October 6, 2025, 2:26 pm | Read time: 5 minutes

What Was Examined–and Why Is It Important?

Cardiovascular diseases are among the leading causes of death worldwide. A key early warning sign is impaired vascular function—the ability of blood vessels to stretch, respond to blood flow, and regulate blood pressure.

This function can now be precisely measured—for example, using ultrasound. Two methods are central:

• FMD (flow-mediated dilation): This method measures how well an artery widens after a brief interruption of blood flow. The better this reaction, the healthier the vessel.²
• PWV (pulse wave velocity): This value shows how quickly the pulse moves through the arteries. In healthy, elastic vessels, this wave moves slower. A higher speed indicates stiffer, less healthy vessels.³

The aim of the study was to determine whether yoga or traditional training like Pilates or interval training can improve these values more significantly in people with a sedentary lifestyle.⁴

How Was the Study Conducted?

The researchers evaluated existing studies according to clear international quality guidelines (the so-called PRISMA standards) and registered their approach in the international study registry PROSPERO. Ten high-quality studies were selected that met the following criteria:

• Participants were physically inactive but healthy.
• Intervention programs focused on yoga or other physical training.
• The effect on vascular function was objectively measured using ultrasound (FMD/PWV).
• Only randomized or comparative studies with clearly documented methods were included.

Five studies examined yoga programs (Hatha, Bikram, Vinyasa), while five others focused on traditional forms of exercise like Pilates, Tai Chi, interval training, or short movement breaks during long sitting phases (called micro-movements).

Participants were between 18 and 70 years old. The duration of interventions ranged from single sessions to 24 weeks, with very different training volumes.

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Pilates, Tai Chi, and HIIT: Clear Benefits for the Vessels

The most significant effects were shown by programs like Tai Chi, Reformer Pilates, or high-intensity interval training (HIIT). These led to:

• Improved endothelial function (higher FMD value),
• less arterial stiffness (lower PWV),
• better blood flow in the vessels.

The effect of traditional training forms is particularly evident in one of the studies included in the review from China: After just one week of high-intensity interval training (HIIT) in a cool environment, the arterial stiffness of previously inactive participants decreased by about 11 percent—a remarkable effect in such a short time.⁵

Reformer Pilates also showed positive effects on vascular health—measurable improvements were visible after just a single 60-minute session.

Yoga: Only Partially Effective–Dependent on Age and Method

The effect of yoga was less clear. While some studies—especially with older participants—showed improvements in endothelial function, arterial elasticity remained unchanged in most cases. This means yoga helped with how well the vessels can widen, but not with their overall flexibility.

The question of whether certain yoga styles or room temperature (such as in Bikram yoga) influenced the results could not be definitively answered.

Micro-Movements: Little Impact on the Vessels

Short movement breaks—like climbing stairs or walking every 60 minutes during longer sitting periods—had only minor short-term effects. Long-term, they could not significantly improve vascular function.

What Do the Results Mean for Everyday Life?

The study shows: Those who want to strengthen their heart and vessels should not rely solely on yoga, as traditional exercises like Pilates, interval training, or Tai Chi show much stronger effects—and that in a relatively short time.

Nevertheless, yoga should not be underestimated: Especially for older people who are physically limited or burdened, yoga can be a useful addition. It demonstrably lowers blood pressure, improves breathing, reduces stress, and increases mobility—all of which indirectly contribute to heart health.

Yoga is also easily accessible, requires little equipment, and can be done at home—a crucial advantage for many people.

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How Reliable Are the Results?

The review meets high scientific standards, but there are some limitations:

• Small participant numbers (mostly under 50 people),
• different study durations (1 day to 24 weeks),
• varying intensity and quality of exercise programs,
• lack of direct comparative studies between yoga and traditional training forms.

Many studies only compared one exercise method with inactivity—a direct comparison of yoga and Pilates, for example, was rare. Additionally, individual differences like age, gender, or health status were only limitedly considered.

Due to the short duration of the analyzed studies, only short-term effects could be shown. Statements about long-term effects were therefore not possible. Perhaps yoga only works if practiced for half a year?

Conclusion: Exercise Helps–But Not All Equally

The systematic analysis shows: Pilates, Tai Chi, and interval training improve vascular function in physically inactive adults more reliably than yoga—at least when it comes to quick effects. However, yoga remains a useful addition—especially for older individuals or those overwhelmed by traditional training.

Those who actively want to protect their heart and vessels should opt for regular, structured training—ideally combined with yoga elements for relaxation and breath regulation. This way, the impact on body and mind can be optimally connected.