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Ayurvedic Treatment
By Dr Raghuram Y.S. MD (Ay).
Many of my patients keep complaining Sir, we have lot of stress and tensions in our life
which you cant understand!
I am not telling that being a doctor I dont have any tensions. All of us do have them. The quality
and quantity of tensions and stress would vary from person to person.
Tensions and stress are sometimes motivating. The positive sides of these things have led to
evolution of humanity as a whole. But the negative part of these is causing serious and
irreversible health hazards at both body and mind levels.
Topics covered below, in this article:
Have more of Vegetables, fruits, whole grains and low-fat dairy foods, includes meat, fish,
poultry, nuts and beans.
Celery, carrot, garlic, flaxseed, flaxseed oil, Tulsi tea, green tea, ginger cardamom tea, orange
juice, non fat yogurt, tender coconut water, water melon, wheat bran, black plum, ginger,
pomegranate, drumstick (moringa), banana, almond, walnut, olive oil.
Have less of sugar-sweetened foods and beverages, red meat and added fats.
Studies have shown that Fish oil / omega-3 fatty acids, Hibiscus tea, Dark Chocolate
(Cocoa, chocolate) reduce blood pressure
Green Coffee extract Raw coffee beans from Coffea fruits which have not been
roasted is called Green Coffee. Chlorogenic acid and Ferulic acid present in Green Coffee
extract is said to reduce Blood Pressure.
Caffeine is said to increase blood pressure especially in those who are already
having High Blood Pressure, therefore its use should be limited. Green Tea or Green tea
extracts are found to reduce blood pressure. EGCG present in a compound in green tea is
said to reduce diastolic blood pressure.
Magnesium is also found to reduce blood pressure though in small proportions
Vitamin D This is naturally found in Sunlight, Fish, Eggs, Fortified Milk, Cod liver oil
etc may help in reducing blood pressure. BP is often elevated when there is reduced exposure
to sunlight / Vitamin D (during winter, greater distances from equator and dark skin
pigmentation.
Bananas in plenty High salt or sodium can raise blood pressure. Potassium on the
other hand counters sodiums ill effects. People with hypertension can benefit from intake or
supplementing Potassium. Good sources of Potassium are Bananas, a baked potato with
skin, orange juice and non-fat or low-fat yoghurt
Coconut Water has good quantities of Potassium and Magnesium and is found to be
beneficial for those suffering from hypertension. It reduces the systolic pressure and also
supports the functioning of cardiac muscles
Eating Watermelon or drinking melon juice will be handy for those suffering from
Hypertension. Citrulline, an amino acid present in Watermelon lowers vascular resistance and
hence lowers BP. It should be consumed early in the morning
Ginger-Cardamom tea is said to be beneficial for those having Hypertension
Exercise options:
Brisk walking for at least 30 minutes a day.
Moderate intensity dynamic aerobic exercise like walking, jogging, cycling or swimming
Isometric resistance exercise, aerobic exercise, resistance exercise and device guided breathing.
Vayu is thus all pervading. All the other Doshas (Pitta and Kapha), Dhatus (tissues) and Malas
(excreta waste products) are dependent on Vayu for their normal or abnormal movements.
When in equilibrium, Vata Dosha is responsible for all the normal life activities (psycho-
somatic).
The same Vayu when gets disturbed is said to initiate the disease process in the body (and
mind) by displacing, misplacing, pulling or pushing the other Doshas and Malas from their
normal and natural seats to abnormal places.
The morbid Doshas getting lodged in the tissues cause tissue damage and thus cause disease
process. Similarly the Malas (excreta, cellular toxins) can get held back in abnormal places,
contaminate the body and cause diseases.
Physiology of blood circulation in Ayurveda:
Rakta Dhatu explained in Ayurveda (inclusive of Rasa Dhatu) can be compared to the blood
tissue. Vata Dosha is responsible for the heart functions including the output (systole) and input
(diastole) of the blood and also the circulation. The circulation of blood takes place by the
integrative functioning and coordination of
Vyana Vayu (Sub-type of Vayu responsible for distribution of essential things in the body),
Ranjaka Pitta (Sub-type of Pitta responsible for formation, qualitative and quantitative
maintenance of the blood tissue) and
Avalambaka Kapha (Sub-type of Kapha located in the chest, responsible for lubrication and
normal functioning of the chest organs Heart and lungs).
