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Effect of rosary prayer and yoga mantras on autonomic cardiovascular rhythms: comparative study
Open accessAbstract
Objective: To test whether rhythmic formulas such as the rosary and yoga mantras can synchronise and reinforce inherent cardiovascular rhythms and modify baroreflex sensitivity. Design: Comparison of effects of recitation of the Ave Maria (in Latin) or of a mantra, during spontaneous and metronome controlled breathing, on breathing rate and on spontaneous oscillations in RR interval, and on blood pressure and cerebral circulation. Setting: Florence and Pavia, Italy. Participants: 23 healthy adults. Main outcome measures: Breathing rate, regularity of breathing, baroreflex sensitivity, frequency of cardiovascular oscillations. Results: Both prayer and mantra caused striking, powerful, and synchronous increases in existing cardiovascular rhythms when recited six times a minute. Baroreflex sensitivity also increased significantly, from 9.5 (SD 4.6) to 11.5 (4.9) ms/mm Hg, P<0.05. Conclusion: Rhythm formulas that involve breathing at six breaths per minute induce favourable psychological and possibly physiological effects. What is already known on this topic: Reduced heart rate variability and baroreflex sensitivity are powerful and independent predictors of poor prognosis in heart disease Slow breathing enhances heart rate variability and baroreflex sensitivity by synchronising inherent cardiovascular rhythms What this study adds: Recitation of the rosary, and also of yoga mantras, slowed respiration to almost exactly 6/min, and enhanced heart rate variability and baroreflex sensitivity The rosary might be viewed as a health practice as well as a religious practice
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“Of those, 11 studies (69%) reported that R/S was significantly related to positive cardiovascular functions or outcomes [367–374] or to lower levels of inflammatory markers such as C-reactive protein [375–377] and fibrinogen [378] that place individuals at high risk for cardiovascular disease.”
From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [367]
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“For example, the timing of repetition of the Ave Maria in rosary prayer and of yoga mantras cycles at ∼0.1 Hz and produces cardiorespiratory synchronization (Bernardi et al., 2001).”
From Hypothesis: Pulmonary Afferent Activity Patterns During Slow, Deep Breathing Contribute to the Neural Induction of Physiological Relaxation (2019) · cites this paper as Bernardi et al., 2001
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“This is an excellent term to use when discussing these ABI BAR BP CABG CAC CAD CC-IMT CD CHF CRP CVD HRV LOS LVM MI MM PTSD R/S SES TIA Ankle brachial index Arterial baroreflex sensitivity Blood pressure Coronary artery bypass graft Coronary artery calcium Coronary artery disease Common carotid intima-media thickness…”
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“…Myers, Sternlieb, & Zeltzer, 2004) along with positive benefits on inflammation (Shete et al., 2017; Vijayaraghava, Doreswamy, Narasipur, Kunnavil, & Srinivasamurthy, 2015), reduction in sympathetic nervous system activity (Riley, 2004), and increases in vagal activity (Bernardi et al., 2001).”
Yoga and hypertension: a systematic review.
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“These findings are congruent with prayer studies in the psychology of religion (Finney & Malony, 1985; McCullough, 1995) and medical science (Bernardi et al., 2001; Leibovici, 2001) that demonstrate the positive psychological and physiological effect of prayer.”
Ranjita, R., Hankey, A., Nagendra, H. R., & Mohanty, S. (2016) · Journal of Ayurveda and Integrative Medicine · doi:10.1016/j.jaim.2015.12.001 · Cited by 89
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BackgroundRespiratory regulation & interactions with neuro-cognitive circuitry
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Relationships among heart rate variability, hypertension, and relaxation techniques
Terathongkum, S., & Pickler, R. H. (2004) · Journal of Vascular Nursing · doi:10.1016/j.jvn.2004.06.003 · Cited by 103
Meditation in Medical Practice: A Review of the Evidence and Practice
Fortney, L., & Taylor, M. (2010) · Primary Care Clinics in Office Practice · doi:10.1016/j.pop.2009.09.004 · Cited by 84
Current Perspectives on the Use of Meditation to Reduce Blood Pressure
Goldstein, C. M., Josephson, R., Xie, S. S., & Hughes, J. W. (2012) · International Journal of Hypertension · doi:10.1155/2012/578397 · Cited by 88
“The mantras often have soft sounds, like “Om,” and these words are thought to produce different vibrations in different people, producing various effects on the individual [34].”
