High blood pressure/ Uccharaktachapa
Blood pressure is a measurement of the force exerted against the walls of the arteries as the heart pumps blood to the body. Hypertension is the term used to describe high blood pressure.
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause any symptoms. Long term high blood pressure, however, is a major risk factor for coronary artery disease, stroke, heart failure, peripheral vascular disease, vision loss, and chronic kidney disease.
High blood pressure is classified as either primary (essential) high blood pressure or secondary high blood pressure. About 90–95% of cases are primary, defined as high blood pressure due to nonspecific lifestyle and genetic factors. Lifestyle factors that increase the risk include excess salt, excess body weight, smoking, and alcohol. The remaining 5–10% of cases are categorized as secondary high blood pressure, defined as high blood pressure due to an identifiable cause, such as chronic kidney disease, narrowing of the kidney arteries, an endocrine disorder, or the use of birth control pills.
Blood pressure is expressed by two measurements, the systolic and diastolic pressures, which are the maximum and minimum pressures, respectively. Normal blood pressure at rest is within the range of 100–140 millimeters mercury (mmHg) systolic and 60–90 mmHg diastolic. High blood pressure is present if the resting blood pressure is persistently at or above 140/90 mmHg for most adults.
• Normal blood pressure is when your blood pressure is lower than 120/80 mmHg most of the time.
• High blood pressure (hypertension) is when your blood pressure is 140/90 mmHg or above most of the time.
• If your blood pressure numbers are 120/80 or higher, but below 140/90, it is called pre-hypertension.
This view has led by the American Heart Association (AHA), to define the following ranges of blood pressure (in mmHg):
• Normal blood pressure is below 120 systolic and below 80 diastolic
• Prehypertension is 120-139 systolic or 80-89 diastolic
• Stage 1 high blood pressure (hypertension) is 140-159 systolic or 90-99 diastolic
• Stage 2 high blood pressure (hypertension) is 160 or higher systolic or 100 or higher diastolic
• Hypertensive crisis (a medical emergency) is when blood pressure is above 180 systolic or above 110 diastolic.
In the course of blood circulation, the heart accepted polluted blood called as deoxygenated blood in its right upper chamber called right auricle and sends it to the right ventricle which further sends it to the lungs for filtration. Then this cleaned blood from the lungs is sent once again to the left upper chamber of the heart called left auricle which then passes it to the left ventricle. At that point the blood is appropriated to different organs. Each touch of this blood transportation step requires stipulated measure of force to convey the blood further. This is likewise called circulatory strain. Because of certain physiological issue, the lumen of the blood vessels contract, their volume additionally decreases. This makes the force exerted by the blood inside the vessels to get raised, which is exerted on the walls of the vessels, the magnitude of this force depends on the cardiac output and the resistance of the blood vessels. Regularly the circulatory strain throughout systole (when the left ventricle contracts) thought to be not more than 120 to 130 mm / Hg. Throughout (when the left ventricle unwinds) the force thought to be around the range of 80 to 85 mm / Hg. At the time when these forces altered or get disturbed for a long time, then the individual is said to be “Hypertensive”.
Causes of hypertension
the disease burden of high blood pressure is a growing problem worldwide, in part because of a rapidly aging population. Other key contributors include lifestyle factors, such as:-
• Physical inactivity
• A salt-rich diet associated with processed and fatty foods
• Alcohol and tobacco use.
• Stress and hectic life-style.
• Vitiation of vata
• Smoking and an excessive intake of intoxicants
• Hardening of the arteries
• Metabolic disorders
• Excessive intake of common table salt
• Overloading of fast foods
Certain diseases and medications can cause high blood pressure, and there are a number of general risk factors for hypertension, including:-
• Age – everyone is at greater risk of high blood pressure as they get older. Prevalence of hypertension is higher in people over 45-50 years of age
• Race – African-American adults are at higher risk than white or Hispanic American adults
• Size – being overweight or obese is a key risk factor for hypertension
• Sex – males and females have different risk profiles. While lifetime risk is the same for everybody, men are more prone to hypertension at a younger age and women have a higher rate of hypertension at older ages
• Lifestyle – greater intake of dietary salt, excessive alcohol, low dietary potassium, and physical inactivity all contribute to an increased risk of hypertension.
Obesity is a risk factor for high blood pressure and other cardiovascular conditions.
