Slow, deep, pranayama-based breathing training has been shown to be effective in reducing blood pressure (BP). The present study was undertaken to determine immediate effects of performing pranava pranayama on cardiovascular parameters in hypertensive patients. 29 hypertensive patients who were on medical treatment and also attending yoga sessions were recruited for the present study. Supine heart rate (HR) and BP were recorded before and after performance of pranava pranayama for five minutes. Post intervention statistical analysis revealed a significant (P < 0.05) reduction in systolic pressure (SP) and a more significant (P < 0.01) reduction in HR, pulse pressure and double product (Do P). The reduction in rate-pressure product (RPP) was highly significant (P < 0.001). Pranava pranayama is effective in reducing HR and SP in hypertensive patients within five minutes of the practice. This may be due to a normalization of autonomic cardiovascular rhythms as a result of increased vagal modulation and/or decreased sympathetic activity and improved baroreflex sensitivity along with an augmentation of endogenous nitric oxide production. Our findings have potential therapeutic applications in day-to-day as well as clinical situations where blood pressure needs to be brought down at the earliest. The significant fall in RPP and Do P signifies a reduction in oxygen consumption and work done by the heart. It is concluded that pranava pranayama, a simple and cost effective technique can be used in the management of hypertensive patients in addition to the regular medical management. Further studies are required to enable a deeper understanding of the mechanisms involved and its usefulness in the long- term management of hypertension.