Raktagata Vata
Hypertension can be compared to a condition called Raktagata Vata. In this condition the
vitiated Vata gets lodged in the circulating Rakta Dhatu (blood) and causes disturbances in its
circulation. Since Rakta and Pitta are related in an inseparable relationship the disturbance of
Rakta also leads to the disturbance of Pitta. In this context Raktagata Vata is basically a
disorder of blood caused by morbid Vata and Pitta. The Kapha component will also be disturbed
leading to loss of support and integrity to the cardiac functions.
When the Avalambaka Kapha Bhava (components) gains a pathological increase, they cause
blocks in the arteries and arterioles leading to atherosclerosis and peripheral resistance. This
further causes Hypertension and cardiac disorders.
The further pathological processes may lead to the aggravated Rakta blocking the normal
movements and functions of Vata leading to a condition called Raktavrita Vata. This may lead
to many complications of Hypertension as mentioned above. The concept of Vatarakta or
Vatashonita too can be included in studying Hypertension from an Ayurvedic perspective
Pachaka Pitta (KayaAgni) and the associated Samana Vayu will be disturbed at the
backdrop of Hypertension leading to disturbance of gross and tissue metabolism.
The Prana Vayu disturbed due to stress, anxiety etc. factors might worsen the disease in
a later condition.
Apana Vayu functions when disturbed can cause Udavarta (upward and haphazard
movement of Vayu) leading to increased pressure in the abdominal and chest organs putting
them under physiological stress.
Sadhaka Pitta in the Hridaya (Heart/Brain) and Tarpaka Kapha (Lubricants of nervous
system) when disturbed cause disturbances in heart functions and a disturbance of brain-
heart coordination.
The involvement of mind factors in the causation of hypertension or as aggravating factors in
the later context of an established disease cannot be ruled out. The
disturbed Rajas and Tamas bhavas (the mind factors responsible for morbidity according to
Ayurveda) definitely contribute in the pathogenesis of Hypertension either in the initial or
terminal stages.
The Prakriti (Basic constitution of the patient) and Vikriti (Pathological state of the disease and
diseased) shall be studied in detail. The basic principles of treatment lie in prescribing Vata-
Pacifying diet, medicines, treatments and lifestyle advises. The pathological states of Rakta,
Pitta and Kapha too should be considered.
Ayurvedic Management of Hypertension
Natural Measures (Preventive):
Dinacharya and Rutucharya: Following the principles of diet, lifestyle, ethics, code
and conduct of ideal living on a daily (Dinacharya) and seasonal (Rutucharya) basis
and Sadvritta wholesome daily regimen as explained in Ayurveda
Achara Rasayana Principles, behaviour and conduct of life which by themselves act as
rejuvenation. Example: Brahmacharya celibacy, courteous behavior etc.
Vega Dharana and Udeerana Helping the body in releasing the naturally manifested
reflexes and urges by not forcibly controlling them (Reflexes of Hunger, Thirst, Sleep,
Defecation, Urination etc). We should also not force the non-impending reflexes from the
body. We should forcibly control within ourselves the urge for emotional reflexes like those of
greed, enviousness, anger, lust etc
Read related: Secret of Ayurveda Do not suppress natural urges
Properly following Trayopasthamba Rules and regulations laid on Diet, Sleep and
Celibacy
Nidana Parivarjana (Avoiding the causative factors) Avoid taking foods and
activities which disturb the 3 Doshas (Vata, Pitta and Kapha) which are the primary culprits
in the causation of Hypertension. 3 Dosha balancing diet (good, healthy, fresh and balanced
nutrition) should be taken on a regular basis (predominant in fruits and vegetables). Mainly
excessive cold or hot, dry or oily, stale, preserved and packed foods, spicy, sour, heavy to
digest foods and junks should be avoided.
