A 2025 randomized trial found that 10 minutes of daily Nadi Shodhan (alternate nostril breathing), added to standard treatment, significantly reduced systolic blood pressure and improved heart rate variability in adults with hypertension. This simple yogic breathing practice may be a powerful, low-cost adjunct for cardiovascular and autonomic health.
A 2025 randomized controlled trial in Annals of Neurosciences explored whether Nadi Shodhan pranayama (alternate nostril breathing), added to usual care, can help lower blood pressure in adults with hypertension. All 68 participants (aged about 61 to 66 years) continued their regular antihypertensive medications; half were randomized to learn and practice two minutes of deep abdominal breathing followed by 10 minutes of Nadi Shodhan once daily for six weeks, while the control group received standard non-pharmacological advice only.
Right after the very first 10 minute session, the pranayama group showed a significant drop in systolic and diastolic blood pressure and mean heart rate, along with increases in RR interval (RR: beat-to-beat interval (time between successive R-waves on the ECG, often written as RR interval)) and heart rate variability (HRV) markers like SDNN (Standard Deviation of NN intervals (overall heart rate variability over the recording)), RMSSD (Root Mean Square of Successive Differences between adjacent NN intervals (short‑term, parasympathetic HRV index)), and high-frequency power signals of stronger parasympathetic (vagal) activity and better autonomic balance. After six weeks of daily practice, their systolic blood pressure was significantly lower than the control group, and HRV indices showed higher total power, higher SDNN, and a lower LF/HF ratio (Low-Frequency to High-Frequency power ratio (balance between sympathetic and parasympathetic activity)), suggesting a sustained shift away from sympathetic overdrive. Diastolic pressure, sleep quality, and anxiety scores improved modestly but not significantly compared with controls, likely reflecting the small, exploratory sample and relatively short practice time.
Mechanistically, slow alternate nostril breathing with deep abdominal patterns appears to stimulate stretch receptors and vagal pathways, reduce sympathetic tone, and synchronize cardio respiratory rhythms, which together ease vascular resistance and cardiac workload. The authors conclude that Nadi Shodhan pranayama, practiced just 10 minutes a day alongside medication, can meaningfully support blood pressure control and autonomic health in people with hypertension though larger, longer trials are needed before it can be formally recommended in guidelines.