Mainly the causes of hypertension are classified into two:
Primary: Primary hypertension is unlikely to have a specific cause but is instead usually a result of multiple factors, including blood plasma volume and activity of the renin-angiotensin system, the hormonal regulator of blood volume and pressure. Primary hypertension is also influenced by environmental factors, including lifestyle-related issues as outlined above. Such causes are:
• The amount of high salt in the body
• Sedentary life style or lack of physical exercise
• Are often stressed or anxious
• Excessive consumption of caffeine containing products
• Hectic and stress crammed life vogue
• Unhealthy food habits
• Excessive consumption of liquors
• Have a family history of high blood pressure
Blood pressure rises with aging and the risk of becoming hypertensive in later life is considerable. Several environmental factors influence blood pressure. High salt intake raises the blood pressure in salt sensitive individuals; lack of exercise, obesity, stress, and depression can play a role in individual cases. The possible role of other factors such as caffeine consumption, and vitamin D deficiency are less clear. Insulin resistance, which is common in obesity and is a component of syndrome X (or the metabolic syndrome), is also thought to contribute to hypertension. Events in early life, such as low birth weight, maternal smoking, and lack of breast feeding may be risk factors for adult essential hypertension.
Secondary : Secondary hypertension results from an definite cause. Kidney disease is the most common secondary cause of hypertension. Hypertension can also be caused by endocrine conditions, such as Cushing’s syndrome, Hyperthyroidism, Hypothyroidism, Acromegaly, Hyperaldosteronism, Hyperparathyroidism. Other causes of secondary hypertension include:
Obesity, Sleep apnea, Pregnancy, Co-arctation of the aorta, Excessive liquorices consumption and certain prescription medicines having the side effect of hypertension and illegal drugs. Arsenic exposure through drinking water has been shown to correlate with elevated blood pressure. So major causes are listed as below:
• Chronic kidney disease
• Disorders of the adrenal gland (such as Cushing syndrome)
• Hyperthyroidism (overactive thyroid gland)
• Hyperparathyroidism (which affects calcium and phosphorous levels)
• Pregnancy or pre-eclampsia
• Medicines such as birth control pills or contraceptive pills, diet pills, some cold medicines, and migraine medicines
• Narrowed artery that supplies blood to the kidney (renal artery stenosis)
• Diabetes (both due to kidney problems and nerve damage)
• Can be caused by the excessive usage of corticosteroid drugs
• Congenital adrenal hyperplasia (disorder of the adrenal glands, which secrete the hormone cortisol)
• Sleep apnea
Symptoms of hypertension:
High blood pressure itself is usually asymptomatic, meaning that patients do not experience any direct symptoms of the condition. This is why hypertension is often referred to as “the silent killer,” as it can quietly cause damage to the cardiovascular system or can cause kidney problems.
Most of the time, there are no symptoms. For most people, high blood pressure is found accidentally when they visit their health care provider or have it checked elsewhere. However Some with high blood pressure reports headache (particularly at the back of the head and in the morning), as well as lightheadedness, vertigo, tinnitus (buzzing or hissing in the ears), altered vision or fainting episodes. These symptoms, however, might be related to associated with anxiety rather than the high blood pressure itself.
Hypertension can also lead to problems in the organs affected by high blood pressure. Such complications are:
The complications associated with hypertension-related arteriosclerosis can include:
• An enlarged or weakened heart, to a point where it may fail to pump enough blood (heart failure)
• Aneurysm – an abnormal bulge in the wall of an artery (which can burst, causing severe bleeding and, in some cases, death)
• Blood vessel narrowing – in the kidneys this can lead to possible kidney failure; in the heart, brain and legs, this can lead to heart attack, stroke or can cause sortof gangrene which later become the need for amputation, respectively
• Blood vessels in the eyes rupture or bleed, leading to vision problems or blindness (hypertensive retinopathies.
• Long-term hypertension can cause complications through arteriosclerosis, where the formation of plaques results in narrowing of blood vessels also.
In Pregnancy hypertension can cause:
Hypertension occurs in approximately 8–10% of pregnancies. Two blood pressure measurements six hours apart of greater than 140/90 mm Hg is considered diagnostic of hypertension in pregnancy. High blood pressure in pregnancy can be classified as pre-existing hypertension, gestational hypertension or pre-eclampsia.
Pre-eclampsia is a serious condition of the second half of pregnancy and following delivery characterized by increased blood pressure and the presence of protein in the urine. It occurs in about 5% of pregnancies and is responsible for approximately 16% of all maternal deaths globally. Pre-eclampsia also doubles the risk of perinatal mortality. Usually there are no symptoms in pre-eclampsia and it is detected by routine screening.
When symptoms of pre-eclampsia occur the most common are:
• Visual disturbance (often “flashing lights”)
• Pain over the stomach
• Swelling, especially in the both lower limbs .
