In order to understand what hypertension is, you need to first understand the cardiovascular system.
The cardiovascular system is composed of two components
- Heart (The pumping organ) and
- Blood-vessels (containing fluid, blood).
The heart is a muscular organ pumping the blood to all parts of the human body by the process of contraction. Pure (oxygenated) blood is carried by the arteries (referred to as dhamani in Ayurveda) and impure (deoxygenated blood) by the veins (referred to as sira in Ayurveda).
Blood pressure is defined as the lateral pressure exerted by the blood flow on the elastic wall of the arteries. Upper value of the blood pressure is known as systolic blood pressure. Lower value of the blood pressure is known as diastolic blood pressure. In Ayurveda, hypertension is known as Uccharakatchapa.
Systolic BP greater than or equal to140 mmHg and/or diastolic BP greater than or equal to 90 mmHg is the currently accepted dividing line based on epidemiological and intervention studies
The incidence of hypertension in India compared to worldwide
Cardiovascular diseases, including essential hypertension, myocardial infarction, angina pectoris and cardiomyopathy were the cause of 2.3 million deaths occurring in Indian in 1990. India is also on the top as far as the incidence of diabetes mellitus is concerned.
As per experts' opinion, the death rate is expected to double by 2020. This increase is much more than 77% for China, 106% for other Asian countries and 15% for economically developed countries. Hypertension is the major culprit responsible for stroke deaths (57%) and coronary artery disease (24%) deaths in India.
Causes of Hypertension
Arteriosclerosis: Age factor is the leading cause of hypertension. As the time passes, the elasticity of the blood vessels (particularly, arteries) decreases and there occurs congestion of blood. Hardening sets in the arteries (medically described as sclerosis) and this process is addressed as, arteriosclerosis. Elevated levels of blood pressure can result bleeding (brain hemorrhage) and even, loss of vision.
Hyperlipidemia: Increased consumption of fatty foods is another factor responsible for the growing incidence of hypertension. Foods containing high levels of cholesterol and triglycerides (types of fats) accumulate in the inner wall of the arteries. Gradually there is a rise in fats (lipids) in the blood and the condition is known as hyperlipidemia (excess levels of fat in the blood).
Dietary patterns: Increased salt intake in the diet leads to hypertension as it results in sodium and water retention in the body and consequence is high blood pressure. Under these conditions, there is copious diuresis (increased urinary flow) to get rid of excess water and sodium. Thereby, reduction of salt intake is the initial step in the treatment of hypertension. Unlimited use of painkillers and steroids is linked with incidence of hypertension. Kidney and endocrine disorders have strong associated with hypertension.
Signs and Symptoms of Hypertension
The majority of the people with hypertension have no signs or symptoms. This is true even if blood pressure recordings (systolic and diastolic) are on the higher side. In a few cases, one may notice flushing, headaches in temporal region), shortness of breath (dyspnoea) or nosebleeds (epistaxis). These signs and symptoms are not considered to be specific until or unless, blood pressure reaches an alarmingly high value.
Allopathic Treatment & Side Effects
Beta blockers, diuretics, calcium channel blockers are the mainstay of allopathic treatment of hypertension. Atenolol, proparanolo, nifedipine, candesartan, olmesartan and ramipril are life saving antihypertensive drugs which have benefited the humanity in many ways. However, long-term use is not safe and some drugs have serious ill-effects, including loss of libido, vivid dreams and depression.
Ayurvedic Treatment for Hypertension
- Guggul: Ayurvedic physicians prescribe Guggul as treatment of high blood pressure in case of serum of lipids, including cholesterol and triglycerides is elevated (hyperlipidemia). One tablet, twice days is normally given for six months for reducing high cholesterol and triglycerides levels in blood. Guggul is, however contraindicated in pregnancy. Avoid it patient has a history of chronic and gastritis.
- Garlic is a good natural aid for preventing high blood pressure. It has good clinical effect on diastolic blood pressure. One capsule, thrice a day is efficacious in maintaining normal blood pressure. In addition, garlic tackles hyperlipidemia as good as statins like atorvastatin.
