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Uccharakatchap is the most common maladies of mankind affecting about 20% of the population globally. About 600 million hypertensives in world are at the risk of heart attack stroke and cardiac failure. Primary question is whether hypertension was as much prevalent in ancient times i.e. time of Charka and Sushruta as it is in today’s life. The hypertension has excited from the time life exists in the universe because diseases like pakshaghata, mootra ghata, hridroga are well explained in our texts which are common complications associated with hypertension.
But definitely situation regarding the hypertensive problems was not so seroius as is shown by present day data regarding hypertension. The simple reason may be peaceful co-existence, natural food products in diet. Non-materialistic life style associated with increase physical activity of ancient times, on its contrary today modern life style is full of anxiety, stress and strain synthetic foods, sedentary life which all are responsible for bursting volcano of psychosomatic disease and especially hypertension.
Life style modification is the primary public approach in trying to reduce the prevalence of hypertension and the average blood pressure in the society. These modifications are non-pharmacological methods that are used for a number of complementary reasons outlined in the W.H.O. technical report on hypertension control. They are:
- To lower the blood pressure in the individual patient.
- To reduce the need for anithypertensive drugs and maximise their efficacy.
- To address the other risk factors present.
- For primary prevention of hypertension and associated cardio-vascular disorders in the population.
- Ahara, (food contents and practice)
- Vihara (personal and social code of conduct following)
Today’s life style modifications are nothing but revisiting the ancient principles of Ahara, and Vihara, likely to save more lives and prevent more myocardial infractions stroke and episodes of heart failure that can be prevented by using drugs in those who are already hypertensive. Though now it is scientifically and statistically establish that such practices are likely to save. Not all the steps required are confined to behavioural practices of potential hypertensives administration and society also needs to work on the part of reducing social occupational and environmental stresses.
- Primary life style modifications.
- Other life style modifications that are routinely.
- Those which are not routinely recommended.
Primary life style modifications
Weight Reduction
Obesity or fatness is an open invitation to various metabolic disorders including ucchraktchap (hypertension). Obese or sthula are considered as sick structure in Ayurveda which are prone to various diesaess such as swasa, jwar, udar roga,, prameha, urustambha, pitika, vidridhi, prameh-pidika, bhgander and vat-vikar. As Acharya Charak said Sthul Pramehi while describing the treatment of prameh shows that medo roga and prameh are highly associated diseases. It is scientifically proved that weight reduction of 5 kg reduces blood pressure in large proportion of hypertensive individuals who are more than 10% over weight and also has beneficial effect on associated risk factors wuch as insulin resistance diabetes, hyperlipidemia and left ventricular hypertrophy.
Exercise
Acharya Charak in Sutra Sathan chapter 17 on “ Non Suppression Of Natural Urges” defined that such a physical action which is diserable and is capable of bringing about bodily stability and strength is known as Vyayam (physical exercise). These exercises are to be practised in Ardhabal praman i.e they are to be practiced in moderation until they bring about lightness and perspiration etc. It is proved scientifically that even 20 minutes daily walk can reduce the risk of hypertension by 28% by decreasing cardiac output and peripheral resistance as well as modification in serum norepinephrine levels, insulin senstirity electrocyts balance, neural and baroreflex mechanism and vascular structure.
Moderation of alcohol
Acharya Charak in Chikitsa Sathan chapter 24 on “Treatment Of Alcoholism” explained that alcohol while reaching the hrdaya (heart) afflicts the ten attributes of ojas (located in the heart) by virtue of its ten attributes, giving rise to mental distortions. This ojas (vital essence) gets destroyed by excess intake of alcohol and causes morbidities in the heart and in the dhatus (sattva etc.) located in it. It is also proved that 10-20 gms ethanol for women and 20-30gms for men can lower blood pressure upto 8/4 mm of Hg in those who have more than five drinks per day.
Reduction in dietary salt consumption
Acharya Charak in Vimansathan chapter 1 on “ Specific Attributes Of Rasa” prohibited excess use of pipali, alkali and salt in diet. Excess use of salt produces fatigueness, weakness, lassitude, premature baldness, grey hair and wrinkles in the skin. It has been proved scientifically that high salt intake has been suggested to decrease levels of prostaglandins PGE2 and thus decrease blood pressure.
Increased consumption of fruits and vegetables
The diet should contain plenty of green vegetables and fruits since they contain few calories, while their bulk helps to full the stomach and provide statiety. They also help to minimize constipation common with a low food intake. It is seen that increased consumption of fruits and vegetable at least four servings per day can lower blood pressure by 6/3 mm of Hg and often help in reduction of salt consumption.
Stress Management
- A stress of 12 stretches in 20 min.
- A progressive relaxation technique 15 min.
- For meditation 15 min.
- For directed or receptive imagery 5 min.
To avoid or minimize the impact of excessive stress it will be highly beneficial to follow the principles of :
- Achara Rasayana.
- Sad vritta
- Sattvajaya
- And other rasayan measures including important physical and mental exercised prescribed by yoga.
Yogic therapy will be beneficial in the preventive treatment of Hridroygas. “Savasana” proved to be effective in hypertension. According to Acharya Charak one who has a positive combination of his thought, speech and action, who has his mind under control, who has his intellect clear and also possesses knowledge of soul and who is devoted to austerities and yoga never suffers from any disease.
By dosing Savasana the person relaxes with slow diaphragmatic breathing. It appears that this yogic exercise influ ences the hypathalmus through continuous feedback of slow rhythmic propriocepture and enteroceptive impulses. This sets the regulatory mechanism on the hypothalamus at a lower level and helps in reduction of blood pressure.
“Vajrasana” will strengthen “Muladhara”. Muladhara governs all the musculature and myocardium is also believed to be under its control.
Meditation versus relaxation
It is a technique for expressing conscious awareness and for reducing stress
and tension. All forms reducing stress and tension. All forms of meditations require physical immobility and some form of perceptual concentration. The concentration may be on an object, idea, image or on mantra. The most interesting finding is the reduction of blood lactate concentration. It is diminished during sleep and relaxed state of mind. It is increased when the person is tense and agitated.
Other life style modification that are routinely recommended
Stop smoking
Acharya Charak in Sutra Sathan chapter 5 on “Quantitative Dietetics” told that excessive smoking cause thirst, excessive bleeding, giddiness in the head and fainting. It has been proved that tobacco avoidance lowers cardiovascular risk independently.
Fish consumption
It improves lipid profile and cardiovascular risk.
Increased dietary fiber
Blood pressure may be lowered by increase in dietary fibre intake. High fibre diets are associated with greater fecal matter and electrolyte excretion
Not Routinely recommended
Dietary Ca and Mg Supplement
Acharya Charak suggested that heart disease is more common in areas with soft water than where the water is hard. Mineral such as Ca and Mg and trace elements like chromium and vanadium present in hard water appear to be protective.
Conclusion
Thus it is concluded that the treatment of hypertension should be aimed at complete Cure diseases not merely suppressing the vitiated doshas. Therefore treatment accompanied by non pharmacological parametere such as weight redaction, daily mild physical exercise, shavasana for 30 minutes twice daily and relaxation by meditation or dhayan is a new approach in the management of hypertension to get complete Cure of the diseases.
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