BackgroundBormann, J. E., Smith, T. L., Becker, S., Gershwin, M., Pada, L., Grudzinski, A. H., & Nurmi, E. A. (2005) · Journal of Holistic Nursing · doi:10.1177/0898010105278929 · Cited by 80
“…practices have been related to positive mood (Domanico & Crawford, 2000), healthrelated quality of life and psychological and physical well-being (Bernardi et al., 2001) in HIV and cancer patients (Aguirre, 1998; Brady, Peterman, Fitchett, Mo, & Cella, 1999; Hall, 1998; Mytko & Knight, 1999).”
BackgroundMethodInfluentialThe neuroscientific study of spiritual practices
Newberg, A. B. (2014) · Frontiers in Psychology · doi:10.3389/fpsyg.2014.00215 · Cited by 90
Hatha Yoga Practices: Energy Expenditure, Respiratory Changes and Intensity of Exercise
Ray, U. S., Pathak, A., & Tomer, O. S. (2010) · Evidence-based Complementary and Alternative Medicine · doi:10.1093/ecam/neq046 · Cited by 86
Yoga for stroke rehabilitation.
Lawrence, M., Celestino, F. T., Matozinho, H., Govan, L., Booth, J., & Beecher, J. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011483.pub2 · Cited by 69
Ikedo, F., Gangahar, D. M., Quader, M. A., & Smith, L. M. (2006) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2006.10.004 · Cited by 77
A Systematic Review of the Empirical Literature on Intercessory Prayer
Hodge, D. R. (2007) · Research on Social Work Practice · doi:10.1177/1049731506296170 · Cited by 76
Respiratory modulation of cardiovagal baroreflex sensitivity
Tzeng, Y., Sin, P. Y. W., Lucas, S. J. E., & Ainslie, P. N. (2009) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00548.2009 · Cited by 75
Markil, N., WHITEHURST, M. A., Jacobs, P. L., & Zoeller, R. F. (2012) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2011.0331 · Cited by 75
“Bernardi et al. 23 demonstrated that mantras and prayer are able to slow breathing, increase baroreceptor sensitivity (a marker of increased parasympathetic tone), and increase R–”
Yoga in the Management of Overweight and Obesity
Bernstein, A. M., Bar, J., Ehrman, J. P., Golubić, M., & Roizen, M. F. (2013) · American Journal of Lifestyle Medicine · doi:10.1177/1559827613492097 · Cited by 77
“Mindfulness-training through yoga may also generate the relaxation response outside the yoga session, which can offset the physiological effects caused by perceived stress,(62) acutely and long-term.(63) The sense of relaxation that comes with the relaxation response occurs as a result of decreased oxygen consumption…”
BackgroundInfluentialImmediate Effect of Sukha Pranayama on Cardiovascular Variables in Patients of Hypertension
Bhavanani, A. B., Sanjay, Z., & Madanmohan (2011) · International Journal of Yoga Therapy · doi:10.17761/ijyt.21.1.y007g51341634172 · Cited by 75
Breathing pattern disorders, motor control, and low back pain
Chaitow, L. (2004) · Journal of Osteopathic Medicine · doi:10.1016/s1443-8461(04)80007-8 · Cited by 77
Paced breathing compared with usual breathing for hot flashes
Sood, R., Sood, A., Wolf, S. L., Linquist, B. M., Liu, H., Sloan, J. A., Satele, D., Loprinzi, C. L., & Barton, D. L. (2012) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0b013e31826934b6 · Cited by 71
Adiponectin, leptin, and yoga practice
Kiecolt‐Glaser, J. K., Christian, L. M., Andridge, R., Hwang, B. S., Malarkey, W. B., Belury, M. A., Emery, C. F., & Glaser, R. (2012) · Physiology & Behavior · doi:10.1016/j.physbeh.2012.01.016 · Cited by 72
“Mechanistic explanations for yoga's mental and physical health benefits have highlighted reductions in sympathetic nervous system (SNS) tone [10,11], and increases in parasympathetic (vagal)”
Effects of Extreme Ritual Practices on Psychophysiological Well-Being
Xygalatas, D., Khan, S. S., Lang, M., Kundt, R., Klocová, E. K., Krátký, J., & Shaver, J. H. (2019) · Current Anthropology · doi:10.1086/705665 · Cited by 68
Nashiro, K., Min, J., Yoo, H. J., Cho, C., Bachman, S. L., Dutt, S., Thayer, J. F., Lehrer, P. M., Feng, T., Mercer, N., et al. (2022) · Cognitive Affective & Behavioral Neuroscience · doi:10.3758/s13415-022-01032-w · Cited by 79
Binaural Beats through the Auditory Pathway: From Brainstem to Connectivity Patterns
Perez, H. D. O., Dumas, G., & Lehmann, A. (2020) · eNeuro · doi:10.1523/eneuro.0232-19.2020 · Cited by 67
“, 2016), and repetitive and rhythmic stimuli (such as mantras or tones) are widely used in contemplative and religious practices with positive physiological impact (Bernardi et al., 2001; Bernardi et al., 2017).”
