Friday, February 13, 2015

Yoga Therapy Research Paper - The State of Cardiovasular Disease in the U.S., its effect on Bermuda and how Yoga Therapy can help



   Research Paper


        Integrated Health Yoga Therapy

                        Dec. 10, 2014



Topic:  The state of cardiovascular disease in the U.S. today, its effect on our Bermuda community, and how Yoga Therapy could help.

-          Joanne Wohlmuth



Introduction: According to The Mayo Clinic, cardiovascular disease generally refers to   conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke. Other heart conditions, such as those that affect your heart's muscle, valves or rhythm, also are considered forms of heart disease”. 1

The Centre for Disease Control and Prevention says,

“Heart disease is the leading cost of death for both men and women….About 600,000 people die of heart disease in the United States each year – that’s 1 in every 4 deaths.2 

In Bermuda, as with much of the Western World, heart disease also is listed as one of the major causes of death, second only to diabetes which according to Bermuda statistics is listed as worse, per capita, than any place in the world!

This research paper will to take a closer look at cardiovascular disease, what it is, how it manifests and the common symptoms and treatments available.  This paper will also explore various developments in the treatment of heart disease over the years highlighting common practices today in the U.S. and how these practices have influenced our Bermuda community.

The second thrust of this research paper will look at the yoga therapy approach to heart disease with a focus on how this approach has developed throughout the years and how (if at all) it is received within the medical community and with what influence.

Lastly this research paper will focus on the Bermuda community, its approach to CAD, particularly in light of its preventive care approach - where it is lacking, and how yoga therapy could offer further remedy.

Bermuda is particularly influenced by the United States, it being the closest mainland in North Carolina, at approximately 700 miles at sea.  Hence Bermuda has adopted much of the culture, habits, diet and diseases common to its American neighbor.  Like the U.S., Bermuda has exorbitant health care expenses particularly influenced by the effects of diseases bought on by diet and lifestyle, cardiovascular disease and type2 diabetes, being the main culprits.

Like the U.S. also, Bermuda is grappling with concerns of what it will and can do to change the trajectory of the rising costs of healthcare in Bermuda; these costs being pushed up by insurance companies in their efforts to care for the all too failing health of all in the Bermuda community.

Contemporary and alternative medicine (CAM) approaches to healthcare, like that of yoga therapy, is steadily becoming a viable option for improved health and cheaper healthcare costs. More and more people seek alternative approaches to allopathic healthcare which they feel are safer, less costly and provide greater quality of life.  Ultimately this research paper will touch on this delicate matter, examining whether or not a “controlled” healthcare system is best, for the treatment of yoga as therapy.   


What Is Cardiovascular Disease?  What is referred to in this paper when talking about “Heart” Disease?
Cardiovascular disease is the common name given to a host of heart diseases and disorders.  These disease categories can be electrical, circulatory or structural. 

“Abnormal heart rhythms or arrhythmias are caused by problems with the electrical system that regulates the steady heartbeat”. Some arrhythmias are dangerous while others “may be bothersome, but are not life threatening”.3

High blood pressure and Coronary Artery Disease (CAD), which causes a blockage in the passageways to the heart, are the main causes of “blood vessel disorders” or problems affecting the circulatory system.  The results from these health conditions can be stroke or heart attack.  These conditions, often associated with lifestyle provide a number of treatment options and in many instances is said to be avoidable, controllable and in some cases, reversible.

Structural abnormalities of the heart are often congenital and may or may not cause problems later on and damage the heart muscle or valves.

 While there are a significant number of people who die from sudden death caused by cardiac arrest related to Ventricular Fibrillation or spasms in the lower heart chambers, (an electrical defect which can only be resolved by shocking the heart to normal rhythm with a heart defibrillator)4;  one third of heart attacks are myocardial infarction - that is they are caused by circulatory problems (clogged vessels etc.); and  these patients require treatment far beyond that offered by a “shock” to the heart valve, to re-engage the heart muscle.

 Coronary Artery Disease, as it is known, a condition under the full spectrum of Cardiovascular diseases, provides the greatest hope for changes, improvements and successes in the treatment of heart disease as Coronary Artery Disease ( CAD as it is known) responses favorable to lifestyle changes, diet and nutrition. 

