Hypertension: An Easy Step Learning with Ayurveda

Hypertension is a  condition in which the blood pressure is chronically elevated. It is considered to be present when a person’s systolic blood pressure is consistently 140 mm Hg or higher, and/or their diastolic blood pressure is consistently 90 mm Hg or higher.

WHO definition the incidence of hypertension in urban population is around 40% and rural around 18%. High blood pressure is dangerous because it makes the heart work harder to pump blood to the body and it contributes to the hardening of the arteries or atherosclerosis. The change in social and economic conditions, lifestyle, dietary habits, and increased stress and strain in earning livelihood have increased the prevalence of this disease. Though a suitable term for the disease condition hypertension is not directly mentioned in the Ayurvedic classics, its symptomatology can be found in the chapters of Vata vyadhi, prameha, and hridroga. A disease condition vyanabala vaishamya, which can be correlated with hypertension, seems to have resulted from the vaishamya / vikriti of vyana vayu. This condition of vaishamya(Disharmony/Disproportion) can be of two types either vriddhi(Increase) or kshaya(Decrease). Hypertension comes under the vriddhi type of vaishamya.

Types of Hypertension

•  Primary or essential hypertension – The hypertension  of unknown origin.
• Secondary hypertension – Hypertension with an identifiable cause secondary to another disease such as renal disease or tumor.
• Isolated systolic hypertension – Most common in old age  due to reduced vascular compliance, systolic B.P > 160 mm of Hg with Diastolic pressure < 90 mm of Hg.

Classification of Hypertension

                                    Systolic B.P.                           Diastolic B.P.

 Optimal B.P                   < 120                                        < 80

 Normal B.P.                   < 130                                        < 85

 High normal                   130-139                                    85-89

Stage 1 Hypertension     140-159                                   90-99

Stage 2 Hypertension     160-179                                 100-109

Stage 3 Hypertension     180                                           > 110

Etiology

1. Hereditary
2. Excess salt intake
3. Sleep apnea
4. Secondary to disease (e.g. polycystic kidney disease or chronic glomerulonephritis, adrenal disease, Cushing’s syndrome and coarctation of aorta, etc.)
5. Certain medication (e.g. NSAIDs, steroids, throat lozenges, and peptic ulcer medicines)
6. Excess intake of oily foods, junk foods, pickles.

Risk factors

1. Child of Hypertensive parents
2. Obese person
3. Age > 45 years
4. Gender (men and postmenopausal women)
5. Diabetes mellitus, dyslipidaemia
6. Physical inactivity
7. Smoking, alcoholism

Clinical features

Hypertension is usually found incidentally by healthcare professionals during a routine checkup, usually produces no symptoms although there may be

1. Headache
2. Fatigue
3. Dizziness
4. Transient insomnia
5. Difficulty in sleeping due to feeling of hot or flushed
6. Tinnitus

Complications

While elevated blood pressure alone is not an illness, it often requires treatment due to the following short and long term effects:

1. Cerebrovascular accidents (CVA) or strokes
2. Myocardial infarction
3. Hypertensive cardiomyopathy (heart failure)
4. Hypertensive retinopathy, nephropathy, and encephalopathy
5. Congestion in the lungs
6. Left ventricular hypertrophy
7. Epistaxis
8. Blurring of vision owing to retinal changes
9. Angina pectoris

Investigations

1. 24 hour ambulatory blood pressure monitoring
2. Urine for protein, blood, and glucose
3. Serum electrolytes
4. Serum creatinine
5. Renal function test
6. Blood sugar fasting
7. Lipid profile
8. Electro cardiogram (ECG)
9. Chest X-Ray (PA view)

Management approaches

A. Prevention

1. Consume plenty of fruits and vegetables such as apple, banana, blackberries, broccoli, cabbage, carrot, garlic, grapefruit, green leafy vegetable, onion, pea, tomato, etc.
2. Consume preferably vegetarian, low fat, low calory diet rich in whole grain, high fiber and nuts
3. Use of garlic and onion in regular diet
4. Practice physical exercises such as brisk walking daily for 30 – 45 minutes
5. Weight reduction (in obese)
6. Limit the use of salt (<5 gm/ day), fats, and sweets
7. Avoid day sleep, anger, anxiety, hyperactivity, overexertion
8. Avoid the use of caffeine, alcohol, and tobacco

B. Medical management

Line of treatment (Charaka Chikitsa.28/92)

1. Nidana parivarjana (avoidance of aetiological factors) -According to Ayurveda, avoidance of the causative factor is the first line of treatment for all diseases. Excess intakes of salt and fatty substance should be avoided and certain medicines such as NSAIDs, steroids, cough syrups, etc. are also to be taken carefully.
2. Samshodhana chikitsa (Bio-cleansing therapies) followed by Samana chikitsa (Palliative therapy) should be advocated.

Drug Therapy

Common medicinal pants

Plant name	Dosage(per dose)	Vehicle	Duration
Sarpagandha (Rauwolfia serpentiana Benth ex. Kurz.)Powder	1 -3 gm	water	15 days
Jatamansi (Nardostachys jatamamasi DC.)Powder	1-3 gm	Water	15 days
Arjuna (Terminalia arjuna W.and A.) Bark Powder	3-6 gm	Water	15 days
Rasona (Allium stivum Linn.) ksheerapaka	10-30 ml		15 days

FORMULATIONS

Drug	Dosage (per dose	Vehicle	Duration
Mamsyadi kwath	10-20 ml	Water	15 days
Sarpagandha ghana vati	125-250 mg	Water	15 days
Prabhakara  vati	125-250 mg	Water/Milk	15 days
Arjunarishta	10-15 ml	Water	15 days
Hridayarnava rasa	125-250 mg	Honey/ Triphala kwath	15 days

Yoga Therapy– The following yogic practices are beneficial in hypertension –

1. Breathing exercises -hand stretch breathing, hand in and out-breathing.
2. Asana- Shavasana, Vajr!sana, Bhujangasana, Vakrasana, Gomukhasana, Pavanmuktasana,Katichakrasana, Ardhakati chakr!sana, Tadasana.
3. Pranayama -Chandra anulomaviloma,Nadisodhana, Ujjayi, Bhramari.

Madhumeha- Type 2 diabetes Management by Ayurveda

Counseling – Advice for

1. Regular blood pressure monitoring
2. Maintenance  of  weight in ratio of height
3. Practice of  regular aerobic exercises (e.g. brisk walk, jogging, weight lifting, etc.)
4. Increase intake of potassium, calcium, and magnesium in the diet
5. Relax mind and body by yoga, meditation, and other methods
6. Consumption of fruits and vegetables such as apple, banana, broccoli, cabbage, carrot, garlic, grape, green leafy vegetables, onion, pea, tomato, etc in plenty.
7. Wise Use of anti-inflammatory medicines.
8. Avoidance of cheese, animal fat, aged/stored meat, chocolate, cream, wine, yogurt, and artificial sweeteners.
9. Avoid the use of antihistaminic drugs unless knowingly prescribed by qualified a physician.
10. Restricted use of sugar and salt in the diet
11. Discontinuation of tobacco and alcohol in any form.

About Auther-

Dr. Manisha Gupta & Dr. Arushi Sharma

M.D. Physician (Ayu)

ITRA Jamnagar

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