The critical Review on Hypertension:An Ayurvedic perspective

Hypertension is lifestyle disease that is characterized by abnormally high arterial blood pressure that is usually indicated by an adult systolic blood pressure of 140mm Hg or greater or a diastolic blood pressure of 90 mm Hg or greater¹.Hypertension results from a variety of reasons like stress, obesity,genetic factors,over use of Salts in diet and ageing.As we all know, Hypertension is called a silent killer because it rarely exhibit symptoms before it damages to the heart, brain or kidney.In 2019 , the global age standardized prevalence of hypertension in adults 30 -79 yrs was 32% in women and 34% in men².It has been found that the percentage of hypertensive patients is rising sharply in spite of number of antihypertensive drugs in modern medicine.In Ayurveda hypertension is neither denoted in samhita nor in any sangraha , acharya charak mentioned in samhita that all vyadhi not need to be denoted by name but dosha is a reason for developing various types of disease. In Ayurveda basic principal of treatment is sampraptibhanga occurs due to dosha, dushya etc.The cause of hypertension is Raktadushti, which also involves the Tridosha, with a strong vata and pittadosha influence. Here, a sincere effort is made to identify the Ayurvedic cause of essential hypertension. This article aims to provide some light on the clinical understanding of Essential Hypertension (EHT) in terms of the patient's clinical symptoms based on Ayurvedic principles, as well as provide insight into Ayurvedic pathology.

KEY WORDS:-  Essential Hypertension, lifestyle disorder,dosha, Ayurveda

The pressure exerted on the wall of arteries by the strength of the contraction of the heart is called blood pressure³ Hypertension (HTN) When the blood pressure is elevated without an evident cause, it is called as Essential hypertension (EHT). HTN produced by an identifiable cause is called Secondary hypertension being a chronic non-communicable disease constitutes an important public health challenge because of its prevalence and concomitant increase in the risk of cardiovascular diseases⁴.The World Health Organization (WHO) has identified India as one of those nations that is going to have most of the lifestyle disorders in the near future⁵.It's estimated that 600 million people are affected worldwide with have hypertension. By the year 2025, approximately 1 in 3 adults aged over 20 years, totally 1.56 billion people worldwide people have hypertension⁶. In Ayurveda there is no description of such a single disease which can resemble with hypertension. As per Ayurvedic principles, in case of unknown disease, the physician should try to understand the nature of the disease through Dosha, the site of manifestation, etiological factors and then should initiate the treatment. So, it becomes necessary to studythe factors which are involved in hypertension and find the effective therapy for the same⁷.Hypertension it can be said that manas dosha Raja and Tama are also.important factors in EHT. Since chinta, Bhay, Krodha etc. Manas bhavas are etiological factors in EHT Dushyaras, Raktadhatu plays important role in pathogenesis of hypertension⁸.The Symptomatology quoted under Raktapradoshaj rogas by Acharya Charak almost coincides with signs and symptoms of essential hypertension among those bhrama (vertigo), shirshool (headache), hriddrav (palpatation), klama (exhaustion without any exertion) etc are common symptoms⁹. Though hypertension may remain symptomless in most of the population, some symptoms are seen in patients. If classification of etiological factors (Hetu), symptoms (Lakshana) and pathogenesis (Samprapti) is done on doshanubandha basis then two set of conditions are seen. One is Kaphanubandhi with Vata dominance (pradhanya) and another Pittanubandhi with Vata dominance (Pradhanya). Therefore, as the science advanced the Ayurvedic physicians and workers also tried to find out the cause and the treatment of Hypertension. Some of them are: Raktagata Vata, Siragata Vata, Avrt Vata, Dhamani Pratichaya, Rakta Vridhi, Rakta Vata.In all different opinions one can said that in Ucharaktachapa –Hypertension the main pathogenesis occurs in Rasa-Raktadhatu, Hridaya and Shira or Dhamani. It is considered as Psychosomatic and Vata Pradhana Tridoshaja Vyadhi. So, one should consider this disease on the basis of symptomatology and basic principle of Ayurveda.Many researches have been carried out on HTN to evaluate the proper diagnosis and treatment modality according to Ayurveda but still a widely acceptable theory is not available.

Ayurveda views hypertension as a complex condition resulting from doshic imbalance and lifestyle factors. The primary dosha involved is Vata, with Pitta and Kapha playing secondary roles. Causes include stress, mental tension, poor diet, digestion, sedentary lifestyle,

family history, and excessive salt consumption. Symptoms manifest as headaches, dizziness, fatigue, palpitations, and nosebleeds. Ayurvedic treatment focuses on restoring balance through Panchakarma (detoxification and rejuvenation), herbal remedies (ashwagandha, arjuna, and hawthorn), dietetics (low-sodium, high-potassium diet), yoga, and stress reduction (meditation, pranayama, and asanas). Lifestyle modifications, such as regular exercise and stress management, are also emphasised. Hypertension results from a combination of factors, including improper lifestyle and food habits, psychological stress, and genetic predisposition, which disrupt the balance of the three Doshas. This disruption triggers the pathogenesis of hypertension through mechanisms such as Anya Dosha Avarana and Anyonya Avarana. Fortunately, modern medical advancements enable early diagnosis.

allowing for effective management and prevention of damage to vital organs. Hypertension can be understood as a psychosomatic haemodynamic condition characterised by the vitiation of Vata-pradhana Tridoshas, affecting Rasa-Rakta Dhatus and impacting both physical and mental well-being. The condition has its roots in Sarva Shareera and Manas, with long-term complications leading to structural changes in organs like the heart, blood vessels, and kidneys.

The disease hypertension is not a single disease entity; rather, it is a common presentation of a wide spectrum of pathological processes. To devise treatment of hypertension as per Ayurveda, the various pathological components (Samprapti), like Dosha, Dushya Srotas, etc., should be examined properly. These pathogenetic factors should be addressed properly with special consideration of the strength of the disease and the diseased while treating hypertension.

Thus, hypertension can be understood as a psychosomatic haemodynamic condition where Vata Pradhana Tridoshas and Mana are vitiated and affecting the Rasa Rakta Dhatus as Dushyas with both the entire body and mind.