 When talking about treatment of heart disease, it should be noted that what is referred to here is treatment of that condition under the heart disease spectrum known as CAD which can be changed, controlled and even reversed. “Coronary Artery Disease is preventable”, said Dr. Johnny Lee, MD, president of New York Heart Associates and an American Heart Association board member.5

 With this in mind, the following final question must be answered when discussing “heart disease” before proceeding further. So, then what is Coronary Heart Disease (CHD)?  How does it differ from Coronary Artery Disease (CAD)?  Does CHD factor into the picture when talking about heart disease in the context of this research paper? 

 Coronary Heart Disease (CHD) is buildup of “a waxy substance called plaque inside the coronary arteries.  These arteries supply oxygen-rick blood to your heart muscle. When plaque builds up…the condition is called atherosclerosis”.6

Coronary heart disease is a common term for the buildup of plaque in the heart’s arteries.  Is there a difference between CHD and CAD? “The short answer is often no…health professionals frequently use the terms interchangeably….however Coronary Heart Disease is the result of Coronary Artery Disease.”7

 Coronary artery disease begins at childhood or is the beginning of the development of CHD and requires a healthy diet, weight management exercise to help prevent it from further developing or becoming CHD where the heart muscle becomes at risk for heart failure.  For the purpose of this paper we will look at both, CHD and CAD. 

Causes for the Condition of Heart Disease

The causes for the conditions of heart disease (CAD), according to popular medical view: is diet and lifestyle. Hence factors like poor nutrition; smoking, stress; and lack of exercise play a major role in preventing and or further accelerating the condition of heart disease. Also according to popular medical review – hyperlipidemia which refers to heightened levels of fat (tryiglycerides) and cholesterol is said to be associated with causes for heart disease or attack; as, is heightened hyperglycemic levels in those who suffer from diabetes. Hypertension or uncontrolled high blood pressure is also a risk factor for heart disease or myocardial infarction (heart attack).  


Signs and Symptoms of Condition

One of the major signs and symptoms for heart disease is obesity - an often telltale sign of poor diet and nutrition; High cholesterol and an over consumption of fat in the diet is another.  Obesity signals a lack of exercise or a sedentary lifestyle which also can be associated with a buildup of stress and the possible condition of hypertension or high blood pressure. Another symptom is angina – a decreased blood flow to the heart, causing a squeezing in the chest.  However some of these signs and symptoms, as popular medical view will admit, are not always accurate.  For instance persons do not have to be obese to have dietary problems associated with cholesterol and nutrition.  Persons needn’t be “fat” to suffer from high blood pressure problems.  In fact, oftentimes hypertension appears –asymptomatic as

“high blood pressure can quietly damage your body for years before symptoms develop. Left uncontrolled, you may wind up with a disability, a poor quality of life or even a fatal heart attack…high blood pressure can damage the cells of your arteries’ inner lining” 9

 Or it can bring about the onset, or diagnosis of arteriosclerosis, a major symptom of heart disease and sign for possible heart attack or stroke.

 Hence the signs and symptoms – obesity, stress, high cholesterol, hypertension, angina etc. while they are symptoms of  the development or presence of heart disease, it is hard to know if someone is having these symptoms just by looking at a person – which is why regular check-ups are so important in the case of a heart condition. 

Common Medical Treatments for Condition

 Common medical treatment for heart disease include “ lifestyle changes, medicines, medical and surgical procedures and cardiac rehabilitation.” The goal of treatment is to relieve symptoms, reduce risk factors, lower risk of blood clots, widen bypass and prevent CHD complications. 10

 Generally CHD is treated with medications, and if conditions are severe or if medications still cause a threat- for example in the case of a blocked artery, angina or heart attack -surgery is performed where a stent is placed in the artery to assist with blood flow and prevent angina or a collapse of the artery and/or a heart attack.  Or, a “by pass is performed to replace the defect artery with an artificial heart valve to preserve the heart and prevent further damage.  Generally medication and surgical procedures are sufficient to relieve symptoms. Then persons are encouraged to make lifestyle changes which include changes in diet, not smoking and learning to manage stress.  Oftentimes these changes are carried out during cardiac rehabilitation where a team of experts work with the patient to help them learn lifestyle changes of diet, exercise and stress release to help prevent a reoccurrence of a heart attack.

