Understanding High Blood Pressure and Scope of Homeopathic Medicine in Treating Hypertension.

Dr. Nazmul Hasan BHMS (G.H.M.C.H)

High blood pressure (hypertension), is a condition commonly associated with narrowing of the arteries. This causes blood to be pumped with excessive force against the artery walls. It is a sign that the heart and blood vessels are being overworked. Untreated, high blood pressure will cause the heart to eventually overwork itself to the point where serious damage can occur. For instance, the heart muscle can thicken (hypertrophy) and function abnormally, or dilate and contract less forcefully (dilated cardiomyopathy). High blood pressure can cause injury to the brain, the eyes (retinopathy) and/or the kidneys (nephropathy). Hypertensive patients are also at increased risk of heart disease and stroke. Most cases of high blood pressure have no cure, but the overwhelming majority can be managed and controlled with diet and medication.

High blood pressure (hypertension) is a condition in which a person’s blood pressure is elevated. Blood pressure is the measure of the force of the blood pushing against the walls of the arteries – the blood vessels that carry blood from the heart to the rest of the body. When the heart contracts to pump out blood, the peak of contraction is called systolic pressure. After pumping, the heart relaxes and pressure drops to its lowest point just before a new beat. That lowest point is called the diastolic pressure.

The measurement of an individual’s blood pressure is always expressed as systolic pressure over diastolic pressure. For example, normal blood pressure for adults is considered to be in the range of 120/80 millimeters of mercury (mmhg).

Generally, blood pressure above 140/90 is considered to be high for adults, and blood pressure under 90/60 is considered to be low for adults. A new category, prehypertension, is being used to refer to individuals with blood pressures between 120-139/80-89. Such individuals are typically not prescribed medication, but are advised to adopt lifestyle modifications where necessary to help keep blood pressure from rising. These include weight loss, diet, exercise, reducing salt intake and quitting smoking.
High blood pressure has been associated with a variety of significant health risks, including an increased risk of heart disease. It is also common in persons with obstructive sleep apnoea.

Unfortunately, many people with high blood pressure are unaware that they have the condition and do not seek treatment. Lack of access to medical care also contributes to under treatment of high blood pressure. Because of this, the rate of high blood pressure among the poor or uninsured may be underestimated because these groups often do not achieve clinical recognition.

Left untreated, high blood pressure will gradually continue to rise even higher over the years, causing the heart to overwork itself to the point where serious damage can occur. Untreated high blood pressure also places other systems (e.g., circulation) and organs (e.g., the kidneys) at greater risk of damage that could lead to dysfunction or failure (CKD).
Hypertensive patients are at increased risk of the following:

  • Heart disease (e.g., heart failure,
    sudden cardiac death, cardiomyopathy)
  • Stroke
  • Hardened arteries (atherosclerosis)
  • Aneurysm (a weakness in the aortic wall where it balloons out to more than 1.5 times its normal size and is in danger of rupturing), often resulting in sudden cardiac death
  • Kidney failure.
  • Retinopathy (loss of vision)

The risk of developing one or more of these serious health conditions increases as blood pressure rises. High blood pressure has often been called the “silent killer” because mild to moderate levels usually go unnoticed by patients until serious damage has already been done. To clarify the risk factors, high blood pressure measurements for adults have been ranked according to risk categories of increasing severity, ranging from “normal” to “stage 4.” The following categories apply to adults (age 18 and over) who are not taking medicine for high blood pressure and do not have a serious short-term illness:

Stage

Systolic Pressure

Diastolic Pressure

Optimal *

Under 120

AND

Under 80

Prehypertensive**

120-139

OR

80-89

Grade 1 HTN

140-159

OR

90-99

Grade 2 HTN

160-179

OR

100-109

Grade 3 HTN

(Severe)

180-209

OR

110-119

Grade 4 HTN

(Very severe)

210 or over

OR

120 or over

Note: *Optimal levels are with respect to heart disease risk. Unusually low readings (below 90/60) can also negatively affect heart health should be reported to a physician.

**The U.S. National Heart, Lung, and Blood Institute (NHBLI, part of the U.S. National Institutes of Health) has proposed a new category, called prehypertension. This refers to individuals who do not have high blood pressure, who do not take blood pressure medication (antihypertensives), but who are considered to be at risk for developing high BP and its associated risk for coronary artery disease and stroke. Earlier, such individuals may have been termed “high normal” or “Boarder Line normal”.