Treatment options
Internal treatments (Antah-Parimarjana)
Takra Shiro Dhara This is a special treatment from the home of Ayurveda in relieving
Hypertension. In this medicated buttermilk will be poured in streams on a shaved scalp while
the patient sleeps on the Dhara table in supine position. The treatment is carried on for a
period of 35-45 minutes.
Ksheera Dhara This is a similar method like Takra Dhara. Here the medicated milk
shall be poured in streams not only on the head but also on the whole body.
Taila Dhara Medicated oil is used for pouring on the body and head in streams. (Other
forms like Shiro Pichu Keeping cotton pieces dipped in medicated oil on the scalp and
tying it in place, Shiro Vasti Pooling of medicated oil in a cabin created on the head etc are
also used alternatively)
Note: The above said Dharas help in relieving one from stress, calms the nerves, improves
circulation, relieves hypertension and insomnia, relaxes the person physically and mentally and
re-establishes health.
Yoga
Taichi (Chinese art of healing)
Acupuncture and Qi Gong A form of traditional Chinese medicine
Autogenic Training Involves series of sessions in which one learns how to control
breathing, blood pressure, heart rate and body temperature. This technique reduces stress and
provides relaxation.
Meditation involving chanting, breathing and visualization
Relaxation and Breathing exercises
Biofeedback It is a technique where people are taught how to gain control over internal
body processes that normally occur involuntarily such as BP, Heart rate, muscle tension and
skin temperature. Other than Hypertension it is also used to treat migraine, tension headache,
chronic pain and urinary incontinence
Indulging in variety of entertaining and pleasing activities to keep away from stress
(Check your stress)
Writing dairies, blogs, books etc
Takradhara for hypertension treatment:
Takradhara is a traditional procedure where a stream of herb-processed buttermilk is flown over
head. Among many options of treatment and medications available in Ayurveda for the
management of Hypertension, Takra Dhara is the best choice.
Thus Takra Dhara is a treatment in which the medicated (processed with herbs, medicines)
buttermilk is poured in stream over the target area. forehead and scalp of the patient suffering
from Hypertension for a fixed duration of time while the patient lies on his or her back over a
specially designed table meant for the treatment.
In hypertension the rakta dhatu or blood element is abruptly handled by the disturbed Vayu.
The blood and Pitta have an inseparable relationship as Pitta resides in the blood. When the pitta
gets disturbed, the rakta too gets disturbed and vice versa. Takra dhara by the virtue of its
coolant effect pacifies the hot, intense and penetrating nature of both pitta and rakta. It also
controls Vayu by the virtue of its combination.
Takra Dhara relaxes & revitalizes the central nervous system, balances the brain and hormonal
functions and thus regularizes and relaxes all the functions of the body. The stress in each and
every cell and passage of the body is removed. It has a soothing effect on the endocrine system.
Takra Dhara improves the supply of blood and nutrition to the brain
The pressure and temperature effect of the medicament cannot be ruled out
With an Ayurveda perspective Takra Dhara might communicate with the deepest recesses of
the brain by soothing the Marmas (vital points of convergence of bones, muscles, blood vessels,
soft tissues and joints) located in the head viz Apanga, Avarta, Shanka, Utkshepa, Seemantha
and Sthapani Marmas with which the dhara liquid comes into contact with.
Most of these Marmas are related to the eye and blood circulation to the brain. By activating the
Marmas Takra Dhara might make a strong impact on the functioning of central nervous system
and important glands within the brain.
Alochaka Pitta (Pitta subtype) which is located in the Eye is said to be of 2 types. One
is Chakshu Vaisheshika (located within the eye and maintains its well being) and the other
is Buddhi Vaisheshika (the part of Alockhaka Pitta which has its connectivity with higher
centres of the brain and thus monitors the higher functions like intelligence, memory
etc). Apanga and Avarta marmas are related to the eye. Dhara might make a soothing impact
on buddhi vaisheshika alochaka pitta through these Marmas and in return soothe the nervous
system.