Pre-eclampsia can occasionally progress to a life-threatening condition called eclampsia, which is a hypertensive emergency and has several serious complications including vision loss, brain swelling, seizures, kidney failure, pulmonary edema, and disseminated intravascular coagulation (a blood clotting disorder).
In contrast, gestational hypertension is defined as new-onset hypertension during pregnancy without protein in the urine.
In Children symptoms related to hypertension:
• Failure to thrive
• Lack of energy
• Difficulty in breathing, can be associated with hypertension in neonates and young infants.
In older infants and children, hypertension can cause Headache
• Unexplained irritability Fatigue
• Failure to thrive
• Blurred vision
• Nose bleeding ( Epistaxis)
• Facial paralysis.
Hypertension is diagnosed on the basis of a persistently high blood pressure. Initial assessment of the hypertensive people should include:
A complete history, that includes physical, medical, hereditary, medical history and personal habits.
Once the diagnosis of hypertension has been made, identify the underlying cause based on risk factors and other symptoms, if present.
Primary hypertension is more common in adolescents and has multiple risk factors, including obesity and a family history of hypertension.
Secondary hypertension is more common in pre-adolescent children, with most cases caused by kidney disease. Laboratory tests can also be performed to identify possible causes of secondary hypertension, and to determine whether hypertension has caused damage to the heart, eyes, and kidneys. Additional tests for diabetes and high cholesterol levels are usually performed because these conditions are additional risk factors for the development of heart disease and may require treatment.
Common Tests done to look for:
• High cholesterol level
• Heart disease, using tests such as an echocardiogram or electrocardiogram
• Kidney disease, using tests such as a basic metabolic panel and urinalysis or ultrasound of the kidneys
Commonly hypertension is caused by the thickening of the blood which usually due to the dyslipidemic changes, that can be assessed from the lipid profile blood test, to access the levels of serum cholesterols and triglycerides.
Electrocardiogram (EKG/ECG) testing is done to check for evidence that the heart is under strain from high blood pressure. It may also show whether there is thickening of the heart muscle (left ventricular hypertrophy) or whether the heart has experienced a prior minor disturbance such as a silent heart attack.
A chest X-ray or an echocardiogram may also be performed to look for signs of heart enlargement or damage to the heart.
In the basic metabolic panel, to evaluate kidney problem, Serum creatinine is the main blood test to assess for the presence of kidney disease, which can be either the cause or the result of hypertension. Additionally, testing of urine samples for protein is used as a secondary indicator of kidney disease.
So, in general following test should be done to rule the underlying cause of hypertension:
• Microscopic urinalysis, protein in the urine, BUN and/or creatinine
• Serum sodium, potassium, calcium, TSH
• Fasting blood glucose, HDL, LDL, and total cholesterol, triglycerides
• Hematocrit, electrocardiogram, and chest radiograph
Treatments for hypertension
Lifestyle changes are important for both treatment and prevention of high blood pressure, and they can be as effective as a drug treatment. These lifestyle changes can also have wider benefits for heart health and overall health.6
The lifestyle measures shown to reduce blood pressure and recommended by experts include:6
• Salt restriction – typical salt intake is between 9 and 12 g a day and modest blood pressure reductions can be achieved even in people with normal levels by lowering salt to around 5 g a day – the greatest effects are seen in people with hypertension
• Moderation of alcohol consumption – expert guidelines say moving from moderate to excessive drinking is “associated both with raised blood pressure and with an increased risk of stroke”
• High consumption of vegetables and fruits and low-fat – people with, or at risk of, high blood pressure are advised to minimize intake of saturated fat and total fat and to eat whole-grain, high-fibre foods, at least 300 g of fruit and vegetables a day, beans, pulses, and nuts, and omega-3-rich fish twice a week
• Reducing weight and maintaining it – hypertension is closely correlated with excess body weight, and weight reduction is followed by a fall in blood pressure
• Regular physical exercise – guidelines say “hypertensive patients should participate in at least 30 min of moderate-intensity dynamic aerobic exercise (walking, jogging, cycling or swimming) on 5 to 7 days a week”
• Stress reduction – avoiding sources of stress, where possible, and developing healthy coping strategies for managing unavoidable stress can help with blood pressure control, especially as many people turn to alcohol, drugs, smoking and unhealthy foods or overeating to cope with stress.
Smoking can also raise blood pressure, and because of its wider effects on heart health and the rest of the body, giving up smoking is highly recommended for people with high blood pressure.
