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(Article published in The IHK News, the official journal of The institution of Homeopaths Kerala)

 

Introduction

There are several health related myths among the public. In common usage, many people consider some normal body functions and even the name of some organs as diseases. For example: BP, ESR, Blood sugar, Cholesterol, Thyroid, Gastric, etc. are considered as names of diseases. You might have noticed even educated patients saying, “Doctor, I have Thyroid, BP and ESR”. Why people make such mistakes? Because, the abnormalities related with these normal things are very common nowadays, hence, even doctors use these terms casually. We often “diagnose” ESR as a disease, just to satisfy the patients! Among the common health related problems as mentioned above, high blood pressure is more common nowadays. Hence, high BP is considered as a global problem. In India, approximately 5 lack deaths occurs every year due to BP related heart diseases. BP is also a layman’s language to indicate short temperedness! An outburst of temper is now termed as “rise of BP”. It shows the relationship of high blood pressure with anger. However, high BP is detected among all types of people including those who are mild natured individuals who never express anger. It is more common among those who suppress their worries, and also among those who suppress their “minor ailments” repeatedly with the material doses of medicines.

 

Hypertension is not a disease, but a chronic medical condition in which the blood pressure in the artery is elevated. Initially, high BP was found among middle aged, but unfortunately, nowadays, even the youngsters are affected. High BP due to some defects in the body, called secondary hypertension, was the main reason for high BP among youngsters. But nowadays, high BP without any special cause (essential hypertension) is also more among them. Even the age groups between 22 to 24 are affected, which is mainly due to changed life styles and suppression of diseases.  Things get more complicated when high BP is associated with high blood sugar, high cholesterol and obesity. When all these abnormalities blend together in the same person, it is called metabolic syndrome.

 

Normal range

In order to get the accurate BP, it should not be checked immediately after food, exercise, coffee, drinks, smoking, mental stress, etc. The subject should take rest for at least 5 minutes before checking. While checking, the cuff and the apparatus should be at same level of the heart of the subject. The handcuff should not be too tight or too loose (It should allow only one finger). It is also preferable to use same apparatus for comparing the BP variations on different occasions. Less than 120/80 mm of hg is considered as normal blood pressure, and it slightly changes with age, time, physical activities and various other factors. However, in a normal healthy person, it won’t go beyond the physiological limit. Doctor apprehension can also increase BP. This phenomenon is called ‘white coat hypertension’, wherein the BP reaches more than 140/90 in front of doctors, and other times less than 135/85. Studies show that stroke is common in white coat hypertensive individuals.

 

 

Types

Essential Hypertension: Here, there is no specific cause or organ involvement for the high BP. About 90 % of hypertension cases come under this category.

Secondary Hypertension: Here the BP increases as a result of some lesions. Only 10 % of cases come under this category. The causes include: kidney lesions, brain disease, diseases of thyroid, adrenal glands, and aortic coarctation. Renal hypertension may be due to diabetic nephropathy, renal artery stenosis and chronic renal disease. Secondary hypertension is the main cause of high BP among children. Congenital hypertension may be due to genetic causes and some congenital defects. Pregnancy induced hypertension is due to the changes taking place in the pregnant women.

 

Grades of hypertension

Depending upon the pressure reading, hypertension may be mild, moderate, severe and gross.

High BP has two stages:

Stage 1: 140- 159/ 90-99. Stage 2: >160/>100.

When the systolic pressure becomes high with a normal diastolic pressure, it is called ‘Isolated systolic hypertension’. In case of ‘pre hypertension,’ the blood pressure ranges between 120/80 to 140/90. Majority of cases come under this group, and they usually do not feel any troubles as a result of increased BP. As they are “normal” in look, they do not consult a doctor. And most of them develop some clinical features only when the lesions in the heart or kidney appear, or when they are about to have a stroke. Obviously, it is going to be a late diagnosis. Though most of the prehypertensive patients are asymptomatic, a few among them may have occipital pain, neck pain, breathlessness, heaviness of head, etc. Immediate treatment is recommended when blood pressure is above140/90. When the blood pressure reaches 160/100 or above 180/90, it is considered as dangerous.

