Having a broken heart can be more than just hard luck; it might put you at greater risk for a host of heart issues. Cardiovascular disease is the nation’s No. 1 killer and affects 6.4 million Americans, according to the American Heart Association. As more clinical studies are being done to research how emotional states impact cardiovascular health, a clearer picture is emerging about how extensive the mind/body connection really is. Although studies show depression and isolation are risk factors for recurrent heart attacks, the good news is that one’s spiritual outlook may have a positive effect on heart disease. A study published in the journal Alternative Therapies in Health and Medicine that asked people to rate their spiritual well-being showed that the highest well-being scores indicated the most regression of coronary artery obstruction, while those with lower scores had the most progression. Of course, becoming more spiritual doesn’t happen overnight. Like anything, spirituality requires practice. Mind-body techniques such as yoga, qigong, and meditation are designed to gradually encourage a more spiritual outlook, as well as reduce stress–one of the biggest factors affecting heart health. The common thread that underlies these approaches is a pattern of breathing that is slow and full. The current research corroborates what the ancient yogis knew all along: The quality of one’s breathing determines the quality and length of one’s life. To understand the relationship between deep breathing and heart health, it helps to know what happens to the body when it is stressed. When a person experiences stress, the hypothalamus and other parts of the brain’s limbic system–its emotional center–cause the sympathetic nervous system to release adrenaline from the adrenal glands. The adrenaline propels you into a state of arousal in which metabolism, heart rate, blood pressure, breathing rate, and muscle tension are all increased. In what’s commonly referred to as the fight-or-flight response, the arteries of the heart dilate, which opens blood flow to the heart so a person can deal with danger. Keeping the body in a continuous state of stress is what increases susceptibility to cardiovascular problems and adrenal exhaustion. One antidote to stress is the “relaxation response,” a term coined by Harvard cardiologist Herbert Benson, MD, in the 1970s. The relaxation response calms down the sympathetic nervous system and amplifies parasympathetic activity, reducing heart and breathing rates. In other words, simply taking some deep breaths can cause the arteries to expand, improve circulation, and lower blood pressure. Increasing numbers of doctors are recommending the use of yoga for stress management as an adjunct to medication, and several forms of yoga created specifically for cardiovascular health have been developed. At Cedars Sinai Medical Center Preventative and Rehabilitative Cardiac Center in Los Angeles, Nirmala Heriza is the resident Hatha yoga therapist. Heriza, author of Dr. Yoga, (Tarcher/ Penguin, 2004), defines yoga as therapeutic stretching combined with deep relaxation. She points out that not all yoga methods produce the same results. “The system of yoga I teach is based on the Integral Yoga series, which is done slowly. Other, more aerobic styles don’t have the relaxation factor built into them,” Heriza says. Heriza teaches yoga classes at the hospital and modifies the postures according to the patients’ abilities. Of the patients who follow through with the program, Heriza says, “There is a 100 percent success rate in terms of blood pressure and cholesterol stabilization and overall rehabilitative response.” The use of specific poses, or asanas, for the heart, lungs, and respiratory system can be extremely beneficial for a recovering heart patient. Heriza is a referral therapist for cardiac specialist Dr. Dean Ornish, who was the first clinician to offer documented proof that heart disease can be significantly affected by changing your lifestyle. Heriza cautions that yoga doesn’t always supplant medications but is often used as an adjunctive therapy. “At Cedars, the trend is to find the balance between yoga and pharmaceutical protocol,” Heriza says. Her advice to those who want to embark on a yoga program for heart health is to see if their physicians recommend any alternative therapies and are willing to make referrals. “Some doctors are still very skeptical about yoga,” she says. “If a doctor says absolutely no way, it won’t work, find a doctor who is more open-minded.” Zen Mind, Happy Heart Even if you are physically unable to do relatively gentle yoga or qigong exercises, meditation alone can have a significant impact on heart problems. Dharma Singh Khalsa, founding director of the Acupuncture, Stress Medicine, and Chronic Pain Program at the University of Arizona’s teaching hospital and author of Meditation as Medicine (Simon & Schuster, 2001), describes meditation as a combination of breath work and focused concentration that can dilate the blood vessels, lower blood pressure, and minimize stress. “When a person is under a lot of stress, the body creates chemicals that send signals of inflammation to the body and heart,” Khalsa says. “Stress makes the body demand more oxygen, which accelerates the aging process. When the stress chemicals go down, the amount of oxygen the body needs is reduced. You are in a rejuvenation mode instead of an aging mode.” According to Khalsa, successful meditation requires four basic criteria: a comfortable position; quiet; any sort of tactic that encourages focus, such as observing the breath; and a favorable attitude. Whether you call it sitting meditation or moving meditation, these alternative practices can have a direct and sizable impact on heart health. A mind/body approach to stress management can help bring the cardiovascular system back into balance and, in some cases, reduce the need for medications. Plus, yoga, qigong and meditation seem to come with a host of beneficial side effects. “It’s the most exquisite form of time-management,” Khalsa says. “For the little time you put in, which might be one percent of your day, you will get tremendous rewards.” Channel Your Chi Another alternative therapy particularly useful for heart health is qigong, a form of traditional Chinese medicine. Like yoga, qigong combines exercise, meditation, and breathing techniques. Qigong is believed to improve health by strengthening the flow of chi (also spelled qi. and known as energy) throughout the body. Roger Jahnke, OMD, director of the Institute of Integral Qigong and Tai Chi and author of The Healing Power of Qi (Contemporary Books, 2002), says stress triggers adrenaline, which can severely constrain the blood vessels that would not be required to help a person in a fight-or-flight situation. “In terms of Chinese medicine, stress damages the chi,” he says. “The solution is to remove the effects of stress on a regular basis, which can be done through tai chi and qigong.” Jahnke points out that tai chi is a subdivision of qigong and is essentially part of the same practice. Numerous studies on qigong/tai chi and cardiology support its efficacy in treating various heart diseases. One recent overview study of the effect of tai chi on patients with chronic conditions, published in the journal Archives of Internal Medicine, showed that tai chi appeared to be safe and effective in increasing cardiovascular fitness and respiratory function. The three primary features–what Jahnke calls “the three intentful corrections”–of qigong are body posture, breath regulation, and mental focus. “When you enter a qigong state, you adjust your posture and movement, which takes gravitational pressure off of the organs and opens up the vascular system,” Jahnke says. Deepening the breath causes the body to relax during each inhale and exhale. By focusing on the present moment with each exercise, worries and stress tend to disappear, Jahnke explains. He recommends a daily practice of qigong, tai chi, yoga, or meditation as a key part of a comprehensive strategy for maximum health. “Don’t forget to do your practice,” he advises. “Over time, [your practice] might actually reduce your need for medicine.”