Blood Pressure-Better Safe Than Sorry!

High blood pressure is a killer disease because it may lead to heart attack or stroke. Even low blood pressure can be life-threatening. Today abnormal BP is more of a lifestyle disorder than an inherent disease. Thus some modifications in life here and there work well for most people. It makes more sense to play safe early than be sorry later.

Blood flows through arteries till the extremities from the heart. The arterial walls are elastic and made up of elastic muscles. When the heart pumps blood, the red life-saving fluid moves through the arteries, via peristaltic movement. (Peristalsis is the squeezing and relaxation movement, of arteries in this case.) This involves certain amount of pressure from the heart, which is called as normal blood pressure.

If due to some obstruction, the heart is not able to push that blood then it is said that the blood pressure is higher than normal. The signal goes to the brain and it instructs the heart to increase the pressure to pump the blood. Thus results high blood pressure.

Low blood pressure is when the circulatory system encounters blood pressure that is lower than average. While flowing through the arteries and veins blood exerts pressure on the walls of the vessels. Following Newton’s Third Law of Motion, the walls of the vessels also exert pressure on the blood propelling it through the circulatory system. When this pressure becomes low, the blood flows less efficiently while traveling to tissues and back to the heart. This is called low blood pressure.

Measurement: While measuring the BP a doctor using a mercury Sphygmomanometer, wraps the cuff or the cloth over the patient’s arm and pumps air into it. What the doctor is actually doing is raising the pressure on the mercury inside the instrument to the maximum i.e. 300 mm. Then she gradually lowers the pressure while listening via the stethoscope or by checking the pulse, for what is called the Korotkoff sounds. This point is called the systolic blood pressure. The pressure on the mercury is further reduced until these sounds stop eventually. This point is the diastolic blood pressure.

Normal BP for a full-grown adult human being is 120/80. General Physician, Dr. Namrata Rao, when asked, if she was still using the analogue instrument, replies, “It is going to be slowly phased out and replaced by an electronic manometer instrument because mercury is toxic.”

Changes according to age/gender: The systolic BP rises after the age of 40. According to Dr. Namrata, “Though gender, usually does not make much of a difference, though the BP in a normal male of the same age would be more than the one for a female.”

Today there is a decrease in the age-group in which there in an increase in blood pressure. Dr. Namrata blames the lifestyle of the people in the age-group of 30-35, who encounter BP problems. Currently there is a higher incidence of BP levels. According to Dr. Namrata, “BP is one of the lifestyle diseases as we call it. We come across patients with one of the metabolic syndromes due to limited physical activity, unhealthy food habits, etc.”

Causes: BP may increase or decrease due to external/internal factors, but that does not necessarily mean that the patient has high/low BP. Regarding this Dr. Namrata says, “Physiological changes causes change in BP. The stress hormone cortisol levels are high early in the morning so BP is more then. The cortisol levels follow the circardian rhythms. Anxiety and excess of salt intake also causes high BP.”

Primary hypertension: Other factors help correctly diagnose that a patient has high/low BP. Dr. Namrata says, “ Additionally, morbid conditions like diabetes, excess of salt intake and inadequate physical activity are the additional requirements to conclude that a patient has high BP. Also in separate readings if the BP is high, then we conclude that the patient needs medications. This is called primary hypertension. Stress and anxiety can also increase cortisol levels in the body, which increases the blood pressure as well.”

Secondary hypertension: There are certain conditions like Cushing Syndrome, Thyroid problems both hypo and hyper, etc., when the BP may increase. This is called secondary hypertension.

Treatment: Managing BP has certain medico-legal connotations. In all types of treatments, first lifestyle modifications, increase in activity, less salt intake (not more than 1 teaspoon a day), etc. are recommended, says Dr. Namrata. She adds, “In most cases the BP gets controlled if these changes are brought about in life. We go for medicines only when the above don’t work.”

Alternative healing: Ayurveda Vachaspati, Dr. Nanasaheb Memane insists on treating the root cause and controlling the emotions to treat blood pressure. He says, “Basically, Ayurveda functions on the concept of tridosha-vata, pitta and kafa. Blood pressure is due to vata or pitta doshas. Vata has the character of hardness and pitta has the properties of heat and fluidity. So there maybe two reasons why there is blood pressure-when the lateral walls become hard and the other when the blood has the property of too much liquidity. This is just one aspect of it. Vata also affects the 3 emotions-bhaya (fear or insecurities), shoka (sadness) and Kama (desires). The first 2 emotions affect negatively. The pressure goes down. Kama on the other hand increases blood pressure. Krodha (anger) also increases blood pressure. Rajasic food also increases blood pressure. A holistic view is taken. The patient’s facial signs and the pulse itself can give a good indication of what health problems she is going through. Asking the patient questions about her lifestyle confirms the initial diagnosis. All these factors together determine the treatment.”