 

Malignant hypertension: It is a complication of hypertension wherein the blood pressure reaches more than 200/140mm Hg. This is considered as an emergency condition, because here the high blood pressure results in complications in the eyes, brain, heart and kidneys. Papilledema is always found in malignant hypertension. Retinoscopy may show hemorrhage or cloudiness in the retina. As a result of increased intracranial pressure, there will be symptoms like severe headache and vomiting, associated with signs of subarachnoid and cerebral hemorrhage. The renal involvement results in hematuria, proteinuria, and even signs of acute renal failure. There is chance for left ventricular dysfunctions as a result of overload on the heart walls.

 

Predisposing factors

 

Even though there is no definite cause for essential hypertension, it is closely related with several factors:

 

  1. Hypertension is common among Type A personality: Highly ambitious, active, responsible, fastidious, and industrious.
  2. Genetic influence: If one parent has HTN, then 25% chance for the children to have high BP. If both parents have, then the chance is 60%.
  3. Stress: Mental stress, job stress, stress in the family, etc. Constant stress results in increased production of cortisone, adrenalin and nor adrenalin, which increases cardiac activity and narrows the blood vessels resulting in high BP.
  4. Menopause: The levels of estrogen starts decreasing during this stage, which in turn increases BP.
  5. Age: When the age advances, the blood vessels become hard, which favors high BP.
  6. Common salt: Increase in blood volume as a result of water retention by the sodium is responsible for high BP. About 30% of high BP is due to increased salt intake. BP is more in costal areas due to presence of more salt.
  7. Drugs: Sympathomimetic drugs, steroids, immunosuppressive drugs, painkillers, oral contraceptives, anti depressants, NSAIDs, etc. can increase blood pressure.
  8. Addictions: Tobacco products, alcohol, coffee, cocaine, etc. are linked with high BP. Smoking and drinking increases adrenalin levels in the blood. Smoking also narrows blood vessels and promotes atherosclerosis. When blood vessels are narrow, naturally, the heart has to work more powerfully; hence BP is increased.
  9. Lack of sleep: It increases the production of stress hormones and the sympathetic nerves get stimulated resulting in high BP. Sleep apnoea is also related with high BP.
  10. Obesity: Obesity is closely related with high BP. Weight reduction can reduce 28% of high BP. Reducing 5 kg weight can show marked improvement in BP.
  11. Blood sugar: Sugar increases the production of adrenalin, which in turn constricts the blood vessels.
  12. Fat: Excess of fat can narrow the blood vessels leading to high BP.

 

Clinical manifestations

When a patient comes with headache or vertigo, the first thing to suspect is high blood pressure. When his BP is high, the doctors feel relaxed, because the reason for high BP is diagnosed! We often come across some patients having no symptoms even though their BP is very high. Many patients come with vague symptoms like headache, vertigo, dizziness, headache, heaviness of head, weakness, loss of concentration, dim vision, anxiety, dyspnoea, palpitation, etc. The blood pressure of a person taking anti hypertensive medicine becomes high systolic and low diastolic, which is also common in old age. Patients also come with clinical features of some complications like stroke.

 

Complications

Actually, increased BP is a mechanism to maintain blood supply under situations that hinders normal circulation. If a person has high BP, it means that is body needs that. But, unfortunately, the increased pressure affects the organs adversely. Stroke can occur even among normotensive people, but more common in patients with hypertension. They have 4 to 9 times more chance for stroke than the normal people. Those who neglect high BP, there is 50% chance for having heart attack in future. Most of the hypertensive patients discontinue treatment when their BP becomes normal, and they also quit all restrictions told by the physician. Such people may come up with a stroke. A small percent of stroke cases also includes undiagnosed BP cases. Transient ischemic attack (TIA) is also common, which is actually a warning sing. But, many patients do not control blood pressure even after recovering from TIA, and finally suffers from permanent stroke resulting in Hemiplegia or quadriplegia or even death. Apart from stroke, high BP can result in heart attack, heart failure, left ventricular hypertrophy, hypertensive retinopathy, hypertensive nephropathy, benign nephrosclerosis leading to chronic renal failure, and hypertensive encephalopathy. Pregnancy induced hypertension affects the fetus as well as the mother. It can damage the placenta resulting in developmental anomalies. Abruptio placenta can also occur in hypertension. Hypertension during pregnancy can also result in convulsions and renal failure.

