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Hypertension

Hypertension

High blood pressure

Because of the hurried life we live these days, every complaint is neglected when it begins and people learn to live with it. People tolerate these complaints mostly due to difficulty in sparing time to go to consult a doctor or difficulty in getting appointments with doctors or sometimes due to simple ignorance. One of the complaints which has been often ignored is hypertension –high blood pressure (BP). It usually presents itself with occasional giddiness or imbalance in gait on exertion or unusual headache or sleeplessness or vague tiredness or leg pain or palpitations or frequent urination. Since these complaints are not supposed to be persistent, people neglect them. This negligence may lead one to myocardial infarction (heart attack), heart failure, stroke (paralysis), renal failure, etc. So one needs to be more cautious about giddiness.

The competitive world creates lots of tension. Some people react to tension with anger and some others submerge the feeling. People who have frequent outbursts and are irritable usually suffer from high BP. They need to go for regular check-ups to rule out if they are suffering from high BP. Also, since blood pressure can usually vary in a day with diurnal, physical, physiological and psychological changes, hypertension needs to be confirmed only after having the same high levels on 2 or 3 occasions.

One needs to maintain normal blood pressure to have good health. Everyone should go for yearly blood pressure check-up after 30 years of age and half-yearly check-up after crossing 40 years of age and quarterly check- up after 50 years of age.

Hypertension may arise in a person at any time with or without any reasons. Sometimes it may be a familial treasure. As it can arise in anyone at any time and remain a silent killer, regular check-ups are absolutely necessary. Many think that hypertension is a disorder of the elderly and they would not suffer at a young age – actually it is not so. Also, some would say staying cool and suave characters who do not have any tension or do not react angrily to anything, they will not suffer from hypertension. Here also it cannot be taken as guaranteed. Further, even though males are the common victims, females can also develop hypertension. Females commonly suffer from hypertension during pregnancy or during menopausal period. Alcoholics, smokers and obese persons should be more cautious about hypertension since they are more prone to it.

Blood flow – The 5 litres of red blood (supposed to be the average in a normal 65 kg adult) are circulated in our body with the force (blood pressure) exerted by heart contractions (pump). In our circulatory system, arteries are the major blood vessels which carry and distribute oxygenated blood throughout the body with its branches arterioles and capillaries. Capillaries are the most permeable parts for transportation of nutrients and oxygen from blood to tissues. These capillaries, after diversification into tissues, tend to unite again to form venules. These venules unite further to form smaller veins which again unite to form large veins. Veins are blood vessels which collect and carry deoxygenated blood towards the heart for recharging with oxygen in the lungs. The force/blood pressure is responsible for supplying/transporting oxygen and nutrients, perfusion, etc.

Blood vessels which carry blood are elastic in nature, i.e. they are free to expand and shrink or they readily collapse due to the thin wall and flexible nature according to the flow or pressure of the blood. Contraction of the blood vessel is termed as vasoconstriction and dilatation of the blood vessels is called vasodilatation. Blood flow rate depends on pressure exerted by vessels (resistance), size and length of the blood vessel, flow direction with gravitational force, viscosity of the blood, etc. But the major factors which reflect pressure are ability of distention and capacitance of the blood vessels.

Blood pressure is the resistant force faced by the blood against the vessel wall (artery or vein). Doctors measure blood pressure with sphygmomanometer. The arterial pressure has the significant value than the venous pump (since it is only a back flow). Normally, the flow is guided by the heart systolic pump (contractions). The return of blood to heart is done with passive pump i.e. muscular pumps which compress veins with movements or exercises. Blood pressure is measured in millimetres of mercury (mmHg). The pressure of flow in major artery is 120 mg of Hg during systole which drops slowly with distribution i.e. with small arteries (70), arterioles (40), capillaries (30), venules (15) and veins (0-15).

The measurement of blood pressure is a very simple technique, but it provides lots and lots of information about the heart, blood vessels and health status of the person. Blood pressure also usually varies according to age, sex, heart functions, density of the blood, etc. Blood pressure also gets altered with the requirement of oxygen for the body (exercise/exertion). BP also indicates the strain of the heart i.e. more the pressure, more strained is the heart. It is mainly controlled by higher functions of the brain in relation with pituitary, adrenal and thyroid glands. The factors which usually trigger change in blood pressure are stress, strain, water balance, sweat, etc.