 It is a long held view by traditional medicine that there is no cure for CAD or CHD, it can only be maintained.  Traditional medical view does not believe heart disease can be reversed.

Yoga Therapy View

 Yoga therapy is the therapeutic application of yoga for the total health and wellbeing of the body, mind and spirit. Its intention is to bring about vital integration of the whole person, physically, mentally and spiritually. 


A trained yoga therapist understands the body/mind connection through that lens and with the tools of yoga.  The yoga therapist comes in after the acute phase has subsided, often working with the referring clinician, and helps the individual find a recovery that puts him or her in a better position to avoid recurrence…..While yoga therapy is not a cure, it can improve the quality of life, and may augment the efficacy of clinical treatment.” 11

In the early 1990’s Dr. Dean Ornish a young cardiologist and yoga practitioner and student wrote a bestselling book “Dr. Dean Ornish’s Program for Reversing Heart Disease.”  Dr.Ornish based his study on a program run at Baylor Medical College where he used yoga, diet, meditation, exercise and relationships to change not only CAD, preventing people from developing plaque in their arteries; but, also CHD (those already with significant plaque buildup in the arteries), by chipping away the plaque already built up in the arteries through the process of yoga therapy.  Hence his claim to “reversing” heart disease” through the number #1 best seller. On January 1, 2010, Medicaid began offering coverage to those persons with heart disease, through the Dean Ornish Preventive Medicine Research Institute (PMRI) under the Intensive Cardiac Rehabilitation (ICR) program, becoming the first yoga therapy preventive heart care program under Medicare.
“Dr. Ornish’s Program for Reversing Heart Disease is the only program scientifically proven to reverse heart disease currently offered in hospitals, clinics, and physician offices that Medicare and other private insurance companies are covering.”12

 Under PMRI the Dean Ornish Heart Disease Reversal program has four component parts – Diet, Exercise, Stress Management and Relationships.  The Stress Management component is that component that specifically uses yogic tools as therapy although the diet and relationships areas also apply.

“When stress is chronic, these physical reactions can lead to disease.  For a person with coronary heart disease, for example, some of these effects can lead to chest pain, shortness of breath, palpitations and coronary artery spasm and sudden blockages of coronary arteries (ie. angina, irregular heartbeats or a heart attack)…..

 The stress management program at an Ornish Retreat derives from common sense and the historical source of yoga: stretches, breathing practices, deep relaxation and meditation techniques.  Yoga encourages comfort, healing and mental poise.”13.

In 1998 I participated in and completed the Dean Ornish based program with the person who developed the stress management component of his program and who was, at that time his Stress Management Director.  This was Nischala Joy Devi.  Nischala Joy Devi’s program, an approved Dean Ornish Stress Management program of Yoga Therapy, was known as “Yoga of the Heart – Cardiac Teacher Training”. 

 The physiological, psychological and spiritual aspects for this stress management program focused on breathing, stretching and calming the mind, relaxing, diet and relationships. The approach was breathing exercises, known as pranayama; meditation, imagery or visualization; yoga poses, the relaxation response, a vegetarian plant based diet and yoga philosophy for spiritual development and an enhancement of personal relationships.


Chakra Focal Point of Condition:

 Kristine Kaoverii Weber, in her lecture on Yoga and Cosmology referred to the chakras as follows:

 Chakras communicate via the nadis. Nadis run through the connective tissue (fascia).  This communication may be explained scientifically through PNI (psychoneuroimmunology). The yogis understand that chakras are related to mental emotional states and that when they are not functioning properly, the mind is imbalanced. 14

 In her book Wheels of Life, Anodea Judith speaks about the fourth chakra as love, air, breath, balance, relationship, affinity, unity, healing….

           Hear it now in your own heart. Its rhythms pumping life and air

           and breath through every part of you, renewing you:…

           Feel it within you, old as you are, beating since the days from deep in the womb,

           feel how long it’s been there,

          Always beating, Never stopping

          Always beating, Never stopping

          Always beating, Never stopping…

          Listen deep and hear inside, a silent sound.

          Anahata, Anahata, Anahata, Anahata……15

Anodea Judith goes on the say, the sanskit name for this chakra “Anahata” which is located in the heart and meaning “unstruck” is as follows:

“this chakra relates to the cardiac plexus..and rules over the heart, lungs and thymus gland..”16

After Dean Ornish’s ground breaking book on reversing heart disease in the early 90’s he set his sights on another more compelling book which he published in 1998.  This book entitled Love and Survival the scientific basis for the healing power of intimacy, began to look more closely at the influence of the Heart Chakra on the effects of healing the heart of heart disease.

