Hypertension And Its Management Through Ayurveda
Hypertension is defined as the sustained rise of systolic blood pressure above 140 mmHg and diastolic pressure above 90mmHg. Hypertension is one of the most serious public health issues, and it is the leading cause of worldwide disease burden. It’s also known as the silent killer because most patients are asymptomatic. However, it causes damage to the target organ and is a substantial risk factor for coronary vascular disorders such as stroke and myocardial infarction.
Types of Hypertension
Hypertension is defined as either primary/essential hypertension or secondary hypertension depending on the etiology.
- Primary/Essential Hypertension: Although the cause of primary or “essential” hypertension is unknown, several lifestyle factors contribute to the illness. About 90–95 percent of hypertension patients are classified as primary hypertension, meaning they have no evident etiology.
- Secondary hypertension is caused by a variety of medical diseases or disorders, as well as the use of certain drugs. Secondary hypertension occurs in a small percentage of people. Renal problems, endocrine abnormalities, pregnancy, and the use of contraceptive pills are some of the reasons of secondary hypertension.
Concept of Hypertension in Ayurveda
There is no one condition described in Ayurveda that is comparable to hypertension. In the case of an unknown ailment, the physician should endeavor to identify the nature of the condition through Dosha, the place of expression, and etiological variables before starting treatment, according to Ayurvedic principles.
Improper life-style and food habits, psychological stress factors like excess worry, fear, anger, dullness etc., with or without genetic predisposition provokes and vitiates all the three Doshas to trigger the pathogenesis of hypertension.
Excessive salt consumption, alcohol use, an oily diet, daytime sleep, and psychological stress all contribute to Shonita vitiation (blood). Shonita, on the other hand, as a Dhatu (tissue), is incapable of vitiating doshas on its own. The Sadhaka pitta and Shonita are vitiated by excessive use of salt and alcohol (blood).
The Avalambaka kapha is vitiated by sedentary habits, and the Prana vayu is vitiated by psychological stress. Prana vayu receives prakopa at first. Because Prana vayu affects Hridaya (heart), it vitiates Hridaya and its constituents such as Vyana vayu, Sadhaka pitta, and Avalambaka kapha. Because it is located in Hridaya, Shonita is also engaged.
Exaggerated contractility of the heart is caused by Prakupita (vitiated) Avalambaka kapha, while exacerbated Vyana vayu causes enhanced gati (speed), the power of blood ejection from Hridaya. These events result into forceful expulsion of blood through dhamanis (blood vessels), ultimately leading into increased resistance in vessels ensuring High blood pressure.
Thus, when the Dosha, Dhatu, and Mala theory is used, the pathology of hypertension appears to be centered on Shonita Dhatu and Tridosha.
Symptoms of hypertension
Usually asymptomatic, provided there are no complications. The diagnosis is usually made at routine examination or when a complication arises.
However, hypertension symptoms include: Headache, Nausea, Burning sensation and/or numbness in hands and feet, Vertigo, Vomiting, Tiredness, restlessness, Breathlessness, Loss of appetite, Pain in chest, Bleeding from the nose, Swelling in the legs and under the eye, Double vision etc.
Management of hypertension in Ayurveda
Ayurveda has certain limitations in the management of Hypertension. Particularly in the treatment of hypertensive crises and other vascular events in an emergency setting. However, in chronic hypertension disorders, where the precipitating factors are hyperlipidemia, obesity, and other lifestyle issues, Ayurveda can play a key role. The management of this condition is according to predominance of Dosha, intensity of symptoms and involved relevant target organ damage in the pathogenesis.
Need of Ayurveda for Hypertension?
Despite the fact that there are several effective antihypertensive medicines on the market today, none of them are without side effects. These medications are not well tolerated by the older population in particular. Fatigue, cold extremities, bradycardia, and heart failure are all common side effects of beta blockers. Angiotensin-converting enzyme inhibitors, on the other hand, might induce cough, rash, and other side effect.
In this modern era of specialties and super-specialties in medical care, Ayurveda stands out by its holistic approach towards the body as one single entity.
Management principles of Hypertension through Ayurveda are summarized below.
- Nidana Parivarjan- Avoidance of etiological factors
- Diet and Life Style Modifications
- Regular physical activity: Regardless of pharmacological treatment, all patients should be counseled to become physically active as part of a complete approach to control hypertension.
