Introduction: Studies on hypertension (HTN) have examined the impact of pranayama breathing techniques on nitric oxide (NO), serum cortisol, and quality of life (QOL) in older patients with hypertension. This trial compared Sheetali and Bhramari pranayama effects on serum cortisol, NO, the 30-second sit-to-stand test, diastolic and systolic blood pressures, and the life quality as assessed by the short form 12 survey in hypertensive elderly (aged ≥60 years old). The aim of this survey was to determine which form of Bhramari or Sheetali is more efficient in improving the QOL in hypertensive patients.Material and methods: At Cairo University's Faculty of Physical Therapy, sixty senior individuals were chosen, and were randomly distributed between the Sheetali category (30 patients) or the Bhramari category (30 patients). The daily 20-minute pranayama interventions lasted for a period of 12 weeks. Outcome measures: serum cortisol, serum NO, systolic blood pressure (SBP), diastolic blood pressure (DBP), 30-second sit-to-stand test, and the SF12 QOL questionnaire were analyzed.Results: The post-comparison between groups showed considerable improvements in serum cortisol↓14.62%, serum NO↑45.12%, SBP↓13.43%, and DPB ↓7.69% in favor of the Sheetali group, with significant improvement in mental health ↑21.04% in the Bhramari group, and nearly the same changes in both groups in (30-second sit-to-stand test, SF12 QOL questionnaire (physical).Conclusions: Sheetali pranayama appears more effective for lowering SBP, DBP, serum cortisol, and increasing (NO) in hypertensive elderly but Bhramari pranayama appears more effective for increasing mental health (Sf12 QOL) in hypertensive elderly. Hence, Sheetali pranayama can be used as an adjuvant therapy to enhance physical fitness and health quality.