 In this very significant reach into the physiological and psycho-emotional dynamics of the healing power of the chakras, Dr. Ornish fortified a very fundamental aspect of his heart health program.  In the book Dr. Ornish states as follows:

 Awareness is the first step of healing, for individuals as well as society……when you feel love, nurtured, cared for and supported and intimate, you are much more likely to be happier and healthier….

A study of 131 women in Sweden also found that the availability of deep emotional relationships was associated with less coronary artery blockage as measured by computer-analyzed coronary angiography. As in the Yale study, this finding remained true even when controlling age, hypertension, smoking, diabetes etc. 17

 In the Dr. Ornish Spectrum program today, relationships remain a key element of his four fundamental components for healing the heart and reversing heart disease. 

Yogic Remedies for Condition:  

 In solidifying the yogic remedies for the condition it is important to first clarify the distinctive differences between a Yoga Therapy based heart health program and one based on the traditional allopathic approach to medicine.

 Some significant remedies in the Yoga Therapy program that still does not exist in the traditional medicine program for Heart Disease today, is as follows:

 1.  The diet component of a yoga therapy heart health program far exceeds that of traditional rehab diet programs for heart health. The Dean Ornish Comprehensive Lifestyle change program, which included diet, saw a reduction in weight loss for most patients - up to 15 lbs after one year- and 90% improvement in all categories of Type 2 diabetes, blood pressure, cholesterol and weight after 1 year of adhering to stringent dietary changes.18.  The Dean Ornish program, as any yoga therapy health program, looks at food as “whole foods”, fresh and organic, with a significant focus of a plant based diet. President Bill Clinton, a client of Dr. Ornish, is living proof of the Dean Ornish diet program.

 Under a traditional system diet, based on the National Heart, Lung and Blood institute,

A healthy diet includes a variety of vegetables and fruits.  These foods can be fresh, canned, frozen or dried….one drink a day can lower your CHD…one drink is a glass of wine, beer, or small amount of hard liquor. 19  

2.       Traditional programs have an exercise component to their program but exclude the very important stress management component, significant under all yoga therapy programs.  It is a fact that stress kills and seemingly very healthy people can die when doing moderate to strenuous exercise, for example, running a marathon, when the body is stressed.  The stress management element using the physiological aspects of yoga stretches, breathing techniques and meditation do not exist in a traditional heart health program.  In traditional programs when dealing with stress, counselling and medication are recommended, creating the potential for further complications. The Dean Ornish program very specifically recommends yoga for stress, advising clients to find a teacher who has experience with stress management for people with heart-health considerations, and or “gentle” yoga or restorative yoga classes.20  


3.      Under the traditional system, cardiac rehab includes on its team doctors, nurses, exercise specialists, physical and occupational therapists, dietitians or nutritionist, and psychologists or other mental health specialists” 21.  This intrinsic difference in the allopathic approach which looks at the “patient” as someone who is un-whole, wounded or unwell is in its very nature alien to the healing process when we consider the chakra system.  Hence the component of a yoga therapy heart health program that focuses on “that you are loved” not “that you are sick”, which involves relationships and heart connections, far supersedes traditional based programs, and lends itself to greater and more long lasting results of healing and wellness for the individual.

Key Remedies of a Yoga Therapy Program for Heart Disease, not specifically expounded upon in the 3 points above are listed below.  They warrant specific mention when referring to heart health.


 One of the first remedies for improved health and wellbeing is to set an intention specifically for that purpose for strengthening willpower and resolve, and instilling hope.

 Sankalpa is the resolve, determination and good intention that resonates precisely in the core of one’s being and aligns sublimely with one’s essence.  Setting the intention for good health and wellbeing and reminding oneself of this good fortune routinely, helps create the reality of what one wants happen.

 Setting intention and reminding oneself of that intention throughout the day or at systematic intervals during the day, is very purposeful and should not be overlooked to help bring about the change that we seek.