The injury of Seemantha Marma (joints of the skull) is said to cause Chitta
Nasha (psychological abnormality) and Bhaya (fear complex). Thus when the same Marma is
healed through Dhara, it may reverse the Chitta Nasha and Bhaya, i.e. it might relieve stress,
anxiety and depression. With this the relaxed nervous system will take care of heart functions
and circulation patterns. This in turn will benefit in reversing the events in hypertension.
The soothing of these Marmas and in turn soothing of Nervous system and endocrine glands as
an effect of Takra Dhara will definitely relax Prana Vayu, Sadhaka Pitta and Tarpaka
Kapha in the brain (head). These inturn will have a relaxing effect over the Vyana Vayu,
Ranjaka Pitta, Avalambaka Kapha and Udana Vayu controlling the heart functions and
circulation. The ultimate effect will be a good relief from Hypertension.
High Blood Pressure is seen to be an ominous sign for cardiovascular health. The more the
pressure, the more is the risk to the heart. High blood pressure also puts pressure on kidneys.
Hence, it is often seen that the patients who are prone for kidney disorders are monitored for
their BP very regularly.
Definition of hypertension:
In Hypertension, we can find that the blood pressure is persistently high in the arteries. The
higher the pressure and resistance, the harder the heart has to pump.
Hypertension is the name given for a condition where the readings of High Blood Pressure
remain high and above normal all the time. That means to tell that in Hypertension, the blood
pressure of the person is high each and every time it is measured (consistently elevated).
This also means that having a High Blood Pressure for a short amount of time and or
occasionally is just normal.
Synonyms of hypertension:
High Blood Pressure
Arterial Hypertension
Fullness Disease
Hard Pulse Disease
Example: In a blood pressure of 120/80 mm Hg, 120 is the systolic pressure. It is measured in
terms of millimetres of Mercury. In this the blood from the heart chamber is ejected into the
adjacent chamber or a blood vessel. Electrical systole can be recorded on Electrocardiogram
(ECG) and precedes mechanical systole (actual contraction of heart).
Diastole Meaning: Drawing apart in Greek: It is a time period when the heart is in the state of
relaxation and dilatation (expansion). It is the minimal arterial pressure during relaxation and
dilatation of the ventricle of the heart. Diastole is the time when the heart fills with the blood. In
a blood pressure reading it is usually the second number recorded. It is measured in terms of
millimetres of Mercury.
Ex. In a blood pressure of 120/80 mm Hg, 80 is the diastolic pressure.
Thus Diastole is a part of cardiac cycle when the heart refills with blood following systole
(contraction).
Ventricular diastole is a period when ventricles (2 lower chambers of the heart) are filling and
relaxing, while atrial diastole is a period during which the atria are relaxing. (Atria 2 upper
chambers of heart).
Secondary Hypertension
It is due to causes that can be very well identified such as chronic kidney disease, narrowing of
the aorta or kidney arteries or an endocrine disorder such as excess aldosterone, cortisone or
catecholamines
Epidemiology
1 in every 4 adults in the world suffers from hypertension
It contributes to 49 % of ischaemic heart disease and 62% of stroke worldwide
Inadequately controlled hypertension is the current number 1 attributable risk for death across
the globe
Causes of Hypertension:
Primary (Essential) Hypertension:Essential Hypertension is a complex process. It results from a
complex interaction of genes and environmental factors.
With ageing the Blood Pressure rises and the risk of becoming hypertensive in the later part of
life also proportionally increases.
Environmental Factors:
These are most of the times held culprit for the causation of Essential Hypertension. They are
said to influence blood pressure either singly or in combination.
The below mentioned are some of the environmental factors which have been identified as
influencing Blood Pressure.
High Salt intake, Salt rich diet through processed and fatty foods
Lack of exercise
Obesity
Stress
Depression
Secondary Hypertension:
Kidney disease (most common)
Obesity
Sleep apnoea
Pregnancy
Coarctation of the Aorta
Excessive liquorice consumption
Illegal drugs (some)
Arsenic exposure through drinking water
Endocrine conditions such as Cushings Syndrome, Hyperthyroidism, Hypothyroidism,
Acromegaly, Conns Syndrome (Hyperaldosteronism), Hyperparahyroidism,
Pheochromocytoma, Congenital adrenal hyperplasia etc
Excess Alcohol (Reversible). Stop alcohol and the blood pressure will start returning to
normalcy.
