Hypertension and Ayurveda

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Hypertension has been the subject of a great discussion in the past few decades. Over one billion people worldwide have higher than optimal blood pressure. Hypertension continues to be the number one attributable risk factor for death throughout the world. Although lowering of blood pressure has been clearly shown to reduce stroke, myocardial infarction, heart failure and kidney disease. Unfortunately, high blood pressure is often not treated as aggressively as many other conditions that have far less impact on human health. Only a small fraction of hypertensive patients are adequately treated, even in countries where major professional and public education efforts have been made to convey the importance of effective treatment.

This means that there is still much work to do, not only in understanding the etiology and pathophysiology of hypertension but also in communicating and implementing what we already know to more effective treatment pf patients. No single textbook or journal can adequately cover all of these advances. However, there have been few attempts to integrate the basic, clinic, and population science of hypertension research and treatment in single textbook that can be used by scientists and practicing clinicians. There is a wealth of new information on epidemiology, pathophysiology, and clinical trials. There are also many drugs available that can be used to effectively treat hypertensions. This has been helped by the ready availability of simple risk charts.

This book “Hypertension and Ayurveda” is indented to be a useful reference for clinicians who provide care for hypertensive patients, for scholars who study the physiology of hypertension. The book will also be a useful reference for other health care professionals. The attempts of Dr. Ajay kumar have to be appreciated in this context, explanation of Ayurvedic views of hypertension and its management may make it easier for scholars to compare easily.

In a textbook of this nature, it is in order to provide the complete review of hypertension and brief overview of the goals, limits and management guidelines. We hope that this book will be of value to readers who are clinicians and students of hypertension and who are interested in the pathophysiology of hypertensive disease. I congratulate Dr. Ajay Kumar for this scholarly contribution and achievement.

I am very happy to present the book “Hypertension and Ayurveda” to esteemed readers and Ayurveda scholars. This book provides the better understanding of hypertension and its Ayurvedic perspectives. Incidence of hypertension is increasing with every passing day and especially in India it is spreading like an epidemic. Changing life styles, eating habits, increasing incidence of hypertension in India. High blood pressure is the end result of a number of factors, both genetic and environment that may be quantitatively and qualitatively different among individuals.

The present book is written in nine chapters respectively; An Introduction, History of Hypertension, blood pressure and hypertension, Physiology of hypertension, Ayurvedic nomenclature of hypertension, Ayurvedic Etio-pathogenesis of Hypertension, Management of hypertension, Herbs for hypertension and lastly Yogic management of hypertension.

In the chapter of ‘introduction’ I have mentioned the brief introduction of hypertension. Although there is no accurate and uniform definition for hypertension because it vary among individuals but I have tried to explain the various definitions. There are also various form of hypertension patients will come in day-to-day practice. I have mentioned all the forms of patients i.e. white coat hypertension, isolated hypertension, malignant hypertension etc.

The second chapter deals with the ‘History of hypertension’. We all know that the disease ‘hypertension’ is not described in ancient Ayurvedic texts. So how this disease comes in knowledge to scientist. Probably the first recorded observations on hypertension were made some 4000 years ago by the Chinese yellow emperor, Huang Ti. Thereafter several developments and hypothesis are made by scientists i.e. relation between kidney and heart, venesection, hard pulse diseases etc. Progress in the study of the disease was rather fast in the earlier decades of this century of the disease was rather fast in the earlier decades of this century and the basis of the measurement of blood pressure established. After successful establishment of hypertension as a disease, it is essential to manage this . For that various trails have been done such as Sodium restriction, Chemical sympathectomy. The biggest step came with the introduction of the first orally effective diuretic, chlorothiazide. Various clinical trials and meta-analyses have firmly established to extraordinary value of modern antihypertensive treatment.

Definition of blood pressure and its regulating factor have been described in the chapter ‘Blood pressure and hypertension’. Blood pressure usually refers to the systemic arterial pressure measured. Accurate measurement of BP is vital for diagnosing hypertension. Arterial pressure is most commonly measured via a sphygmomanometer. In this chapter, I have described the methods of accurate and ideal blood pressure measurement i.e. when blood pressure should be taken, what should be the posture of patient and physician, what should be the position of arm and instrument, what should be the cuff size etc.

The chapter ‘physiology of hypertension’ deals with the physiological variations of blood pressures and regulation of blood pressure. Blood pressure is jointly dependent on the balance between cardiac output and peripheral resistance. All physiological or psychological states that affect blood pressure, or combination of the two. The effect of age, sex, race, body composition, emotional conditions and habitat etc. are described in this chapter. The effect of central nervous system along with renal system is also described in detail.

In the next chapter ‘Ayurvedic nomenclature of Hypertension’ we have concluded all the possible names for Hypertension. Many scholars tried to name this disorder by himself based on this ideas and hypothesis. Such names are raktagatavata, siragatavata, pittavrittavata, raktavrittavata and dhamanipratichata etc. some scholars have considered this disorder as a complication of vata so given the name such a vyanabala, dhamaniprapuran and raktavegavridhi also.

‘Ayurvedic Etio-pathogenesis of Hypertension’ is the next chapter which deals with the detailed description of etiology and pathogenesis of Hypertension. Detailed doshik correlation with the factors will be made like nidan, purvarup and rupa by which we can evaluate the disease on the basis of vata, pita and kapha. The etio-pathogenesis of hypertension is described on the basis of panchnidana. ie. nidana, purvarupa, upashaya and samprapti.

In the chapter ‘Management of Hypertension’ we have tried to explain various management plans according to Ayurveda and World Health Organization guidelines along with JNC criteria. In the context of Ayurvedic chikitsa, nidan parivarjan is the first measure to follow. These are just like non-pharmacological measures as described in modern medicine. Aacharya Charak has described many types of treatment in which samshodhan, shamsaman and nidan privarjan is most important. As per modern view, the main objective in the management of hypertension is prevention of target organ damage and reduction of cardio-vascular risk. Lifestyle modification such as weight reduction, salt and alcohol restriction and regular exercise to reduce blood pressure should be try prior to start medicines. Because, in some patients, only non-pharmacological measures causes significant reduction in blood pressure.

There are too much herbal drugs are described in Ayurveda and also they have clinically proven in management of hypertension. The next chapter ‘Herbs of hypertension’ is written specially to describe those herbs. The drugs for hypertension work by different way. Some drugs have diuretic property by which they decrease blood pressure due to excessive water loss. Some drugs have anxiolytic property. So they relax mind and reduce blood pressure. Some drugs have cardio tonic energy property so they lower the blood pressure directly controlling the heart rate.

In ‘Hypertension and Yoga’ it is described that, the mind is the most important component in the etiology of hypertension. Through experiences and deeper understanding of the whole human organism. We see that the mind plays an important role in the function of body and can cause disease such as hypertension. Stress and tension causes disturbance in the balance illnesses of mind. Yoga and exercise, both aim to remove hypertension and its potential lethal effects through a system of asanas, pranayam and meditation along with a complete reappraisal of lifestyle. In this way we can remove mental diseases that often lead to physical disease.