A Hatha Yoga Sampler Therapy Program for Heart Health might look as follows:

 If the client has had heart surgery particularly Open Heart Surgery, then the client is generally fearful to damage their heart again, however during this stage when they are able to start moving again, movement will be a very mindful, very gentle and particularly focused practice, perhaps commencing in a chair eg:


ü  Shoulder shrugs

ü  Wrist movements

ü  Ankle and leg stretches

ü  Leg to chest bends

ü  A Deep Relaxation on the side or in a chair

ü  3-part breathing.

 It will help the pain that usually accumulates in the shoulders, discomfort in the chest, swelling in the feet ankles and legs and fluid in the lungs.

As the body gets stronger the client could then add the Sun Worship, done in a chair:


 For example:-

This would help further release tension in the chest.


During this first stage also, clients could begin Sarvangasana by putting their legs on a chair –Sarvangasana also known as the Shoulderstand or All Members Pose, because if its many benefits to the body is particularly helpful with CAD because it:


 Allows the heart to rest, and poor circulation in the legs is greatly improved….Many of us sit or stand for hours with our feet down. The pull of gravity and lack of muscle movement encourages the blood to pool in our feet and legs…..Shoulder stands aid the return of the blood to the lungs for oxygenation, by raising the feet and legs and pelvis higher than the head.22


Note in this version there is always a pillow placed under the buttocks to elevate the pelvis higher than the head or heart and provide support to the neck and shoulder.

The shoulder stand also enhances the lymphatic system thus bringing about a healthier immune system. 

 Once the shoulder stand is comfortable clients are encouraged to begin the Fish Pose with a small pillow to support for the neck and to provide a gentle arch in the back. This pose is very useful to relieve tightness in the chest after surgery.



Sun worship with chair



As the client’s strength and confidence improve, he or she can move from doing the Sun Worship in the chair to doing the sun worship with the chair.


Hence one would continue in this gradual fashion until regular yoga practice can be resumed.



Meditation – Has many physiological, emotional and spiritual benefits which work when practiced with regularity and sincerity.  Physiological conditions like high blood pressure, anxiety or depression can improve or subside when practicing meditation on a regular basis.  Nishala Joy Devi says,


  In the Dean Ornish program for Reversing Heart Disease, we have found that those who did the most meditation and stress management, have seen the most benefit from the reversal of coronary artery disease…people who did stress management after their first heart attack were significantly less likely to have a second.”23



Imagery/Visualization – Another useful method to accompany meditation is imagery or visualization.

 With the pain or sickness calling our attention, we just need to meet that attention in a positive instead of negative way.  You may have a wound that is open and sore.  Imagine what it looks like when it is healed. Then, slowly – in your mind – create the healing” 24

 Ayurveda – Diet and nutrition, a sister therapy treatment that works hand in hand with yoga therapy is Ayurveda.   Following an ayurvedic diet, understanding one’s doshas both primary and expressed, and taking ayurvedic herbs and spices in the diet can help the patient come back to balance and eliminate inflammation buildup in the body.

 According to Ayurveda principle there are 6 stages of disease: accumulation; aggravation; overflow, relocation, manifestation; diversification. Yoga creates balance and a certain patterning within the body that maintains balance. Hence a yogic map of healing comes about when the patterns of yoga practice create a dynamic balance within the life. #25

Breathing practices/Pranayama – breathing practices are key to burning impurities in the body and mind and stilling the mind in preparation for meditation.

 When we practice pranayama, we either reinforce patterns of breathing already set or we create new patterns. 

 When we do the various pranayama techniques we are patterning the input thru inhalation, exhalation, right and left sided breathing… practicing pranayama you are orchestrating a complex form and sequence of vagal stimulation that has significant implications in the way that the nervous system configures itself. #26

 Deep breathing creates a calming effect on the body and mind and allows us to step back and become more aware of how the mind and breath are functioning.  When this happens this awareness gives us an opportunity to choose rather than react… is at this stage of awareness that we can begin to set new patterns and change or reset the central nervous system and therefore greatly influence, in a positive way, the healing process. 

 Pranayama, or breathing practices are very key to yoga and to the healing aspect of yoga.  It is scientific and was developed by ancient yogis to help maintain a healthy body, not for the body itself, but because a healthy body, they realized, was needed to attain self-realization.  The power of the breathing practices of yoga has this promise.  Hence it is a very useful tool to use in the process of yoga therapy for all health conditions.