Excess Tobacco (Reversible)
Use of oral contraceptives (Reversible)
Hormonal therapy for menopause (Reversible)
Note: In secondary Hypertension the symptoms of the disease on the backdrop too would be
manifested along with hypertension.
Source.
Note: These symptoms may be related to associated anxiety rather than the high blood pressure
On physical examination Hypertension may be associated with changes in the optic fundus
seen by opthalmoscopy (hypertensive retinopathy). The severity of retinopathy is proportionate
with duration and / or severity of hypertension
Pathophysiology of Hypertension
In established Essential Hypertension Cardiac output is normal. High pressure is due to
total peripheral resistance (increased resistance to the blood flow). Peripheral resistance is the
resistance to the flow of blood due to narrowing of small arteries and arterioles at the periphery.
Reduction in the number of capillaries or density of capillaries may also contribute to peripheral
resistance.
Isolated systolic hypertension The pulse pressure (difference between systolic and diastolic
blood pressure) is frequently increased in these conditions, especially in older people with
hypertension. The systolic pressure is abnormally high and diastolic pressure is normal or low at
times. This may be due to increased arterial stiffness associated with ageing.
Abnormalities of rennin-angiotensin system and symphathetic nervous system leading to
disturbances in the kidneys salt and water handling mechanisms which further lead to a rise in
peripheral resistance contribute to most cases of essential hypertension.
Endothelial dysfunction and inflammation in blood vessels (vascular inflammation) may
contribute to increased peripheral resistance and vascular damages occurring in hypertension
Interleukin 17 increases the production of several immune system chemical signals like tumour
necrosis factor alpha, interleukin 1, interleukin 6 and interleukin 8 which take part in the
causation of hypertension
Masked Hypertension is opposite of White Coat Hypertension. Here the patients BP is above
normal during daily activities but when the patient is in a clinic setting it is in a normal range
Pseudo-hypertension in the elderly (Non compressible artery syndrome) Caused due to
calcification of arteries resulting in high readings (cuff readings) while intra-arterial
measurements of BP are normal
Orthostatic hypertension BP increases upon standing
Pulmonary hypertension:
It is a rare lung disorder. Here the pipes carrying blood from heart to lungs is narrowed, making
it difficult for blood to flow through the vessels. As a result, the blood pressure in these arteries,
called pulmonary arteries rises far above normal levels.
Apart from recording the blood pressure readings, the doctors would like to record a detailed
case history of the patient and also of family history. Detailed physical examination of the patient
with special interest towards cardiovascular health will be done.
Preventive Measures:
Population strategies, awareness about this global epidemic and preventive counselling for those
prone to get hypertension is basically aimed at reducing the consequences of high blood pressure
and the need for antihypertensive drugs.
Even before starting high BP treatment, lifestyle changes are recommended as a natural measure.
Below mentioned are the proposed lifestyle changes (2004 British Hypertension Society
guidelines) for the primary prevention of hypertension:
Body weight maintenance Adults should maintain normal body weights (BMI 20-
25kg/m2)
Reduction of Dietary Sodium intake To less than 100mmol/day (less than 6 gram of
sodium chloride or less than 2.4 gram of sodium per day)
Regular aerobic physical activity such as brisk walking (more than or equal to 30 minutes
per day on most days of the week or almost daily) Moderate intensity dynamic aerobic
exercise like walking, jogging, cycling or swimming should be done on 5 to 7 days per week
basis
Limiting alcoholic consumption to not more than 3 units/day in men and no more than 2
units / day in women
Consumption of a diet rich in fruit and vegetables (at least 5 portions per day) People
with high blood pressure are advised to eat fish at least twice a week and between 300 and
400 grams of fruit and vegetables a day
Giving up smoking should also be considered
Note: Effective lifestyle modification may lower BP as much as an individual antihypertensive
drug. Combinations of 2 or more lifestyle modifications can achieve even better results.