 

Some dangerous signs and symptoms associated with high Blood pressure:

  • Sudden confusion
  • Disorientation
  • Loss of consciousness
  • Changed mental state
  • Sudden and severe headache
  • Dizziness or incordination
  • Seizures
  • Facial drop
  • Epistaxis
  • Sudden visual problems
  • Sudden loss of vision
  • Retinal bleeding
  • Slurred speech
  • Neck stiffness
  • Breathlessness
  • Angina
  • Cardiac enlargement
  • Sudden numbness or weakness of extremities
  • Inability to raise arms
  • Tremors
  • Muscular incordination
  • Edema of extremities
  • Decreased urine output
  • Albumin and casts in the urine
  • Weakness

 

Prevention

 

It is very essential to maintain a normal blood pressure, because when the BP is normalized, we can reduce heart attack by 25%, and stroke by 40 %. An ‘Excess input’ can always favor high BP. Once we control all predisposing factors related with BP, it can definitely change the situation.

 

  1. Make life free from Hurry worry and curry.
  2. Avoid overuse of gravy, which usually contains salts, spices and oils in excess.
  3. Try to avoid fast foods and tinned items.
  4. Take nutritious diet in adequate quantity.
  5. We need only 5 to 6 gm of Nacl daily, but our intake is more. Hence, as a substitute for common salt, use a mixture of sodium chloride and potassium chloride. But renal patients should monitor potassium levels while following this method.
  6. The intake of salt should be restricted, but never stopped, because sodium is very essential for our existence.
  7. Adjust salt intake as per the BP levels.
  8. In case of an episode of high BP, avoid salted fish, pickles, papads, salted chips, etc.
  9. Take fruits and vegetables.
  10. Dietary Approaches to Stop Hypertension (DASH): This method really helps to normalize hypertension. This method suggests adequate quantities of fruits, leafy vegetables, other vegetables, germinated peas, non polished cereals, fat free milk, oils containing essential fatty acids, small fishes, lean meat, etc.
  11. Take oils containing omega 3 fatty acids.
  12. Avoid animal fats. Sunflower oil, rice bran oil, virgin oil, etc are better than other oils.
  13. Aerobic exercise is more useful than anaerobic heavy exercises.
  14. Regular exercise and walking can reduce BP.
  15. Avoid excess intake of coffee.
  16. Avoid drugs that result in High BP
  17. Avoid suppression of diseases right from the childhood.
  18. Meditation and yoga can also help.

 

Investigations

An occasional rise of blood pressure may not be significant. Hence, it should be monitored regularly. 24 hours ambulatory pressure monitoring is also very useful. The causes of secondary hypertension should be identified by different tests like RFT, USG, Echo, Angiography, CT scan, MRI, Hormonal studies etc. Retinoscopy is also a must in hypertension.

 

Homeopathic approach

 

The blood is a fluid connective tissue, specially organized to perform several functions in our body. The force needed for the blood to perform its function is the blood pressure, without that, the blood will not be able to perfuse. The combined action of cardiac muscles and the muscles of the blood vessels work for this. Their action is under the control of autonomic nervous system and the hormones secreted by the endocrine glands, which is under the control of the mind. So, homeopathic medicines that act through the Psycho-Neuro-Endocrino-Immunological axis can definitely cure hypertension.

 

Miasmatically, psora is expressed as a deficiency. Hence low BP is basically psoric in origin. Hypertension is the expression of sycosis, because ‘excess’ is the basic expression here. In sycosis, there is an incordination in body functions. Blood pressure is maintained due to the coordination between several factors that constrict and relax the blood vessels. Here the coordination is lost and it becomes excess. A sycotic person is narrow-minded. When the same narrowness affects the blood vessels, it leads to hypertension. Here the constriction from the mind goes to the vessels. Nowadays we come across even younger age groups having primary hypertension. They are the victims of sycotic miasm. These miasms gets transmitted to the next generations. Nowadays obesity is very common even in children. Matabolic syndrome is actually a blend of ‘excess’ in different systems. Excess deposition of fat and hypertrophy of organs are also sycosis. The sycotic individuals become edematous due to excess fluid collection. When the cases get complicated with syphilitic miasm, it leads to destruction. Most of the secondary hypertension cases are syphilitic in origin. Malignant hypertension, infarction, cardiac failure, nephropathy, retinopathy, stroke, etc are the expression of syphilitic miasm. Hypertension due to congenital defect is also syphilitic. Now a days most of the cases are presented with changeability in all aspects including blood pressure, which is a blend of miasms called tubercular miasm. They often come with hypertension followed by an episode of hypotension, hence create confusion regarding salt restriction and other medications. Involvement of blood and blood vessels is also a tubercular manifestation.