According to age blood pressure could be variable, and must be considered in diagnosing hypertension.

Age Blood pressure
Age 20-40 years <140/<90 mmhg
Age 40-50 years 160/95 mmhg
Age 50-60 years 160/95 mmhg
Age above 60 years 170/105 mmhg

High blood pressure has been traditionally classified as 140/90 millimeters of mercury (mmHg) or above. Now, prehypertension describes systolic blood pressure of 120-139 mmHg or diastolic blood pressure of 80-89 mmHg; a desirable normal blood pressure remains at less than 120 systolic and less than 80 diastolic.

Researchers at the NHLBI report that the risk of developing coronary artery disease can begin at blood pressures little higher than 115/75 mmHg, and that risk doubles with each 20/10 mmHg increment.

Prehypertensive individuals are typically not given medication, but are recommended to adopt lifestyle modifications where necessary to help keep blood pressure from rising. These include weight loss, diet, exercise, reducing salt intake and stopping smoking. For persons having diabetes or kidney disease, the goal is to keep blood pressure under 130/80 mmHg, for which antihypertensive drugs may be advised.

An important exception to the information listed above is noted among patients with diabetes and/or kidney disease. These patients will require treatment if their blood pressure is above 130/80. For individuals with diabetes and high blood pressure, the drug was seen to lower blood pressure without affecting blood sugar levels.

Usually what patient says in hypertension?

The majority of people with mild to moderate high blood pressure cannot tell when their blood pressure is too high. In fact, about one-third of hypertensive people are not aware of their condition. Patients may experience chest pain (angina), shortness of breath or other symptoms related to heart disease or underlying damage. High blood pressure may cause any of the following: 1) Fatigue. 2) Confusion. 3) Nausea or upset stomach 4) Vision changes or problems 5) Excessive sweating 6) Paleness or redness of skin 7) Nosebleeds 8) Anxiety or nervousness 9) Palpitations (strong, fast or obviously irregular heartbeat) 10) Ringing or buzzing in ears 11) Impotence 12) Headache 13) Dizziness

Diagnosis methods for high blood pressure: 

When diagnosing high blood pressure, a physician will get a patient’s full medical history. For example, the physician will ask whether high blood pressure runs in the family and what the patient’s dietary habits have been like (e.g., salt intake, fat intake). The physician will also give the patient a complete physical examination, which will include checking the patient’s blood pressure in both arms while standing and lying down. The physician may ask the patient to take his or her own blood pressure at home and bring in a daily log of blood pressure measurements. It is more useful in diagnosing uncontrolled hypertension. May be some patient having low blood pressure, e.g. 105/60mmhg. If this patient come with 120/80 mmhg the physician should not aware of his BP, because its’ the normal BP for general people, where as its high blood pressure for the patient then. So if a patient maintain a blood pressure chart its helpful to diagnose whether the patient is hypertensive or not.  It has also been shown that, in adults 65 years of age and older, blood pressure may drop somewhat in the first two hours after eating. This may result in an inaccurate blood pressure reading if taken during that interval.
Following the physical examination, a number of tests will often be ordered, which include the following:

  • Urinalysis and various blood tests (e.g., electrolytes and waste products) tests to rule out kidney disease.
  • Electrocardiogram (EKG), which measures the heart’s electrical activity. By analyzing the EKG results, a physician can check for heart-related problems that could be associated with high blood pressure (e.g., left ventricular hypertrophy/LVF).
  • Echocardiogram, which uses ultrasound waves to visualize the structures and functions of the heart. This test is also used to check for heart-related problems such as left ventricular hypertrophy, vascular abnormality, complain regarding vulves etc.
  • Chest x-ray to rule out an enlarged heart.

Once a diagnosis has been made and serious problems (e.g., kidney disease) have been ruled out, then treatment can begin. However, very high blood pressure may require additional testing to rule out an unusual cause. For example, a renal Doppler sonogram or scan may be ordered to evaluate for high blood pressure in the blood vessels of the kidneys (renovascular hypertension). Also, a 24-hour urine test may be needed to rule out an endocrine disorder, such as Cushing disease or pheochromocytosis.