Blood pressure is required for blood to reach the brain or other parts of the body up to the tip of extremities from the base of heart. Also, it needs to travel against gravitation force to reach the brain. If there is no force, the blood circulation time will be prolonged and it cannot satisfy all the tissues with its oxygen supply or nutrients.

Normal blood pressure – The maximum pressure (systolic pressure) is attained at the end of contraction of the heart (systole). The minimum pressure (diastolic pressure) is attained at the end of dilatation or relaxation of the heart (diastole). Pulse pressure is the difference of these pressures. It is raised in elderly persons and diseased persons. Optimum BP (expected to be normal) is sketched as 120/80 mm Hg. But variation is widely accepted depending upon the age, sex, individual, work, sleep, medicines, etc. Pressure that exceeds 140/90 mmHg is considered as hypertension or high BP. The lowered pressure, below 100/70mmHg, is considered as low BP which is also called hypotension.

High blood pressure – is the pressure reading above 140/90mmHg. Usually, sporting or strong persons will have strong heart and stable low pressure than normal (120/80mmHg) i.e. it would be 110/70 (males) or 100/70mmHg (females) but not below that. This lower pressure usually reduces the risk of cardiac or heart problems. This stable pressure also indicates that the heart is well trained to withstand any exertion. If BP stands higher than the normal level for a prolonged time, then many organs can get damaged.

As untreated hypertension affects all organs/systems and can shorten one’s life, it is better to be aware of it, its causes and management.

Hypertension – high blood pressure, is one of the very commonest complaints of this tension-filled world. People are now compelled to face this as a reward for lifestyle changes/tension culture. As it can remain silent and cause irreversible damages to every part of the body over time (especially heart and kidney) which might be fatal in the end, it is really unsafe to neglect it in the initial stages or to let it be untreated. Blood pressure readings above 130/90mmHg certainly need to cared-for and treated.

Most of the times, hypertension remains silent, damaging all parts of the body. Now that people are conscious about taking yearly master health check-up and approach insurance companies to provide risk insurance for hypertensive people, it has created good awareness and made people detect hypertension in the early stages itself. Also, one needs to be more cautious when hypertensions joins hands with diabetes and high cholesterol levels, since this can move any one slowly to heart attack. So

Never let failures touch your heart
Never let success reach your head
Never let blood pressure (& emotions) hinder your heart and brain.

Incidences – Nowadays, nearly 1/4th of the adult population suffers from pressure variations and 3/4th of them suffer from hypertension. In the case of senior citizens (over the age of 60), more than 60 per cent people suffer from hypertension and its complications. Likewise, 60 per cent of obese persons suffer from hypertension after the age of 40. Also, 40 per cent of the people who suffer from hypertension have hypertension as a familial trait.

Other than incidences of hypertension in old age, due obesity and & familial trait, researchers’ records reveal that tall people, people of the black race, females after or around menopause, smokers, heavy drinkers and sedentary workers are more prone to hypertension. Persons who suffer from diabetes and high cholesterol are also more vulnerable to high blood pressure and complications. The persistent job tension, lack of sleep, worries, anxiety, tension-filled life, etc., and overeating non-vegetarian food, fatty diet, fast food, smoking, drinking alcohol often provide a ladder to high blood pressure.

After all the incidences and causes have been related scientifically and with experience, when the medicine world sees a cool, relaxed, tension free, teetotaler suffers from hypertension without any family history, there arises a suspicion of a bias or incompletion in our records. Still Nature’s treasure is hidden and seems to be a miracle.

Types – Blood pressure may get increased persistently or temporarily. Temporary increase in blood pressure needs to be cared for with lifestyle changes, whereas persistent rise in blood pressure needs to be treated with medicines. The temporary causes may be

  • Physiological – Sleeplessness, exertion/exercises, pregnancy and delivery can cause temporary increase of blood pressure
  • Psychological – emotional tension and stress can temporarily increase blood pressure

The persistent increase in blood pressure may be due to specific reasons or may not be so. They can be classified as two types. They are:

Essential hypertension – Most of the hypertension cases fall in this category. It is otherwise called primary hypertension. This essential hypertesion usually strikes due to unknown causes, affects both sexes and is more correlated to lifestyle changes, body constitution, resistance of blood vessels and is hereditary.

Secondary hypertension – This type of hypertension comes as a secondary or as a compliment to other disorders or disease or drugs, hence the name, “secondary hypertension”. For example – renal arterial stenois, hydronephrosis, renal failure, heart failure, etc.