 

The aim of homeopathy is to treat the cause, i.e. the fundamental cause. Removal of cause also includes the external causes responsible for the progress of the disease and its complications. Some times, reducing BP is life saving, and we can do this with our own medicines. Apart from signs and symptoms, the plan of treatment in hypertension also depends upon the situation, because patients with hypertension come to us in different stages. High BP is identified in many cases coming for routine checkup. Other group includes those who come with symptoms of high BP, which mainly includes known cases of hypertension coming for follow-ups. Often we come across hypertension among those who comes to us for the treatment of an acute disease. Even acute emergency cases due to malignant hypertension, TIA and stroke may also come to us. A few patients come under the category of secondary hypertension, wherein the chief complaints are due to the basic pathology. Many patients discontinue treatment when the blood pressure comes to normal level, and they keep on taking some prescriptions we had given long back. These patients usually come across complications and create bad name for homeopathy. Hence, patients with this tendency should be identified and advised properly to prevent complications. Depending upon the type of case presented before us, the indicated medicine has to be administered in suitable potency and dose. Some times, the seemingly indicated medicine may not give any response, under such situations, we can use some clinical tips to handle the situation. A second opinion from our colleagues can also help in case of confusion. Some times, pathological prescription, organ remedies, so called specifics, etc. may be required to manage the cases successfully. These are actually the different levels of expression of the similia principle, because there are different levels of similarity! 

 

There is a close association between common salt and blood pressure, similarly, there is a close link between Natrum mur and many high BP patients, especially the asymptomatic group. When there are no symptoms to prescribe one particular remedy, we can consider Natrum mur. Other drugs like Aur met, Lachesis, Baryta mur, Glonoine, Verat virid, Gelsemium, Bell, Bothrops, coffea are some of the commonly used drugs on the basis of symptom similarity. When a person comes with sudden rise of BP, drugs like coffea can work magically. When the case is an acute emergency, a suitable medicine similar to the acute totality can manage the situation. While managing hypertension, we should not ask the patient to stop the anti hypertensive drugs abruptly, gradually tapering the dose is advisable. We can also handle the situation with mother tinctures as a substitute. Giving a tincture is far better than allowing the patients to continue some dangerous modern medical drugs. If we have our own tools, why should we depend on other systems? Even in prescribing tinctures, the concept of minimum dose works. You might have noticed better results with a few drops of tinctures than heavy doses mentioned in some books. Mother tinctures like Rauwolfia, Cratageus, Adonis vern, Allium sativa, Strophanhus, Spartium scop, etc. are useful to manage hypertension till we find out the individual drug. Most of the cases of High BP respond to Rauwofia, where as renal hypertension does not give result. Spartium scop is useful in renal hypertension and hypertension with edema, because it has diuretic properties. Inhalation of Amyl nitrosm Q can dilate the blood vessels. It is also indicated in angina and breathlessness. In all conditions where the blood vessels are spasmodically contracted, it gives relief.

 

But, we should always keep in the mind that the clinical tips and tinctures could work only on certain situations to manage the result of diseases. In order to treat the man as a whole, and to block the continuity of the real disease, the simillimum has to be administered in suitable potency and dose.

 

Conclusion

Treating an individual having hypertension is an art, because most of the BP patients keep on moving from one physician to the other. The success of treatment depends up on the selection of a drug similar to the acute totality, followed by the administration of the constitutional drug. Along with suitable remedy, a repeated and strong suggestions and advice regarding diet and regime is very essential. When the condition of the patient becomes worse even after trying different remedies in various potencies, it is mandatory to refer the case to a higher center. Definitely, it is not the failure of our system, but our own failure in selecting the true simillimum!

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Comment by Dr Muhammed Rafeeque on October 19, 2011 at 12:14am
Thanks for the comments.
Comment by Debby Bruck on October 18, 2011 at 1:14am

This article complements the BlogTalkRadio shows given by Dr Aadil Chimthalawala this month all about Hearth Health and Homeopathy. Very comprehensive. Thanks Dr Rafeeque

Dr Rajneesh has also written an article about Hypertension and Homeopathy

 

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