Prevention and management of hypertension w . s . r . to Ayurveda : review article

Ayurveda is not only an ancient medical science but it is a complete life science.The main aim of Ayurveda is to maintain the health of a healthy person & to cure the disease of diseased person. From last few decades due to globalisation there is drastic change in working pattern, dietary habits & lifestyle. According to a new research, lifestyle diseases replaced traditional health risk factors resulting in an increase in incidents of diseases & deaths in India in the last two decades. Now most of the diseases & deaths are caused by High Blood Pressure, high cholesterol, obesity, alcohol use and poor diet. Unhealthy lifestyle is the root cause of many diseases broadly termed as lifestyle disorder. Hypertension is the most common lifestyle disease affecting population all over the world. About 26.4% of the world adult population in 2020 had hypertension and 29.2% were projected to have this condition by 2025. India is labeled as global capital of hypertension. The Ayurveda concentrates on achieving the promotion of health, prevention and management of disease for a healthy and happy life in the ailing society. The principals of Ayurveda are focused on maintaining good health by good diet and good lifestyle. Proper dietary habits, proper exercise, Yoga, Meditation along with Ayurveda herbs can be beneficial to balancing of mind, which reduce stress and maintain the blood pressure. The present review article is aimed that the planning of proper herbal medications as per Ayurveda guidelines will definitely control the high blood pressure without any hazardous side effects of drugs.

as global capital of hypertension. The Ayurveda concentrates on achieving the promotion of health, prevention and management of disease for a healthy and happy life in the ailing society. The principals of Ayurveda are focused on maintaining good health by good diet and good lifestyle. Proper dietary habits, proper exercise, Yoga, Meditation along with Ayurveda herbs can be beneficial to balancing of mind, which reduce stress and maintain the blood pressure. The present review article is aimed that the planning of proper herbal medications as per Ayurveda guidelines will definitely control the high blood pressure without any hazardous side effects of drugs. INTRODUCTION Hypertension is described as a metabolic disorder having multiple aetiologies. Hypertension is one of the most common lifestyle diseases today. Every third person is having suffering from it. Even kids can be victims of Hypertension. About in 90% patients there is no known cause for hypertension and this is very important to be alert. Blood is driven through the arteries at a considerable pressure. If there were no pressure, there would be no circulation. It is highest when the heart contracts (systole) and lowest when it relaxes (diastole). In a healthy young male (adult) & the normal pressure at systole is 120 mm Hg. It is often a little lower in female. The blood pressure tends to rise with age. 1 Blood pressure is the pressure exerted by blood on the walls of blood vessels. It is characterised by increased systolic and diastolic blood pressure i.e. elevated BP. This also causes changes in large arteries. There is thickening of the media, increase in collagen and secondary deposition of calcium. These changes results in loss of arterial compliance which in turn leads to more pronounced arterial pressure wave. Endothelial dysfunction with alternations in agents such as Nitric oxide and endothelins appear to be involved. Left ventricular hypertrophy and changes in renal vasculature can also be seen. 2 Transition of our ancestors from primarily diurnal standard of living to unhealthy diet habits, physical inactivity, excess workload, increasing mental stress, addiction of drugs, intake od alcohol & smoking & also the habit of sophisticated life style in developing countries are major contributors in the growing incidence of Hypertension. 3 An estimated 1.13 billion people worldwide have hypertension mostly twothird of them living in low and middle income countries.
It is a major cause of premature death worldwide. One of the global targets for non communicable diseases is to reduce its prevalence by 25% by 2025. 4 It has become a serious health problem with continuously increasing rates of prevalence & mortality by increasing the risk of heart, brain, kidney & other diseases. 5 According to Charakacharya, sometimes neither it is possible nor it's necessary to identify a disease by a name an Ayurvedic physician should attempt to construct the Samprapti (Pathogenesis) of a given clinical condition on the basis of signs, symptoms and investigative findings in each case and should plan the management accordingly.
The disease Hypertension is abnormality of Rakta Dhatu, (Blood) and is popularly known as Shonit Dusti (Vitiated Blood). The unique category of clinical presentation comprising RaktaPitta. (Abnormal bleeding from different roots of the body) Rakta Pradara (excessive vaginal bleeding), RaktaMeha (Hematuria) etc. and Vat Rakta (Group of vascular disorders with Gouty Arthritis) and some of mucosal inflammations as Mukhapaka (Oral Ulcers), Akshiraga (Redness of Eyes) Upakushaand pootigrahaare also regarded maladies of Shonita Dusti (vitiation of blood). Shiroruka (Headache) Klama (Nausea, Vomiting), Anidra (sleeplessness), Bhrma (imbalance of the body), Buddi Sammoha (Slugishness in Intellects), Kampa (Tremors) etc. Also it is interesting to note that all these symptoms are akin to manifestations of hypertension. More to add, Mada (Delerium), Moorcha (Stupor) and Sanyasa (Coma), the different diseases caused by Shonita Dushti (vitiation of blood) are described also as progressive manifestation of increasing Shonita Dushti. So also, such a sequele is equally true in relation to malignant Hypertension. All these deliberation corroborates parlance of the Shonitadusti and its different clinical manifestation of Mada Moorcha and Sanyasa to the essential Hypertension as well as Malignant Hypertension.
The essential hypertension when thought adapting the principle of Dosha, Dhatu and Mala theory pathology seems to be centered on Shonita Dhatu and Tridosha. there is a need to understand the cause, pathogenesis, acuteness, chronicity, complication and Symptomatology of the disease & its holistic management.

Ayurveda Approach to Hypertension
According to Ayurveda, high blood pressure involves all three Doshas, the heart, and the blood vessels. In high blood pressure we can see signs and symptoms of disturbance of Vata dosha that mainly of 'Vyana vayu'. The treatment is also on the basis to correction of the balance of Vata dosha. Pitta dosha vitiation is also seen often and it should be treated. People with Pitta and Vata predominant constitution are more prone to hypertension than any other. Unprocessed anger, frustration, irritability, anxiety and fear are leads to mal-adaptation of the endocrine system, which leads to conditions like hypertension. Some Ayurveda scholars are correlate hypertension with the Raktagata vata. According to Maharshi Charaka, it is not essential to give a specific name to the every disease. In those conditions the physicians should treat the patient to be considering the nature of disease, its sites, etiology and Dosha-dushya sammurchhana.

Shamana Chikitsa
The following drugs (single/compound drugs) are commonly used for prevention

e. Marecha (Piper nigram) 24
Chemical constituent: Piperine, Piperidine, Piperttine, Chavicine Marecha is having Chedana property which is very useful in dissolving the blockages and releasing the pressure of blood on arterial walls. Marecha is very powerful substance so, used in very less quantity as a medicine.
f. Jeeraka (Cuminum cyminum) 25 Chemical constituent: Cumaldehyde Jeeraka is Vikrutakaphavatahara also Raktashudhikara. Hence, used in hypertension. Also the property Mutrala of Jeeraka gives significant antihypertensive effect without any side effect.Therefore, Jeeraka can safely recommended for longer period to the patients of mild to moderate hypertension mainly associated with fluid retention.

Yoga & Meditation in HTN:
Excessive mental, emotional and physical stress can get worse the symptoms of many chronic disorders, including hypertension. This is due to the cause of hormonal changes and other biochemical responses to stress. That can imbalance the nervous system and depress the healing ability of the body.