- Smoking cessation: Quitting smoking does not directly lower blood pressure, it does significantly lower overall cardiovascular risk. People who smoke have a higher risk of myocardial infarction and stroke than nonsmokers.
- Dietary salt restriction: As part of a healthy eating pattern, recommend low-salt and reduced-salt items.
- Dietary modification: Change your diet to include more fruits and vegetables, lean protein, and whole grains for a heart-healthy diet. A low-sodium, low-cholesterol, low-saturated-fat, and low-total-fat diet has been demonstrated to decrease high blood pressure. A healthy eating pattern consists primarily of plant-based foods, such as fruits, vegetables, pulses, and a wide variety of wholegrain foods, with moderate amounts of low-fat or reduced-fat dairy products, lean unprocessed meats, poultry, and fish, and moderate amounts of polyunsaturated and monounsaturated fats (e.g. olive oil)
- Weight reduction: Reduction in body weight lowers systolic BP. Weight loss of 10 kg can reduce systolic BP by 6–10 mmHg.
Samshodhana treatment (Bio-cleanising therapies)
Samshodhana treatment is a specialist Ayurvedic therapeutic technique that involves performing bio-cleansing procedures, such as Panchakarma, to remove toxins from the body. Shamana Chikitisa is usually the next step (Palliative therapy). However, the physician determines whether or not shodhana therapy is appropriate based on the patient’s condition.
- Snehapana/internal oleation –by taking Guggulu tiktaka ghrita
- Baspa sweda- form of sudation
- Lekhana Vasti (a type of medicated enema)
- Virechana Karma (Purgation) with Eranda taila (Castor oil)
- Shirodhara with medicated liquids, Takra (butter milk), milk, water, and medicated oils according to the severity and specifications
- Rakta mokshan (Rakta Mokshan) (Blood-letting)
Shamana (Palliative) treatment
The following drugs (single/compound formulation) are commonly used for prevention and control of Hypertension (to be taken under Ayurvedic medical supervision):
- Single Drugs: Sarpagandha churna, Jatamamsi churna, Rudraksha churna, Arjuna twaka churna, Gokshur churna
- Compound Formulations: Sarpgandha ghana vati, Brahmi vati, Arjunarishta, Pravala pishti, Sveta parpati, Hridayarnava rasa, Mukta bhasma
Management of Secondary Hypertension
- Renal hypertension – Mutraghata Chikitsa ie, Gokshura, Punarnva, Shilajit
- Endocrine disorders – Pitta Shamak & Agni Deepak Chikitsa
Yoga, Meditation and Pranayama
The feeling of constant stress might exacerbate hypertension. As a result, stress management is crucial in the treatment of hypertension.
Ayurveda emphasizes meditation, yoga, and pranayama. These help to alleviate worry and stress.
- Meditation: Meditation is the ideal relaxation therapy since it relieves anxiety and tension, allowing the body to recuperate. 10-20 minutes of meditation twice a day is recommended for overall health and well-being.
- Yoga and Pranayama: A variety of yoga and pranayama techniques can help you manage stress. It helps to reduce hypertension by relaxing the body, mind, and soul.
- Yoga Asana: Padmasana, Balasana,Vajrasana, Pawanmuktasana, Shavasana.
- Pranayama: Bhastrika, Kapalbhati, Anulom-Vilom, Nadishodhan, Bhramari
The 107 essential regions of the body were described in ancient Ayurvedic literature as a seat of prana (life force) and together referred to as marma. The marma, or vital points, should not be harmed, according to Ayurveda’s classical scriptures. However, in today’s world, these marma are stimulated in a controlled manner to treat ailments.
Talahridaya marma was discovered to have a mild immediate effect and a good long-term effect in lowering the patient’s blood pressure.
Talahridaya marma is found in both the upper and lower limbs on both sides. There are four talahridya marma in the body, two in the upper limb and two in the lower limb. Talahridaya marma is located in the middle of the palm, on the line between the middle and index fingers.
Hypertension is one of the most serious public health issues, and it is the leading cause of worldwide disease burden. It’s also known as the silent killer. When using the Dosha, Dhatu, and Mala theory, the pathophysiology of hypertension appears to be centered on Shonita Dhatu and Tridosha, according to Ayurveda. Ayurveda, with its various shamana medicines and shodhana treatments, as well as yogic practices, can effectively treat persistent hypertension.