Common causes – In most hypertension cases, the real cause remains unknown. Hypertension is not supposed to be a disorder of the elderly even though many of the old people commonly suffer from it. It is not a male disorder even though males more commonly suffer from it. It is not supposed to descend only from familial trait even though its incidence is more in particular families. It is also not supposed to be an emotional disorder even though it can be seen in all cases of emotional conflicts (in office or home). Now researchers have identified lots of causes in correlation with occurrence of hypertension. They are:

  • Blood – Increased volume, more density, polycythaemia (increased RBC’s), etc.
  • Blood vessels & heart – Diseases of blood vessels – stiff and hardened blood vessels due to depositions (fat), high pumping efficiency of enlarged hypertrophied heart, narrowing (stenosis) or obstruction in renal blood vessels, etc.
  • Hormones – Increased secretion of adrenal, pituitary, thyroid and parathyroid glands
  • Temperatures – Exposure to extreme temperatures of cold and hot (sunstroke).
  • Infections – Pancreatitis, peritonitis, pulmonary oedema, septicemia, etc.
  • Diseases – Diabetes, high cholesterol / hyperlipidemia, kidney dysfunctions and infections, stroke, migraine, encephalitis, increase in intra-cranial pressure, etc.
  • Drugs – Medicines used for depression, pain, congestion, contraception, etc., may alter blood pressure levels.
  • Habits – Sedentary lifestyle, smoking, alcohol and addiction to drugs, coffee, tea, more intakes of chips and pickles.
  • Mind – Prolonged suffering from stress, tension, anger and emotional conflicts
  • Constitution – Obesity

Symptoms – In many a case, it may present itself even without showing a single symptom, since everyone gets accustomed to the slowly developing persistent conditions. So, often people used to identify hypertension in later stages through its complications. But, any sudden change in pressure or very high levels will usually alarm or alert one with symptoms of giddiness or instability.

Usually, every complaint will be cared for automatically by our body (Natural cure – Miracle of Nature). For hypertension also, nature takes care of the body on its own: at best with frequent urination, excessive perspiration and compelling one to take rest to reduce one’s blood pressure. Due to these adjustments between development of high blood pressure and the body’s natural care, blood pressure readings, complaints/symptoms may be fluctuating in the initial stages. If the body’s natural care could not cope with the situation, the persistent high reading of blood pressure follows with its symptoms and complications. The symptoms of high BP are more or less the same as with low BP i.e. hypotension. Sometimes, constant tension/anger at even trivial problems, and sleeplessness may be the first guiding symptoms to get investigated for hypertension. The common symptoms are:

  • Fainting or reeling sensation or giddiness
  • Low vitality or weakness or easy fatigability or exhausted feeling
  • Irritability and prone to get angry soon
  • Profuse sweating
  • Frequent urination
  • Headache and stiff neck with a sensation of heaviness or fullness
  • Lack of concentration with sleepiness or sleeplessness (confusion and drowsiness)
  • Palpitation and occasional chest pain
  • Shortness of breath/breathlessness
  • Tremors and irregular heartbeat
  • Bleeding from nose
  • Tinnitus or noises in ears

Diagnosis – Fast, full and pounding pulses can give an idea about hypertension. Any way, it can be easily made out with the help of a BP apparatus (sphygmomanometer). But, as blood pressure tends to vary widely with variable physical exertions, physiological nature and psychological causes, it is necessary to confirm it on two or more occasions at different timings before proceeding for treatment. Also, the measurement needs to be analysed while lying, sitting and standing. Further, it is better to evaluate the person on a whole to find or rule out the underlying causative factors with master health check-ups. So one needs to undergo

  • Blood tests for Tc, Dc, Esr, Hb, lipid profile, sugar, creatinine, urea, thyroid hormones (T3, T4, TSH), etc.
  • Urine tests for sugar, albumin and deposits
  • X-ray chest, ECG and Echo cardiogram – to analyse the heart chambers, functions, blood flow and its pumping efficiency.
  • Finally, ultra sound abdomen scan to rule out involvement of liver and kidney as complication or causative factor.