Lifestyle Modifications:
Lifestyle changes form the first line of treatment in hypertension. Dietary changes, physical
exercises and weight loss have shown to significantly reduce blood pressure in people with
hypertension.
Even in severe hypertension demanding medications, lifestyle changes should be combined for
an effective result
Effective dietary changes Diets with low sodium, DASH diet, Vegetarian diets and high
potassium diets
This is a dietary pattern prompted by the U.S. based National Heart, Lung, and Blood
Institute to prevent and control hypertension.
The DASH diet is rich in vegetables, fruits, whole grains and low-fat dairy foods,
includes meat, fish, poultry, nuts and beans. The diet is limited in sugar-sweetened foods and
beverages, red meat and added fats.
It is designed to be a well-balanced approach to eating for general public in addition to its
effect on blood pressure. Reference
Effective physical exercises Isometric resistance exercise, aerobic exercise, resistance exercise
and device guided breathing
Medications:
It is defined as hypertension that remains above goal blood pressure in spite of using at
once, 3 anti-hypertensive medications belonging to different drug classes.
Low adherence to treatment may be the chief cause.
It may also represent the result of high activity of autonomous nervous system and is
called Neurogenic Hypertension
Complications of Hypertension:
William Harvey (physician) first described the circulation of blood in his book De
motu cordis. This led to the modern understanding of the cardiovascular system.
Stephen Hales (English clergyman) made the first published measurement of blood
pressure in 1733
In 1896 Scipione Riva-Rocci invented the cuff-based Sphygmomanometer. Following
this hypertension as a clinical entity came into being. This allowed the measurement of blood
pressure in the clinic.
In 1905, Nikolai Korotkoff improved the technique by describing Korotkoff
sounds that are heard when the artery is auscultated with a stethoscope while the
sphygmomanometer is deflated
Fullness Disease: This is a disease explained in medieval Persian medical texts. The
signs and symptoms are similar to those of patients with hypertensive crisis. The symptoms
include headache, heaviness in head, sluggish movements, general redness and warm touch
feel of the body, prominent, distended and tense vessels, fullness of the pulse, distension of
the skin, coloured urine, loss of appetite, weak eyesight, impairment of thinking, yawning,
drowsiness, vascular rupture and haemorrhagic stroke.
Descriptions of hypertension as a disease came from Thomas Young (1808)
and Richard Bright (1836).
The first report of elevated BP in a person without evidence of kidney disease was
made in Frederick Akbar Mahomed (1849-1884)
Hard Pulse Disease A disease named Hard Pulse Disease which resembles high
blood pressure was historically treated by reducing the quantity of blood by bloodletting or
application of leeches. This was advocated by Yellow Emperor of China, Cornelius Celsus,
Galen and Hippocrates. The treatment approach included changes in lifestyle like staying
away from anger and sexual intercourse. The dietary programme included avoiding wine,
meat and pastries, reducing the volume of food in a meal, maintaining a low energy diet and
use of spinach and vinegar.
3 treatment modality: In the 19th and 20th centuries, before effective pharamacological
treatment for HTN became possible the 3 treatment modality were used Strict sodium
restriction (ex. Rice diet), sympathectomy and pyrogen therapy. They had a lot of side effects
and did not get popular.
Sodium thiocyanate was the first chemical for hypertension which was used in 1900.
It got unpopular because of many side effects.
Post 2nd World War Tetramethylammonium chloride, Hexamethonium, Hydralazine
and Reserpine 9derived from the medicinal plant Rauwolfia serpentine were brought into
practise
Major Breakthrough The discovery of well tolerated oral agents made a major
breakthrough in the treatment and management of HTN. The first was Chlorthiazide,
the first thiazide diuretic which came available in 1958. Subsequently the beta blockers,
calcium channel blockers, angiotensin converting enzyme inhibitors (ACE inhibitors),
angiotensin receptor blockers and rennin inhibitors were developed as antihypertensive agents