High blood pressure may occur in either adults or children. Some people may also be diagnosed with the opposite condition: Low blood pressure (hypotension). Although some hypertensives do not need to take medication as long as they can control their risk factors (e.g., weight), most cases generally require long-term treatment with medications.

Diagnosing HTN could be guided by the national health council/authority to avoid any confusion in understanding the disease. Usually Govt. Authority has special body to settle this. In Bangladesh, National Heart Foundation doses this thing. So, it is wise to follow the national guideline to avoid any hazards, because the diagnostic procedure and due to climatic and geographic variables the information given above may conflict and may misguide to treatment. e.g. BP of a hilly person may varies from a person from low land. Again BP of a person from sea shore differs from the person from dry land.

What will a Physician suggest?

Lifestyle changes can significantly improve a patient’s blood pressure. Definite steps that can and should be taken to lower and control blood pressure include: 1) Quitting smoking 2) Losing weight 3) Following the DASH diet (Dietary Approach to Stop Hypertension) 4) Getting adequate amounts of vitamins and minerals. 5) Engaging in regular aerobic exercise. 6) Avoid alcohol, if necessary than may use one drink per day for women and two drinks per day for men (In Cold Countries) 7) Limiting salt intake to 2,000 milligrams (2 grams) of sodium per day. 8) Using stress management techniques. Women are also encouraged to discuss with their physicians the increased risk of high blood pressure that results from taking birth control pills, particularly if they are over the age of 35.

Scope of Homeopathic medicine

In hypertension allopathic medicine works properly and effectively, no doubt. But it is obvious, that the medicine should be taken regularly and for the rest of his life from the day of starting anti hypertensive drugs. Due to these drugs’s property, in course of time they become resistant to our body and need to increase the amount of dose and drug properties in the selective drugs recipe. Other ways, these well active drugs become useless and patient become helpless. But, Homeopathic medicine can help them with great efficiency. As homeopathic medicine has very less chance to become resistant to human body (due to its preparation procedure) it has a wide open scope in treating hypertension. It also ensures that, medicine would not be needed to take for life long. Once the blood pressure become normal and regular, along with the proper diet and lifestyle the patient could stop the medicine; Obviously under supervision of good homeopathic physician. We all know that homeopathic medicine will be selected according to symptom similarity. In homeopathy there are many medicines to control hypertension; we can have a short list from our various repertories. e.g. Aconite, Adonis, Arg. Nit, Baryta M, Coffeea, Con, Crategus, Glonoin, Kali mur, Lachesis, Naja, Nat mur, Nux Vom, Rauwl, Sulph, Vanadium etc.

Some of the drugs are described below to understand the relation between the disease picture and the drug picture.

Aconite: Great anguish and palpitation of the heart; pulse hard, strong, and full, in inflammations, with great thirst with great fear of death. Carotids beat violently.

Adonis: Heart muscles faces fatty degeneration.Cardiac oedema.

Rauwolfia: It relaxes the vascular tension and releases the lateral blood pressure. Occasional Bradycardia, Aorititis.

Glonoine: High systolic pressure, distinct pulsation over the whole body, feeling of the pulse in the head.

Lachesis: Heart feels constricted; rheumatism of the heart. Cramp-like pain in the precordial region, causing palpitation with anxiety. Great shortness of breath.

Sulphur: Short stitches in precordial region, with palpitation, with burning in hands and feet. Sensation as if heart were enlarged.

It is must that homeopathic medicine should not be taken without proper guidance or without prescription; If a homeopathic physician treat a patient with proper care, its’ sure that the patient should get relief from hypertension complain. So, please whenever you take homeopathic medicine should not think about the doctor’s age but about his knowledge.

Lifestyle considerations with high blood pressure:

People with high blood pressure should avoid certain activities and situations that may raise their heart rates and blood pressure to dangerous levels. These include the following: 1) Saunas 2) Steam baths 3) Steam rooms 4) Heated whirlpools 5) Hot tubs 6) Very warmly heated swimming pools.

It is very important for hypertensives to limit the amount of time spent in these activities to less than 10 minutes, after which they should sit down out of the heat for a few minutes before standing to minimize the risk of dizziness or passing out (syncope).

Hypertensives patients should not take any medication without concerning his/her physician. It may put his/her life in risk. So, do as your physician says and take medicine as prescribed, live well.