Re-patterning and The Koshas –

 In Yoga Therapy it is also important to pay special attention the The Koshas, or 5 sheaths and the idea of  “re-patterning”.  According to Rick Panico, MD, in “How Yoga Heals”, he puts special attention on the koshas as a map for healing, pointing out that:

 Annamaya kosha – re-patterns the tissues

Pranamaya kosha – re-patterns the movement of energy

Manamaya kosha – re-patterns the thought processes

Vijanamaya kosha – uses these new processes to change our present attitudes and actions

Anandamaya kosha – changes the heart  #27

Dr. Panico says, “Re-patterning is the goal of healing with yoga The first step in re-patterning is awareness practice.  Finding unhealthy patterns and unlinking with them over and over again and re-linking with what is desirable.   #28

 If someone stands constantly with his or her feet moving outward and tries during yoga practice to change that proprioception, this is what occurs with re-patterning.  However re-patterning is more than “proprioception”, the 5 sheaths or koshas, reach deeper than just the physical body.

 It should also be remembered that when we do our yoga, we impact these sheaths, sometimes more than one at a time. Even our karma yoga has an impact of the koshas.  This also explains how and why the power of relationships (in addition to its effect on the chakras) can be so healing for the body, mind and spirit.


Challenges in Bermuda 

 Heart disease is the leading cause of death in Bermuda as it is in the United States of America. 

 Every 33 seconds someone in the United States dies from cardiovascular disease…by 2020, heart disease will be the leading cause of death throughout the world.  #29

 The percentage of Bermudians with cardiovascular disease as of a 2011 statistic is between 5-10%. 
Although this number may not seem high, problems with hypertension, kidney disease, diabetes have gone up since 2006 while emotional support and the quality of life for Bermudians has significantly dropped, signally further problem relating to health and wellness and perhaps heart disease, for years to come. (see Health Survey of Adults in Bermuda 2011). Notwithstanding, despite future data, heart disease and its treatment remains the biggest draw on the healthcare system in Bermuda.

 Insurance companies remain uncommitted and uncertain about the benefits of yoga therapy particularly in matters relating to major diseases like heart health; and, therefore continue to deny coverage to patients for this alternative treatment.

 Change will take time.



Understanding the Insurance Model and its Impact  

 Insurance companies are a business, so ultimately health care deductables would need to satisfy their business plan in order to be considered for coverage.

 Complementary and Alternative Medicine, known as CAM, according to the National Centre for Complementary and Alternative Medicine of the National Institute of Health, says that in 2007, as much as 33 Billion dollars was spent on alternative healthcare. #30

 Yet still today, in 2014, insurance companies still shrink away from insuring CAM providers.  Hence, also in Bermuda, Chiropractors, massage therapists and acupuncturists remain the only

Alternative Health Care providers covered under insurance. This practice, it does not appear, will change anytime soon.  A few factors explain why this may be so:

 1.       Bermuda is a heavily influenced “Christian” community, and the concept of yoga, is still perceived by many, to be “religiously based”.  The education and reintroduction of yoga as therapy is just beginning to take root.

 2.      Health insurance companies say they want proof, despite the fact that a steadily growing portion of the community are willing to pay out of pocket expenses for their yoga practice and therapy.

3.      Some companies are offering their employees yoga classes, for “fitness” purposes, however are yet unwilling to include the therapeutic aspect for yoga for remuneration.

 4.      The wheels of change in Bermuda turn slowly.

Members of our Bermuda community have commenced the Bermuda Association of Yoga Therapists to begin educating the Bermuda community and those in powerful positions to effect change, about the therapeutic approach to yoga, and how it works.

 Trainings have begun in the Bermuda community to connect symbiotic stakeholders; for example, we recently held a Pain Care Yoga training for physiotherapists and yoga therapists and  teachers. This has gone a long way to refine and reestablish “scope of practice”; hence now in particular, some physiotherapists better understand when to refer to a yoga teacher and a yoga therapist; and, when patients that they may be currently seeing and/or cannot service might benefit from the service of a yoga therapist.

 Insurance companies and the Bermuda Health Council continue to be educated and kept abreast of the work of the Bermuda Association of Yoga Therapists.

 Change will take time, however the high cost of servicing health care in the Bermuda community may very well speed up the decision for more inclusion and a cheaper alternative. 

