise from home on days when travel would tire you. Flametree classes adapt poses with chairs and props. New students can begin with our new-student offer of 2 free classes, then 10 at half price. Book a class

Where this comes from: BKS Iyengar, The Tree of Yoga, Yoga: The Path to Holistic Health, Astadala Yogamala (volume 4) and Sparks of Divinity; BKS Iyengar and Geeta S Iyengar, Basic Guidelines for Teachers of Yoga; Geeta S Iyengar, classes in Sydney, 1996. Dr Krishna Raman, A Matter of Health; Dr J. T. Shah, Therapeutic Yoga. Timothy McCall MD, his June 2019 list of 117 health conditions helped by yoga and its reference list, and Yoga as Medicine (Bantam). Australian figures: Strange and others, Heart, 2012 (Armadale, Western Australia) and Haji and others, Heart, Lung and Circulation, 2018 (Central Australia). Studies as linked above, each looked up in PubMed in November 2026. Everything is summarised in our own words.

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