BackgroundSalmoirago‐Blotcher, E., Fitchett, G. A., Hovey, K. M. O., Schnall, E., Thomson, C. A., Andrews, C., Crawford, S. L., O’Sullivan, M. J., Post, S. G., Chlebowski, R. T., et al. (2013) · Annals of Epidemiology · doi:10.1016/j.annepidem.2013.03.002 · Cited by 66
Increased heart rate variability during nondirective meditation
Nesvold, A., Fagerland, M. W., Davanger, S., Ellingsen, Ø., Solberg, E. E., Holen, A., Sevre, K., & Atar, D. (2011) · European Journal of Preventive Cardiology · doi:10.1177/1741826711414625 · Cited by 71
“This shows that the HRV changes observed in this study were in fact caused by the mental technique and not by slow breathing, as observed in other techniques.(51,52) In line with previous findings from other meditation techniques, no substantial change in the acute mean heart rate was observed, which supports the noti…”
ResultDevice-guided breathing to lower blood pressure: case report and clinical overview.
Elliott, W. J., & Izzo, J. L. (2006) · PubMed Central · Cited by 64
Mind–Body Therapy for Military Veterans with Post-Traumatic Stress Disorder: A Systematic Review
Cushing, R. E., & Braun, K. L. (2017) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2017.0176 · Cited by 69
“35 Another aim of MRP is to help individuals slow down by acting with a purpose.”
Insulin sensitivity and cardiac autonomic function in young male practitioners of yoga.
Chaya, M., Ramakrishnan, G., Shastry, S., Kishore, R. P., Nagendra, H., Nagarathna, R., Raj, T. D. S., Thomas, T. S., Vaz, M. A. P., & Kurpad, A. V. (2008) · PubMed · Cited by 62
Why do you sigh? Sigh rate during induced stress and relief
Vlemincx, E., Diest, I. V., Peuter, S. D., Bresseleers, J., Bogaerts, K., Fannes, S., Wan, L., & den Bergh, O. V. (2009) · Psychophysiology · doi:10.1111/j.1469-8986.2009.00842.x · Cited by 63
Measures of Heart Rate Variability in 24-h ECGs Depend on Age but Not Gender of Healthy Children
Bobkowski, W., Stefaniak, M. E., Krauze, T., Gendera, K. K., Wykrętowicz, A., Piskorski, J., & Guzik, P. (2017) · Frontiers in Physiology · doi:10.3389/fphys.2017.00311 · Cited by 65
“, 2009), non-invasive estimation of the autonomicmodulation of the cardiovascular system during stress (Srivastana, 2014), relaxation (Quintana and Heathers, 2014) or the assessment of the effects of physical training on fitness level (Bernardi et al., 2001; Makivić et al., 2013; Sanchez-Gonzalez et al., 2015).”
