HIGH BLOOD PRESSURE (HYPERTENSION) - ITS MODERN UNDERSTANDING AND HOMOEOPATHIC APPROACH

                                                                                               

Hypertension or high blood pressure, sometimes called arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries is elevated. Hypertension, or abnormally high blood pressure, is often referred to as the “silent killer.” This is because it does not usually manifest any symptoms while causing damage to the heart, brain, kidneys, and eyes. By hearing the word Blood Pressure, People himself thinks that it’s a serious disease likewise but fact is that increased blood pressure than its normal range is not merely a disease by itself, but a sign or manifestation of a pathological process.

According to the World Health Organization, “Hypertension affects 600 million people worldwide. Yet many are unaware that they have the disease and are at risk of developing a stroke, heart disease, blindness and kidney failure. Hypertension causes five million premature deaths per year, yet there is no proper solution for curing hypertension.”

High blood pressure seems to be more common in modern times. Intensive struggle for existence associated with continual anxiety, greed, ambition, artificial methods of living, want of faith in religion, intemperance, irregular hours, adulterated and unwholesome food and many vices peculiar to modern civilization do play an important part in its causation. With the advancement of medical sciences and the invention of sphygmomanometer, the detection of hypertension become very easy and patient myself inclined to check there blood pressure in frequent intervals and more cases are brought to the notice of the physicians.

Normal blood pressure at rest is within the range of 100– 140mmHg systolic and 60–90mmHg diastolic. High blood pressure is said to be present if it is often at or above 140/90 mmHg.

Causes of Hypertension

Hypertension is classified as either primary (essential) hypertension or secondary hypertension; about 90–95% of cases are categorized as "primary hypertension" which means high blood pressure with no obvious underlying medical cause. The remaining 5–10% of cases (secondary hypertension) are caused by other conditions that affect the kidneys, arteries, heart or endocrine system. In females the prevalence is closely related to age, with a substantial increase occurring after age 50. This increase is presumably related to the hormonal changes of menopause. The ratio of hypertension frequency in women versus men increases from 0.6 to 0.7 at age 30 to 1.1 to1.2 at age 65.

Primary (essential) hypertension - For most adults, there's no identifiable cause of high blood pressure. This type of high blood pressure, called essential hypertension or primary hypertension, tends to develop gradually over many years.

Secondary hypertension - Some people have high blood pressure caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including:

Kidney problems, Adrenal gland tumors, Thyroid problems, Certain defects in blood vessels congenitaly, Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs, Illegal drugs, such as cocaine and amphetamines, Alcohol abuse or chronic alcohol use, Obstructive sleep apnea.

Risk Factors

Strong familial and genetic predisposition and a number of modifiable predisposing factors have also been identified. Several studies have demonstrated the influences of Weight gain, Insulin resistance, Salt intake, Physically inactive, Mental stress, Tobacco Smoking Alcohol use, Elevated haematocrit, Hypertriglyceridaemia and Rapid heart rate. Sometimes pregnancy contributes to high blood pressure, as well. Although high blood pressure is most common in adults, children may be at risk, too. For some children, high blood pressure is caused by problems with the kidneys or heart. But for a growing number of kids, poor lifestyle habits, such as an unhealthy diet, obesity and lack of exercise, contribute to high blood pressure.

Clinical manifestations

Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. Although a few people with early-stage high blood pressure may have dull headaches, dizzy spells or a few more nosebleeds than normal, these signs and symptoms usually don't occur until high blood pressure has reached a severe or life threatening stage.

American Heart Association, Recommended Blood Pressure Levels are

1.      Optimal Level < 120 / 80, it should be rechecked in every 2 years.

2.      Normal Level < 130 / 85, it should be rechecked in every 2 years.

3.      High Normal Level <130 – 139 / 85 – 90 it should be rechecked in every 1 years.

Diagnosis

Blood pressure measurements fall into four general categories:

Normal blood pressure - blood pressure is normal if it's below 120/80 mm Hg. Once blood pressure rises above 120/80 mm Hg, the risk of cardiovascular disease begins to increase.