For the primary prevention of hypertension:
• maintain normal body weight for adults (e.g. body mass index 20–25 kg/m2)
• reduce dietary sodium intake to • engage in regular aerobic physical activity such as brisk walking (≥30 min per day, most days of the week)
• limit alcohol consumption to no more than 3 units/day in men and no more than 2 units/day in women
• consume a diet rich in fruit and vegetables (e.g. at least five portions per day);
Effective lifestyle modification may lower blood pressure as much as an individual antihypertensive drug. Combinations of two or more lifestyle modifications can achieve even better results.
The Root Causes of Hypertension
According to Ayurveda, the following are the general types of imbalances responsible for most chronic conditions, including hypertension:
1. Toxins accumulating in tissues and blocking circulation.
2. Poor nutrition.
3. Poor digestion.
4. Imbalance of the nervous system.
5. Accumulation of physical and mental stress.
6. Lowering of natural resistance and immunity.
7. Disruption of natural biological rhythms.
The common modern medical approach that matches drugs to symptoms does not completely address many of these factors. As a result, modern medicine often cannot fully remove the disorder and the condition becomes chronic. Chronic means that the condition persists over time even with the best modern medical treatment
A Natural Treatment Program for Hypertension:
1) Removing the Toxins and Impurities from the body
Most chronic disorders start when toxins accumulate in tissues and begin to disrupt the delicate biochemistry there. Toxin buildup can also obstruct the channels of circulation and elimination. This blockage prevents proper nutrition from reaching the tissues and blocks the processes that cleanse them of impurities. These type of impurities and blockades will be removed with the help of unique panchakarma therapies that includes, Shirodhara especially takta dhara, various types of basties ( enemas), raktamookshana ( bloodletting) through various methods etc.
2) Rasyana Therapy
The most powerful treatment for removing toxins and opening circulation is the RASAYANA Therapy treatments, that includes various medications.
3) Herbal Oil Massage
Herbalized oil massage is used to aid the cleansing process. Herbal oil massage provides a deeply soothing and balancing effect for the entire physiology. The motion of massage creates heat and friction which enhance circulation and help cleanse affected tissues of chemical impurities that could be causing symptoms of hypertension. The oil and herbs cleanse and nourish the tissues to aid in their repair and development.
4) Proper Nutrition
This includes, understanding for which foods to favor and to avoid for your condition. Avoid foods that are hard-to-digest, clogging to the physiology and aggravating to the functioning modes that are already imbalanced in you. Favor foods that are easy-to-digest, nourishing, cleanse the physiology, strengthen digestion and balance your body’s inner intelligence.
One of the great strengths of the Ayurveda dietary approach is that it contains knowledge of how to have a light, easy-to-digest diet that still is both satisfying and nourishing. Many individuals have easily followed this diet and have improved their digestion and energy while also reducing their symptoms.
5) Ayurveda herbs
Herbs are considered nutritional supplements in Ayurveda. Their purpose is to restore balance to the specific functioning modes, whose malfunctioning is causing the condition.
There are lot of ayurvedic hers available, which have significant role in treating the hypertension like:
• Mukta pisti
• Pravala pisti
Commonly available formulations :
• Brahami vati
• Sarpagandha vati
• Prabhakar vati
• Nagarjuna abhrak
• Lasunadi vati
• Yogendra rasa
• Punarnavadi mandoora
• Gokshuradi guggulu
6) Creating Strong Digestion
Our ability to properly digest food is as important as what specific food we eat. Incompletely digested foods create toxins and impurities that are eventually absorbed, travel throughout the physiology, localize in tissues and disrupt their functioning. This process plays a major role in a wide variety of chronic conditions, including hypertension.
So, recommendations for strengthening digestion includes:
• Proper use of spices and cooking oils.
• Herbal preparations for improving digestion.
• Important differences between breakfast, lunch and dinner foods.
• A simple system to determine a balanced diet.
• Digestion-enhancing foods to favor.
• Digestion-depressing foods to reduce.
• Eating behavior for maximum digestion.
• Proper food combinations to avoid indigestion.
• Non-dietary regiments to improve digestive strength including exercise, specific Yoga asanas and breathing techniques.
7) Stress Management
• Excessive mental, emotional and physical stress can worsen the symptoms of many chronic disorders, including hypertension. This is due to hormonal changes and other biochemical responses to stress that can imbalance the nervous system and depress the healing ability of the body. Regular Yoga practitioners are less prone to experience the ill effects of high B.P. than their age & sex matched partners.
Common Stress relieving managements to be done like:
• Yogasanas, like shavashana, sarvangashana etc.
• Pranayamas, like anuloma-viloma, kpalabhati, bhramari etc.
• Yog mudras like pavana mudra, prana mudra, gyana mudra etc.