- Arjunarishta is the standard Ayurvedic treatment for maintaining healthy the heart. Six teaspoonfuls of the preparation mixed with equal water, twice a day, should be given for six months.
- Sarpagandha is the herb of choice in the Ayurvedic treatment of high blood pressure. ½ teaspoonfuls (2.5 g) of sarpagandha powder, twice a day is clinically proven in restoring normal blood pressure. Pharmaceutical companies marketing tablets of sarpagandha. Two tablets, twice a day, are highly beneficial in treating hypertension. Sarpagandha has got some side effects, if used for long term therapy. It should be taken under expert medical supervision.
Precautions or Diet
In addition to medicine, lifestyle changes are must in proper management of coronary heart disease.
- Slow down or take frequent breaks
- Avoid large and heavy meals and rich foods that leave you feeling stuffed
- Try to avoid situations that make you upset or stressed
- Eat a healthy diet to prevent or reduce high blood pressure and high blood cholesterol, and obesity,
- Quit smoking.
- Exercise as directed by the doctor.
- Lose weight if overweight.
- If there is a history of diabetes, follow the doctor’s advice and take all medications as directed.
Ayurveda Clinical Studies
In a study the bark powder of Terminalia Arjuna was tested in treating congestive cardiac failure. It showed a marked improvement in over 40% of the cases. Also observed were a congestive cardiac failure due to congenital anomaly of heart and valvular disease being brought under control as well as 4 out of 9 cases of CCF as a result of chronic bronchitis being relieved by the treatment.
Symptomatic complaints of essential hypertension viz. Giddiness, insomnia, lassitude, headache and a lack of concentration ability were relieved by Terminalia Arjuna. Coagulation, bleeding and prothrombin time can be reduced by oral administration of an aqueous suspension of the bark powder.
In a study, the cardio protective activity of the bark extract of Terminalia arjuna was studied in twelve patients with refractory congestive cardiac failure. The extract demonstrated significant cardio protective activity as compared to placebo.
This randomized, double-blind study divided 61 patients aged 25-65 years with serum cholesterol levels >200 mg/dl into two groups. Throughout the study, both groups were advised to eat at least 400 g/day of fruits and vegetables and had other dietary restrictions aimed to lower their cholesterol levels.
One group was given 50 mg guggulipid BID for 24 weeks, followed by a 12 week washout period. The second group was given a placebo in place of the guggulipid.
While the diet alone caused a significant decrease in total cholesterol, LDL and triglycerides in both groups, those treated with the guggulipid adjunct had a significant further reduction of nearly twice as much as with the diet alone. The washout period results further pointed to guggulipid as the producer of the noted effect.
This clinical trial divided 120 patients into obese, hypercholesterolemic or hyperlipemic groups, which were further divided into 21-day treatment arms of: (1) 2 g three TID ‘purified’ guggulu (according to Ayurvedic texts), (2) 500 mg BID Fraction ‘A’ of petroleum ether extract of gum guggulu, (3) placebo or (4) 500 mg TID clofibrate.
Significant reductions in serum cholesterol and total lipids were seen in the Fraction ‘A’ treatment arm of the hypercholesterolemic group. The reduction was comparable to that seen with clofibrate. Other significant reductions occurred in other treatment arms, but larger, focused studies are needed to replicate this data.
In a clinical trial of 103 patients with hypercholesterolemia, patients were randomly chosen to receive 1 gram guggulipid, 2 grams guggulipid or placebo three times daily for eight weeks.
Patients in both of the guggulipid groups failed to show any lowering of total cholesterol, HDL cholesterol, triglycerides or VLDL cholesterol. Furthermore, patients treated with guggulipid were found to have statistically significant increases in LDL cholesterol levels when compared with those in the placebo group.
Researchers suggest that the diet or genetic makeup of patients in previous Indian trials of guggulipid may have accounted for some of the perceived cholesterol-lowering effects. The researchers also suggest that previous studies did not use the standard ultracentrifugation technique to directly measure levels of LDL cholesterol.
Hypertension is known as the silent killer. Keeping in mind the growing incidence of hypertension in India, we require strict vigil for optimal control. Regular exercise, decreased salt intake and preventing obesity, are the mainstays of rational treatment of hypertension.
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