BackgroundMethodInfluentialOsypiuk, K., Thompson, E., & Wayne, P. M. (2018) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2018.00174 · Cited by 61
“Others including breath and imagery-related changes in autonomic tone (Lang et al., 1980; Carroll et al., 1982; Bernardi et al., 2001; Wang S. Z. et al., 2010), heightened sensorimotor acuity (Jacobson et al., 1997; Kerr et al., 2008; Li and Manor, 2010; Manor et al., 2013; Chang et al., 2016;…”
BackgroundMenuet, C., Ben‐Tal, A., Linossier, A., Allen, A. M., Machado, B. H., Moraes, D. J. A., Farmer, D., Paterson, D. J., Mendelowitz, D., Lakatta, E. G., et al. (2025) · Nature Reviews Cardiology · doi:10.1038/s41569-025-01160-z · Cited by 66
Regulation of gene expression by yoga, meditation and related practices: A review of recent studies
Saatcioglu, F. (2012) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2012.10.002 · Cited by 62
“In addition, yogic/meditative practices increase vagal activity (Bernardi et al., 2001); together”
BackgroundIs crying a self-soothing behavior?
Gračanin, A., Bylsma, L. M., & Vingerhoets, A. J. J. M. (2014) · Frontiers in Psychology · doi:10.3389/fpsyg.2014.00502 · Cited by 75
“, and Koch, P. (1985). Rhythmical stereotypies (leg-swinging) associated with reductions in heart-rate in normal school children.”
BackgroundResultInfluentialHayward, R. D., Owen, A. D., Koenig, H. G., Steffens, D. C., & Payne, M. E. (2012) · Depression Research and Treatment · doi:10.1155/2012/745970 · Cited by 60
Cooper, D. C., Thayer, J. F., & Waldstein, S. R. (2013) · Annals of Behavioral Medicine · doi:10.1007/s12160-013-9540-4 · Cited by 58
“Research on prayer and cardiovascular health has produced mixed results and has largely focused on general frequency of prayer during a specified time interval rather than stressor-specific coping behavior [16, 18–22].”
BackgroundHeart rate dynamics in different levels of Zen meditation
Peressutti, C., González, J. M. M., Manso, J. M. G., & Mesa, D. (2009) · International Journal of Cardiology · doi:10.1016/j.ijcard.2009.06.058 · Cited by 58
Meditation on OM: Relevance from ancient texts and contemporary science
Telles, S., Kumar, S., Nagendra, H., Manjunath, N., & Naveen, K. (2010) · International Journal of Yoga · doi:10.4103/0973-6131.66771 · Cited by 58
“[13] A study was conducted to test whether rhythmic formulae, namely, recitation of the rosary and yoga mantras can synchronize and reinforce inherent cardiovascular rhythms and modify baroflex sensitivity.”
Papp, M. E., Lindfors, P., Storck, N., & Wändell, P. E. (2013) · BMC Research Notes · doi:10.1186/1756-0500-6-59 · Cited by 58
“Breathing frequency affects HRV, and respiratory sinus arrhythmia (RSA) has its maximal amplitude with a frequency of 6 breaths per minute; baroreflex sensitivity is also enhanced with this breathing frequency [4].”
Yau, K.-Y., & Loke, A. Y. (2021) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2021.101315 · Cited by 71
Metadata
- Authors
- Bernardi, L., Sleight, P., Bandinelli, G., Cencetti, S., Fattorini, L., Wdowczyc-Szulc, J., & Lagi, A.
- Affiliations
- University of Pavia (IT)
- John Radcliffe Hospital (GB)
- University of Gdańsk (PL)
- Corresponding author
- Bernardi, Luciano
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2001-12-22
- Volume
- 323
- Issue
- 7327
- Pages
- 1446-1449
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC61046
- OpenAlex
- W2026434512
- Cited by
- 486
- References
- 10
- Citations by year
- 2026: 26 · 2025: 27 · 2024: 15 · 2023: 18 · 2022: 25 · 2021: 26 · 2020: 22 · 2019: 19 · 2018: 21 · 2017: 30 · 2016: 16 · 2015: 24 · 2014: 25 · 2013: 24 · 2012: 33
- FWCI
- 5.84
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- Ave Maria, slow-paced breathing, baroreflex sensitivity, heart rate variability, blood pressure, cerebral circulation
- MeSH terms
- Adult, Blood Pressure, Cardiovascular Physiological Phenomena, Cerebrovascular Circulation, Cross-Cultural Comparison, Electrocardiography, Female, Humans, Male, Religion, Respiration, Yoga, Baroreflex
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