Prehypertension - Prehypertension is a systolic pressure ranging from 120 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg. Prehypertension tends to get worse over time.

Stage 1 hypertension - Stage 1 hypertension is a systolic pressure ranging from 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mm Hg.

Stage 2 hypertension - More severe hypertension, stage 2 hypertension is a systolic pressure of 160 mm Hg or higher or a diastolic pressure of 100 mm Hg or higher.

Both numbers in a blood pressure reading are important. But after age 60, the systolic reading is even more significant. Isolated systolic hypertension — when diastolic pressure is normal but systolic pressure is high — is a common type of high blood pressure among people older than 60.

White coat high blood pressure

A single elevated blood pressure reading in the doctor's office can be misleading because the elevation may be only temporary. It may be caused by a patient's anxiety related to the stress of the examination and fear that something will be wrong with his or her health. The initial visit to the physician's office is often the cause of an artificially high blood pressure that may disappear with repeated testing after rest and with follow-up visits and blood pressure checks. One out of four people that are thought to have mild hypertension actually may have normal blood pressure when they are outside the physician's office. An increase in blood pressure noted only in the doctor's office is called 'white coat hypertension.' The name suggests that the physician's white coat induces the patient's anxiety and a brief increase in blood pressure. A diagnosis of white coat hypertension might imply that it is not a clinically important or dangerous finding. However, caution is warranted in assessing white coat hypertension. An elevated blood pressure brought on by the stress and anxiety of a visit to the doctor may not necessarily always be a harmless finding since other stresses in a patient's life may also cause elevations in the blood pressure that are not ordinarily being measured. Monitoring blood pressure at home by blood pressure cuff or continuous monitoring equipment or at a pharmacy can help estimate the frequency and consistency of higher blood pressure readings. Additionally, conducting appropriate tests to search for any complications of hypertension can help evaluate the significance of variable blood pressure readings.

Borderline high blood pressure

Borderline hypertension is defined as mildly elevated blood pressure higher than 140/90 mm Hg sometimes, and lower than that at other times. As in the case of white coat hypertension, patients with borderline hypertension need to have their blood pressure taken on several occasions and their end organ damage assessed in order to establish whether their hypertension is significant. People with borderline hypertension may have a tendency as they get older to develop more sustained or higher elevations of blood pressure. They have a modestly increased risk of developing cardiovascular disease. Therefore, even if the hypertension does not appear to be significant initially, people with borderline hypertension should have continuing follow-up of their blood pressure and monitoring for the complications of hypertension.

If, during the follow-up of a patient with borderline hypertension, the blood pressure becomes persistently higher than 140/ 90 mm Hg, an antihypertensive medication is usually started. Even if the diastolic pressure remains at a borderline level (usually less than 90 mm Hg, yet persistently above 85) treatment may be started in certain circumstances.

Complications of hypertension:

In the beginning hypertension is labile, but in due course, it becomes established hypertension. The complications are more common in higher blood pressures. The accompanying arteriosclerosis may be the reason for cardiovascular diseases in uncontrolled hypertension; Ischemic heart diseases like angina pectoris, myocardial infarction or congestive heart failure. 50% of patients die, 33% get cerebral strokes, 15% get renal failure. Renal failure is more common in hypertension with diabetes as the patients suffer from proteinuria, which is an evidence of nephropathy.

