HERBS

HYPERTENSION

ABOUT THE DISEASE

Hypertension, also referred to as high blood pressure, is a transitory or sustained elevation of arterial blood pressure that in long term causes end organ damage. The term Essential hypertension is reserved for patients with no definable cause. It constitutes more than 95% of all cases of hypertension.

Classification of Hypertension by Blood pressure (Joint National Committee, 2004)

Category Systolic Pressure mmHg Diastolic Pressure mmHg
Normal* <120 <80
Pre-Hypertension 120-139 80-89
Hypertension**    
Stage I (mild) 140-159 90-99
Stage II (moderate) 160-179 100-109
Stage III (severe) ≥180 ≥110
Isolatedsystolic hypertension    
Grade 1 140-159 <90
Grade 2 ≥160 <90

Hypertension can also be classified as;

  • TEMPORARY: - Symptomatic Hypertension occurs during exercise, emotional disturbances and can be seen in acute attack of gout.
  • PAROXYSMAL: - It is due to tumor of suprarenal medulla (Phaechromocytoma).In this blood pressure can elevate at regular episodes.
  • PERSISTENT HYPERTENSION: - It is a clinical entity. It can again be classified into two groups.
  • Essential Hypertension
  • Secondary Hypertension

ESSENTIAL HYPERTENSION

Synonyms: Primary Hypertension, Essential Hypertension, Idiopathic Hypertension.

Patients with arterial hypertension and no definable cause are said to have essential hypertension.

The term essential hypertension is reserved for 95% of cases in which no evident cause or structural organ defect can be found for the raised BP

A number of environmental factors have been implicated in the development of hypertension including salt intake, obesity, occupation, alcohol intake, family size, and overcrowding.

SECONDARY HYPERTENSION

It includes high blood pressure caused due to other diseases like – kidney disorders, Neurogenic disorders, Hormonal diseases, Coarctation of aorta, intake of certain drugs (E.g oral contraceptives, anabolic steroids, corticosteroids, NSAID’S, Carbenoxolone, Sympathomimetic agents) etc.

Risk factors for Hypertension includes:-

Diabetes mellitus, Obesity, Smoking, excessive alcohol intake, High cholesterol levels, family history.

PATHOGENESIS

Normal blood pressure depends on various factors like nervous control on blood vessels, Renin angiotensin system, various hormones like Atrial Natriuretic peptide and Adrenal steroids, kinin system, Endothelium enzymes, Sodium and water balance excretion etc.
Pathological factors which play central role in High Blood Pressure includes:-

  • Increased systemic vascular resistance,
  • Increased vascular stiffness, and
  • Increased vascular responsiveness to nervous stimuli.

In the younger age group, the cardiac output is often elevated, while in older patients increased systemic vascular resistance and increased stiffness of the vasculature play a dominant role.

SIGN & SYMPTOMS

There are no specific symptoms related to Hypertension. In many cases Hypertension may go undetected until the blood pressure is taken. That’s why it is also called as “Silent killer”.

  • The elevated pressure itself.
  • In the case of secondary hypertension, the symptoms are related to the underlying disease.
  • Headache mainly in the backside of head most often occurring in the morning, dizziness, palpitations, fatigue, vertigo and tinnitus
  • Complaints referable to vascular diseases include epistaxis, haematuria.
  • Blurring of vision.

EFFECTS OF HYPERTENSION

Effect of long standing Hypertension on Body occurs in various systems. It includes:-

  • Effect on Heart – Coronary heart diseases, Cardiac enlargement (Hypertrophy), Congestive Cardiac failure.
  • Effect on Kidneys – Vascular lesions in kidney leading to decreased glomerular filtration rate and dysfunctioning of nephrons tubules. Also called as Hypertensive nephropathy.
  • Effects on eyes – Breaking of small blood vessels supplying the retina of eye leading to hypertensive retinopathy.
  • Effects on Blood vessels – Chronic Hypertension may lead to stiffening of blood vessels (Arteriosclerosis) resulting in their weakness, may create localized bulging in the wall of artery (Aneurysm) also may lead to breakage of walls of arteries.
  • Neurogenic effects - Cerebrovascular accident is also most common neurological disorder of Hypertension. It may be due to cerebral ischemia, embolism and thrombosis or hemorrhage.

AYURVEDIC VIEW

As hypertension is diagnosed basically through sphygmomanometer, its direct reference on ancient texts cannot be possible but there are many references in relation to blood circulation and cardiovascular systems described in ancient Vedas and Samhitas.