Tolerance of high blood pressure commonly varies from person to person. I.e. some would tolerate even very high BP like 220/120 mm of Hg, but some others would suffer even with its rise of 150/100 mm of Hg with assorted sets of symptoms to becoming  bedridden. Normally now, for the age group 20-40, BP up to 130/90 mm of Hg is considered/accepted as the normal range and for the 40-60 age group, 140/90 mm of Hg is considered/accepted as the normal range and for the 60+ age group, 150/90 mm of Hg is considered/accepted as normal range. But, to be on the safer side, it is better to maintain blood pressure level always below 130/90. Diastolic pressure needs to be cared for more than the systolic pressure as it indicates pressure exerted on the heart (strain of the heart). It should not exceed 100mg of Hg.

Complications – Every complaint when not treated properly often frustrates one with complications. The complications of an ailment usually occur depending on the site of action and period of suffering. High pressure is capable of damaging all parts of the body except the hair, nails and teeth. Pressure can burst blood vessels to induce bleeding i.e., small petechial (very minute red spot) haemorrhages to profuse bleeding in any part of the body. It can also damage the parts by pressure itself or with induction of high perfusion to cause the tissue to swell and get disfigured. It can cause angina, ischaemic heart diseases, heart failure, renal failure, Hydronephrosis, intra-cranial bleeding, stroke, retinal hemorrhage, blindness, Epistaxis, tinnitus, etc.

Prevention and management – In the initial stages, the patient themselves can keep hypertension under control even without any medication, i.e. by changing lifestyle, controlling emotions, nutrition, exercise, dietary changes, losing weight, etc. Traditionally, garlic, onion, olive oil, etc., are used and said to have a good effect on hypertension and the heart. The other common essentials for controlling hypertension are:

Do’s

  • Change lifestyle to cope up with the condition
  • Monitor blood pressure regularly to maintain it in the normal range
  • Exercise regularly at least for half-an-hour (preferably walking than jogging)
  • Monitor your weight regularly and try to reduce weight at your best
  • Sleep at least for 8 hours per day
  • Meditation to make the mind calm and relax the body
  • Take plenty of vegetables, fruits, juices, etc., to energise your blood and body

AVOID

  • Stress and strain
  • Anger and worries
  • Fatty, fried and salty diet, snacks
  • Non-vegetarian food, especially mutton. Chicken and fish can be taken within limits
  • Smoking, drinking/coffee/tea
  • Hot sun and extreme cold weather
  • Vigorous exercises which causes profuse sweating
  • Unnecessary drugs
  • Being overweight
  • Constipation and violent cough

Treatment options – As hypertension comes often with complications, it is better to start treatment as early as possible to halt every facet of complaint and complications. The sufferer can opt for any system of medicines to control hypertension. The only thing is, it should be maintained in the normal range without much variations or oscillations and treated without any side-effects or with negligible side-effects. Each system will have its own limitations and advantages. One can choose advantageous remedy in adequate quantity to bring forth good control over high BP with the help of experts.

On getting diagnosed as hypertension, one would hesitate to start or opt for medications and/or go in search of experts to consult for a way to get cured. Also, people often would like to try an alternative system of medicines to get cured. In fact, many a time, hypertension needs medication for life time (in all systems of medicines) and only in a few cases, for people who take care by changing their lifestyle, emotions, stress, weight, habits, sleep, food, can it be maintained in the normal ranges without any medication or with short-term medication. They too may need medicines in future or in the near future even while following all precautions/preventive measures in a strict manner. It is always better to opt for treatment with a nearby family physician since one needs a check-up every three months.

One should also be aware of the adverse effects of the medicines. You should compare the advantage of drugs overruling their side-effects with the effects of hypertension. As most of the drugs act through the blood to act on blood vessels and other sites, side-effects are inevitable and high toxic quantity can damage the liver and kidney. I.e. whatever the medicines we have, liver (purifier) will break them down to get easy filtering out in the kidney (eliminator). As this natural detoxification process works in s continuous process, you need to take medicines daily as maintaining dose to maintain normal pressure levels. So, you must be conscious and cautious in adding medicines for not loading liver and kidney’s work.

Some people take medicines regularly and some others intermittently or irregularly. When medicines are taken regularly, there won’t be any problem at all except the drug effects, but when BP medicines are taken irregularly, it causes sensitive unpredictable ups and downs in the blood pressure. This will cause strain on heart, blood vessels to end in irreversible damage. So once medication is opted, it should be taken regularly. Also you should be cautious about the dosage and in bringing down the high BP to normal level, i.e., BP should not be brought to normal level immediately from a very high level all of a sudden since it may cause shock-like symptoms or sometimes may end in fatality.