The complications are classified into two types-

Hypertensive complications like Malignant hypertension, Congestive cardiac failure Aortic dissection and aneurysm, Nephrosclerosis, Cerebral hemorrhages and infarctions

Atherosclerotic complications like Ischemic heart diseases like angina pectoris and myocardial infractions, Sudden death, Arrhythmias, Cerebral thrombotic strokes, Peripheral vascular diseases

Home Remedies for High Blood Pressure:

• Bananas are one fruit that people with high blood pressure can eat regularly to control it. Bananas are a rich source of potassium, which helps control blood pressure levels. At the same time, they are low in sodium and have no cholesterol, both of which also are good for people with this problem.
• Coconut Water - People with high blood pressure must keep their bodies well hydrated. It is a good idea to drink eight to 10 glasses of water daily. Coconut water is particularly beneficial for lowering blood pressure.
• Black seed oil contains a number of active ingredients that have been shown to help reduce cholesterol and control high blood pressure. Therefore, to reduce excess blood pressure simply take one teaspoon of Black Seed oil daily. Black Seed Oil can also be mixed into juice or tea if you don't like the taste of the raw oil.
• Garlic has also been known to help reduce high blood pressure. Although the exact reasons are still not clear, studies have shown that eating just a single clove a day (either raw or cooked) has a beneficial effect. An added bonus for eating garlic is that it is also known to reduce cholesterol. Therefore, regularly consuming garlic, either fresh or in capsule form, is a great way to reduce your risk of heart disease.
• Lemons help keep blood vessels soft and pliable and by removing any rigidity, high blood pressure will be reduced. In addition, you can help lower your chance of heart failure by consuming lemon juice regularly, due to its vitamin B content.
• Ginkgo Biloba is an herb which helps increase blood circulation in our bodies by dilating our blood vessels. Therefore, asimple remedy to lower blood pressure is to take 120mg of Ginkgo Biloba extract daily before any meal.
• Watermelon seeds contain a compound called cucurbocitrin, which helps widen the blood capillaries. At the same time, it also helps improve kidney functioning. This in turn reduces blood pressure levels and also helps a lot with arthritis.

HOMOEOPATHIC MANAGEMENT

Homoeopathy considers health as a state indicating harmonious functioning of the life force. Disease is a deviation from health, which develops when the life force is unable to overcome obstructions to its smooth functioning. Being a chronic disease, it requires constitutional, antimiasmatic treatment. It is the totality of symptoms which guides the homoeopath to the indicated remedy. A constitutional remedy chosen by an experienced prescriber is the most appropriate way to treat deep-seated, serious, or chronic conditions. Some remedies may be useful as first-aid in intense situations, but medical care should also be sought immediately. Remedies below have been helpful to some people with hypertension.