• Yoga nidra
8) Lifestyle and Daily Routine
One of the most important factors for maintaining healthy functioning is to have a lifestyle that does not disturb natural bodily rhythms. When we eat, sleep and exercise in constantly fluctuating and disturbing patterns, the body loses its natural balancing cycles and cannot cleanse or heal itself as effectively. Therefore, regularity in our daily routine can be extremely effective in reducing physiological imbalance at the basis of hypertension.
Hypertension is the most important preventable risk factor for premature death worldwide. It increases the risk of ischemic heart disease, strokes, peripheral vascular disease, and other cardiovascular diseases, including heart failure, aortic aneurysms, diffuse atherosclerosis, chronic kidney disease, and pulmonary embolism. Hypertension is also a risk factor for cognitive impairment and dementia. Other complications include hypertensive retinopathy and hypertensive nephropathy.
The goal of treatment is to reduce your blood pressure so that you have a lower risk of complications. If you have pre-hypertension, your provider will recommend lifestyle changes to bring your blood pressure down to a normal range. Medicines are rarely used for pre-hypertension.
Fast facts on hypertension
Here are some key points about hypertension. More detail and supporting information is in the body of this article.
• Hypertension is defined as blood pressure higher than 140 over 90 mmHg (millimeters of mercury).
• A diagnosis of hypertension may be made when one or both readings are high: systolic (the pressure as the heart pumps blood around the body), given first; or diastolic (pressure as the heart relaxes and refills with blood), given second.
• Modern lifestyle factors are responsible for a growing burden of hypertension: physical inactivity, salt-rich diets with processed and fatty foods, and alcohol and tobacco use.
• High blood pressure can also be secondary to other conditions – kidney disease, for example – and can be associated with some medications.
• Hypertension itself does not cause symptoms but in the long-term leads to complications caused by narrowing of blood vessels.
• Doctors diagnose high blood pressure over a number of visits using a sphygmomanometer, which involves applying an inflatable cuff to the upper arm.
• Lifestyle measures are used first to treat high blood pressure, including salt restriction and other dietary changes, moderation of alcohol, and stress reduction.
• One or more drugs from a number of different classes may be used for treatment.
Points to remember
As acute stress, intense exercise and other factors can briefly elevate blood pressure even in people whose blood pressure is normal, a diagnosis of hypertension requires several readings showing high blood pressure over time.
Having high blood pressure for a short amount of time is a normal physiological response to many situations. However, a systolic reading of 180 mmHg or higher OR a diastolic reading of 110 mmHg or higher could be a sign of a hypertensive crisis that warrants immediate medical attention.
Anyone who gets such a reading when testing their own blood pressure should wait a couple of minutes and repeat the test. If the reading remains at that level or increases, seek emergency medical treatment.
Blood pressure does vary throughout the day, lowering during sleep and rising on awakening. It also rises in response to excitement, anxiety and physical activity.
Blood pressure also increases steadily with age as arteries become stiffer and narrower due to atherosclerotic changes or plaque build-up. Vascular and heart disease also contribute to rising blood pressure in older adults, and a high systolic reading is a major risk factor for cardiovascular disease in adults over 50 years old.
Home Remedies For:
• A tablespoon every of contemporary amla juice and honey mixed along taken each morning is another effective remedy for high blood pressure.
• Juices of carrot, beetroot, cucumber, papaya, alfa-alfa and orange are often taken.
• Garlic or Rasona is most important substance helpful in alleviating vata dosha controlling blood pressure. Garlic lowers cholesterol and triglyceride that have impact on heart disease. A paste made of about 1 gm of garlic should be mixed with a glass of buttermilk. Drink this buttermilk twice a day. It will bring your blood pressure down. Read more about garlic
Eating 2/3 raw clove of garlic (prior to soaking it in buttermilk) on empty stomach in the morning will correct any vitiation of vata dosha and will help to lower your blood pressure.
• Powder of ‘Triphala’ should be taken regularly at night with warm water. This will help maintain constipation and bowels will remain clean.Read more about Triphala
• Soak 1tsp fenugreek seed in water for a night and munch them early in the morning on empty stomach
You can do many things to help control your blood pressure at home, including:
• Eat a heart-healthy diet, including potassium and fiber.
• Drink plenty of water.
• Exercise regularly for at least 30 minutes of aerobic exercise a day.
• If you smoke, quit.
• Limit how much alcohol you drink to 1 drink a day for women, and 2 a day for men.
• Limit the amount of sodium (salt) you eat. Aim for less than 1,500 mg per day.
• Reduce stress. Try to avoid things that cause you stress, and try meditation or yoga to de-stress.
• Stay at a healthy body weight.