General treatment – In Allopathy, to keep BP under control, medicines are selected according to the causes. Treatment point of view always differs according the condition i.e., it differs for complicated and uncomplicated hypertension, likewise it differs for diabetic cases, nephrology cases, cardiac cases, etc.

To

  • Dilate the blood vessels to lower the blood pressure – Vasodilators, calcium channel blockers / calcium antagonists are prescribed
  • Eliminate water content more frequently to lower the blood volume and thus pressure – Diuretics are used
  • Treat / support heart to function in better way without any strain – Nitrate preparations, calcium channel blockers, beta blockers and low dose aspirin are used
  • Treat psychological conditions – Anti depressants are used
  • Treat sleeplessness – Sedatives are used
  • Treat high cholesterol – Statin drugs (Antilipidemics) are used
  • Treat renal origin hypertension – angiotensin-converting enzyme (ACE) inhibitors / angiotensin receptor blockers (ARBs) / alpha blockers are used

Treating hypertension according to the cause and using diuretics / calcium antagonists usually give amazing results instantly. However, now people are getting prescribed with multiple drugs to control hypertension on a precautionary ground or as a safety measure with all types of drugs (one for vasodilatation, one for better urine output, one for good sleep, one for calming the mind, one for lowering cholesterol level, etc., + supplements). This approach is not good as they are also prescribed and need to be continued for life time. These dealings will often bring early drug effects and side-effects. The common side-effects of anti-hypertensive drugs are dizziness, sleepiness, discomfort, lack of concentration, headache, tremor, impotence, etc. So, unless otherwise drugs are used within limits, one needs to suffer with artificial complex drug disease also in addition to hypertension effects.

Homeopathic approach – One of the commonest reasons people seek Homeopathic care is for the cure provided by refined medicines, i.e. permanent relief without any side-effects. In hypertension cases (essential hypertension), when Homeopathic treatment is provided constitutionally in the initial stages, there are chances for cure or at least hypertension can be postponed for 3-5 years. But in all other cases, in Homeopathy also, one needs to depend on medicines to keep high blood pressure under control. Also it is helpless while one opts for high blood pressure treatment after the prolonged use of massive doses of allopathic medicines. Here they can get Homeopathic treatment for complications along with their existing allopathic medicines. No need to fear of interactions or side-effects.

One major advantage of Homeopathy is it has no side-effects. Unlike other systesm of medicines, it doesn’t act through the blood after digestion of the drug materials, i.e., it acts simply through nerve endings in the tongue. It reaches the brain from there and works from that higher level. As Homeopathic drugs take the route of nerves one can skip contamination of blood and side-effects of drugs in various organs. Every disease needs care in the initial days itself to root out the complaints or otherwise it can grow roots. Appropriate Homoeopathy medicines, when administered with the guidance of an expert, can ease the condition and assist in preventing further complications.

Homeopathic treatment can provide a natural way to reduce one’s blood pressure by rooting out the cause, treating anxiety, tension and restlessness. The sufferer should also overcome stress and strain by quitting impulsive habit, calming their mind and relaxing the body. Homeopathy can cooperate and help them cope with the situation. Every patient has their own pattern of falling ill and will experience different sets of symptoms even for the same illness as per the diagnosis. Hypertension is in no way an exception.

By emphasising on individualisation, Homeopathic treatment will be provided on a constitutional basis (analysing the patient and his symptoms as a whole). Homeopathy treats the patient (their symptoms) in all ways, always. For selecting the right drug it gives importance to the character of onset of symptoms, its aggravating or precipitating factors, and characteristic symptoms of patient, exciting cause, thirst, sweat, shivering, appetite, sleep, stool habit, mental restlessness, relieving factors, associated symptoms, etc. Comfort feeling can be felt only by the patient and cannot be examined or diagnosed by doctor or lab findings. This well-being sensation and comfort feeling will be provided commonly as the first improvement with Homeopathic medicines.

Homeopathic medicines commonly used in cases of hypertension are Acid flour, Aconite, Allium sativa, Apis mel, Ars alb, Aurum met, Aurum mur, Belladonna, Bartya mur, Bryonia, Cactus, Calc carb, Ceanothus, China, Conium, Crataegus, Ferrum met, Gelsemium, Glonoine, Ignatia, Lachesis, Lycopodium, Nat mur, Passiflora, Phosphorus, Plumbum met, Pulsatilla, Rauwolfia, Strophanthus, Veratrum viride, Viscum Album etc. These medicines should be taken under the advice and diagnosis of a Qualified Homoeopath.