The Causative factors of Hypertensioncan be divided into four types i.e., Diet(Ahara), Lifestyle (Vihara), Psychological factors (Manasa) and Genetic (Bija Dosha). These factors lead to aggravation of Mansika Dosha and Vata, Pitta and Kapha.
Aggravated Mansika Doshas (Psychic factors like stress , anxiety) lead to vitiation of Hridaya (Heart and Mind) . The Aggravated Kapha Dosha due to its slimy,cold ,smooth and heavy properties lead to formation of Dhamani uplepa (plaque formation in blood vessels) which results in narrowing of blood vessels. It also causes aggravation of Vata Dosha.
The Aggravated Pitta Dosha lead to disturbed Agni (Metabolism) causingformation of Aam (toxins in blood due to improper digestion). Aam causes malformation of Rasa Dhatu (Blood plasma).
Aggravated Vata Dosha due to its cold and dry properties causes stiffening of blood vessel walls. It can also lead to disturbance in rhythmic movements of heart.

All these aggravated doshas together lead to Hypertension.

PRINCIPLE OF TREATMENT

The main line of treatment in hypertension is to regulate Vata Dosha of the body along with Pitta and Kapha. Improve Agni (Digestion), which will boost metabolism of the body. Medhya drugs to balance CNS effect on high Blood pressure and Mutrala drugs to decrease the after load of heart.

MEDICINES

1. Kwath (Decoction)/Asava/Arishta(Alcoholic preparations) – Dashmool kwath, Parthadyarishta, Saraswatarishta.

2. Rasa Preparations (Herbo mineral preparations) – Mukta Pishti, Akik Pishti, Hridayarnav Rasa, Hridayamruta Rasa, Nagarjunabhra Rasa.

3. Panchkarma – Internal Panchkarma procedures like Virechan, Basti or Raktamokshan and External Panchkarma procedures like Snehana, Swedana, Shirodhara are very effective in treating chronic hypertension.

5. Examples of Drugs which help in relieving anxiety and stress are:-

  • Sarpagandha (Rauwolfia serpentina)
  • Ashwagandha (Withania somnifera)
  • Tagar (Valeriana wallichii)
  • Vacha (Acorus calamus)
  • Jatamansi(Nordostachys jatamansi)
  • Rudraksha ( Elaeocarpus ganitrus)

6. Examples of drugs which through their diuretic action reduce the after load on heart are:-

  • Punarnawa (Boerhavia diffusa)
  • Gokshura (Tribulus terrestris)
  • Trinpanchmoola kwath
  • Gokshuradi kwath etc.

7. Examples of drugs which have protective functions to heart are:-

  • Praval pishti
  • Mukta pishti
  • Akik pishti
  • Praval panchamrit rasa etc.

8. Medohar drugs:- They help in blood cholesterol levels and thus decrease the blood pressure by decreasing peripheral resistance

  • Guggulu (Commiphora mukul) e.g :- navak guggulu , triphala guggulu
  • Lashun (Allium sativum)
  • Methika (Trigonella foenum graecum)

HOME REMEDIES

1. Control Body weight according to the BMI, Excess fat in the body leads to clogging up of arteries (atherosclerosis) leading to increase in the blood pressure.

2. Restrict salt intake to less than 5 gm/day. Avoid food rich in salt content like chips, fast food, Namkeen, snacks etc.

3. Avoid oily, fatty and spicy diet. Take foods which are high in potassium and low in saturated fat like fruits and vegetables, whole grain meals (DASH diet), low fat dairy products.

4. Drink 6-8 glasses of water daily.

5. Lashun ksheer paak - Take 2 -3 cloves of garlic and boil it in 1 glass of milk and 1 glass of water till half portion remains. Intake of this milk daily controls high level of cholesterol and also helps in decreasing weight and controls high level of blood pressure.

6. Arjun ksheer Paak – Take 5 – 10 gms of Arjuna bark powder and boil it in 1 glass of milk and 1 glass of water till one fourth of the solution remains. Intake of this milk daily provides strengthening to heart muscles and controls blood pressure.

7. Hypertension is an important disorder where yoga therapy is claimed to be effective. Practise yoga asanas like Bhujangasana, Makarasana, Vajrasana and Pranayama (meditation).

Disclaimer

The purpose of Ayurvidya is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider regarding your medical condition or treatment and before undertaking any new health care regimen.