Indicated Remedies	Indications
Argentum nitricum	If blood pressure rises with anxiety and nervousness, this remedy may be indicated. “Stage fright” or anticipation of a stressful event can bring on dizziness, headache, diarrhea, and a pounding pulse. People who need this remedy are typically warm-blooded, imaginative, impulsive, claustrophobic, and have strong cravings for sweets and salt.
Aurum metallicum	This remedy is sometimes indicated for serious people, focused on career and accomplishment, with blood pressure problems related to stress. Worry, depression, or anger may occur, especially when these people feel they have made a mistake or failed in some way. A general tendency to feel worse at night, and a strong desire for alcohol, sweets, bread, and pastries are other indications for Aurum.
Belladonna	This remedy is indicated when symptoms come on suddenly, with great intensity and heat. The person’s face is flushed, with dilated pupils, and pulsations and throbbing may be felt in various parts of the body. Despite the general heat, the person’s hands and feet may be cold. Vertigo and pounding headaches, worse from jarring and worse from light, may also occur.
Calcarea carbonica	This remedy is often helpful to people with high blood pressure who easily tire and have poor stamina. They are typically responsible types, who feel overwhelmed when ill and fear a breakdown. Palpitations and breathing problems can be worse from walking up a slope or stairs, and also when lying down. A general chilliness with clammy hands and feet (the feet may heat up in bed at night) and sweat on the head during sleep are other indications. The person may have cravings for sweets and eggs, and tend toward weight problems.
Glonoinum	A flushed face with a pounding headache and visible throbbing in the blood vessels of the neck may indicate a need for this remedy. The chest can feel congested or hot, with a pounding or irregular heartbeat. The person is worse from moving around, after heat and sun exposure, and after drinking alcohol. A feeling of “being lost in a familiar place” is a strong indication for this remedy.
Lachesis	A person who needs this remedy typically is intense and talkative, with inner passion and agitation that need an outlet—a “pressure-cooker.” The person may have a strong fear of disease, and feelings of suspicion, revenge, or jealousy are common. The person may also have heart or artery problems, look flushed or purplish, and feel constriction in the chest, with pulsations in many areas. Feeling worse after taking a nap or on waking in the morning, and a strong intolerance of clothing around the neck (or any kind of restriction) are other indications for Lachesis.
Natrum muriaticum	A person who needs this remedy seems reserved and responsible, but may have very strong feelings (of grief, disappointment, anger, lingering grudges, a fear of misfortune) inside. Headaches and palpitations are common, as well as a feeling of tension (even coldness) in the chest. The person feels worse from being in the sun, worse around midmorning, and better from being alone in a quiet place. A craving for salt and strong thirst can help to confirm the choice of this remedy.
Nux vomica	A person who needs this remedy is usually impatient and driven—easily frustrated, angered, and offended. A strong desire for coffee and other stimulants, sweets, strong foods, and alcohol or drugs may aggravate blood pressure problems. Palpitations, constricting feelings in the chest, constipation, and hemorrhoids are often seen. The person is typically sensitive to light, noise, odors, and interference.
Phosphorus	A person who needs this remedy usually is sensitive, suggestible, and sympathetic, with a tendency toward weakness, dizziness, a “spaced-out” feeling, and fearfulness. Nosebleeds, facial flushing, palpitations, and a feeling of heaviness or pain in the chest, and left-sided problems are often seen. A strong desire for cold drinks and refreshing things, and a marked improvement after eating and sleeping are other indications for Phosphorus.
Plumbum	This remedy is indicated for people with degenerative problems of the nerves and hardening of the arteries. Chest tightness and palpitations are often worse when lying on the left side. Contractures, paralysis, and nerve or muscle problems are also likely. The person may have a history of heavy drinking and “high living”—becoming apathetic or depressed when physical debility and memory problems develop.
Sanguinaria	A feeling that blood is rushing to the head, with flushed red cheeks and pulsing in the neck, may indicate this remedy. The person may have headaches or migraines (usually on the right and worse from light and noise). Right-sided neck and shoulder problems, allergies, heartburn, and digestive problems are often seen, and burning pains are typical. Symptoms are worse from motion, and relief may come from being in the dark and sleeping. A craving for spicy food, and a tendency to feel worse from eating sweets are other indications for Sanguinaria.
Terminalia Arjuna	A great remedy for heart maladies. Highly effective in cases of high blood pressure with vertigo, palpitation and a sense of mental and physical exhaustion. It is a good remedy for diseases of the heart, both organic and functional, angina pectoris, weakness and pain in the heart.
Viscum Album	Feeling of suffocation when lying on the left side. Stertorous breathing. Spasmodic cough. Arterial hypertension with valvular insufficiency. Unable to rest in a reclining position. Oedematous swelling of the extremities. Teeth chatter. Eyes sleepy, difficult to open, lids heavy. Bowels obstinately constipated. Urine milky-white after standing. Palpitation during coitus. Heart gives a throb and then a pause. Pulse small, quick and very irregular, slow, full and bounding. Low tension due to dilated blood vessels.
Ignatia Amara	Indicated in high blood pressure due to emotions, disappointed love and/or grief. Fluttering of the muscles of chest. Throbbing cardiac hyperaesthesia. Anxious feeling in precordia. Difficult respiration, as if there is some weight on the chest, shortness of breath when walking. Feeling of suffocation on running. Palpitation of the heart at night. Strong disposition to be frightened. Sadness and concentrated sorrow with sighing. Loves solitude.