Since Bermuda is on par with the US in health care costs, the squeeze is on to “do something” to benefit ailing clients/patients.



 Cardiovasular problems and treatment under the traditional system, focusing first on medication and second on surgery, is driving the cost of healthcare through the roof, and therefore continues to shine the spotlight on this approach and its effectiveness.

 Insurance companies request and require measurements, lasting many years oftentimes, before sponsoring treatment.  Hence it is no wonder the Dean Ornish preventive healthcare program is the only one of its kind that is being sponsored. 

 At the moment those invested in healthcare (insurance companies, corporations, governments) continue to be cautious about programs like yoga or yoga therapy as an adjunct to tradition treatment and recovery.  However, this is changing as more and more people, particularly those who can afford it, are having input into the decision making for their own healthcare approach and treatment.

 Programs like the Dean Ornish program and other successful yoga therapy programs are paving the way.  Clients are wishing and requesting options that might afford them a better quality of life. Yoga therapy, particularly for improved heart health and possible reversal of the heart condition, provides a hopeful option.

 Under traditional care, doctors treat the condition, which may happen again and again.  The yoga therapy approach for CHD (and CAD) is a preventive approach, so the goal is to treat the whole person, using yoga therapy to bring body, mind and spirit back to balance and to understand that patient care and cooperation are paramount in the outcomes of their treatment plan.  

 If we consider the dilemma of healthcare today - particularly in the US and in Bermuda, next to the U.S. - it is just a matter of time, when less invasive and expensive; and, more holistic approaches, like yoga therapy, will be welcomed.  


1.       Article Mayo Clinic Diseases and Conditions/ Heart Disease July 29, 2014

2.       Centre for Disease Control and Prevention

3.       Heart Diseases & Disorders

4.       Heart Diseases & Disorders

5.       Article Coronary Artery Disease-Coronary Heart Disease, Sept 2, 2014

6.       Article National Heart, Lung and Blood Institute - What Is Coronary Heart Disease?

7.       Article Coronary Artery Disease-Coronary Heart Disease, Sept 2, 2014

8.       Article High Blood Pressure dangers: hypertension’s effect on your body, Feb 18, 2014

9.       Article National Heart, Lung and Blood Institute - How Is Heart Disease Treated?

10.   Article What is Yoga Therapy by Larry Payne PH D 6/20/13

11.   PMRI Ornish Programs Reimbursed by Medicare

12.   The Ornish Spectrum /

13.   Yoga and Cosmology, The Manifestation and Evolution of Consciousness, Kristine Kaoverii Weber

14.    Wheels of Life, Anodea Judith, Ph D., p. 188/189

15.   Wheels of Life, Anodea Judith, Ph D. p. 193

16.   Love & Survival, Dean Ornish, MD p. 23/25

17.   PMRI Ornish Programs Reimbursed by Medicare

18.   Article Lowering Cholesterol and Blood Pressure After a Heart Attack, by Roselyn Carson Dewitt, MD. October 6, 2008

19.   The Ornish Spectrum

20.   Article National Heart, Lung and Blood Institute – How Is Heart Disease Treated?

21.   The Heart Health Foundation Heart Disease: Scope and Impact

22.   Yoga of The Heart, Cardiac Yoga Training by Nischala Joy Devi p.64/65

23.   Yoga of the Heart, Cardiac Yoga Training by Nischala Joy Devi p. 145

24.   Yoga of the Heart, Cardiac Yoga Training by Nishcala Joy Devi p 33

25.   How Yoga Heals, Manjula Spears/ Rick Panico, MD pt. 3 & 4

26.   How Yoga Heals, Manjula Spears/ Rick Panico, MD. Pt 3.3

27.   How Yoga Heals, Manjula Spears/ Rick Panico,MD Pt 3.

28.   How Yoga Heals, Manjula Spears/Rick Panico, MD Pt. 4

29.    Heart Disease Scope and Impact , Heart Disease Facts

30.   Americans Spent $33.9 Billion Out Of Pocket On Complementary and Alternative Medicine,

By National Institute for Complementary and Alternative Medicine, July 30, 2009








  1. Really a great informative article you have shared here on yoga therapy. You know I am learning yoga at Thousand Oaks Yoga classes in morning, and I am sure if I will attend my yoga classes daily, I will get perfect body shape in just few days.

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