Homeopath Dr. Kirti Mutreja says, “We first find out the history of patient, with mental and physical make-up. We then try to find the root cause, like for example, kidney problem, etc. We then give them plant or mineral extracts, i.e. mother tinctures, to immediately bring down the BP, in case it is high. The medicine changes according to the root cause and the manifestation or associated symptoms like headache in the patient with high BP. In patients with low BP, with symptoms like giddiness or vertigo, we try to increase the immunity and stimulate the patient. This has to be complimented by a good diet, since sometime the cause of the blood pressure could be faulty diet. At the same time we try to make sure that there is no reversal of the condition-high or low pressure.”

Unani Hakim Zafar Iqbal, from the pharmaceutical company Hamdard, insists, “Quran has a lot of information on different plant products to be used to treat different health conditions. The researchers relied on pure intuition to decide the treatment for different diseases. Pure extract was mixed with honey to get the right effect. We try to catch the root cause of the problem. For example, if it is primary hyper tension (High BP) due to hyper cholestremia the result is narrowing of the arteries. We give them lipotab, aslufene, etc. The effect is similar to sorbitrate, when there is a sudden reduction in BP. This in turn results in relaxation of the heart.”

Naturopath, Munveer Kaur says, “The concept of naturopathy is based on the use of a variety of treatment modalities, which varies as per training and scope of the practice. The demonstrated efficacy and scientific rationale also varies. I use an integrated approach where I use the natural elements (the Five Mahabhutas) to overcome the imbalances of the body by eliminating the toxins from within and restoring the functioning of important organs of body like digestive and circulatory system; along, with fitness, relaxation and meditation.  The study of lifestyle and Nutrition plays a very important role because High Blood Pressure is not a disease of separate identity and it usually appears as a symptom of other diseases; also, could be called as a disease of modern life. Similarly, High Blood Pressure could also be due to excessive mental work and tensed daily routine, wrong eating/living habits and competitive lifestyle.”

According to Munveer, naturopathy is different from Ayurveda and Homeopathy, which use naturally available materials as plants and their extracts for treatment. She adds, “Under Naturopathy, we use no medicine, only nature i.e., the Panch Mahabhutas to enhance the functioning of the organs and allow the body to heal itself without administering anything. The Main aim is eliminating the toxins. Healthy lifestyle is adapted and good knowledge of healing nutrition is emphasized. Fitness has lots of importance with well balanced mind-body co-ordination.”

Diet: Dietician Sonal Rastogi Bhoocher considers factors like excess weight, high cholesterol levels, high alcohol intake or high sodium intake have a direct impact on the blood pressure. She adds, “These factors are mainly governed by one’s diet and lifestyle. Hence, diet plays an important role in maintaining blood pressure. BP can be easily controlled by bringing about some healthy changes in one’s diet.”

According to her, Dietary Approach to Stop Hypertension (DASH Diet) is a specially designed intervention that aims in controlling hypertension. She adds, “It encourages a high intake of fiber (fruits, vegetables and whole grain cereals and pulses) and low intake of fats. DASH diet recommends limiting salt intake to 3/4th of a tsp a day. DASH diet also helps in shedding off those extra pounds and reducing the cholesterol levels.”

She recommends the following diet for hypertensive patients:

• Increase the intake of fruits, salads, green leafy vegetables
• Increase intake of whole grain cereals and whole pulses.
• Say no to table salt.
• Limit the alcohol intake.
• Limit the intake of caffeine rich drinks.
• Limit the intake of pickles and sauces.
• Limit the consumption of processed and packaged foods as they are high in sodium content.
• Check the food labels for sodium content.

On the other hand, low blood pressure referred to as hypotension can be avoided, by eating small and frequent meals. In case of sudden episode of hypotension, one should be immediately given caffeine like coffee or tea.

Yoga: Vishal Verma, a corporate yoga trainer opines, “There are numerous risk factors for high blood pressure connected to lifestyle. If you cannot sit and bend over to touch your toes, you might be at a risk for heart attack or stroke. It means that the flexibility of your arteries has been lost and they have become stiff and rigid. Normal arteries are healthy, flexible and they have elasticity, thus keeping the blood pressure normal.”

He maintains, “Yoga stretches start a physiological chain reaction. As a result, age-induced arterial stiffening slows down or is thwarted. Muscles are made flexible due to collagen and elastin and when stretches stimulate the production of these, arteries are also kept flexible, thus the risk of heart disease and stroke comes down.”

He adds, “Reduced stress will reduce stress hormones and will in turn reduce blood pressure. By inducing deep relaxation in the body, Yoga lowers blood pressure naturally. This is linked to reduced nervous system activity. There is also a sense of well-being, maybe due to higher levels of antioxidants and lower levels of cortisol. Stress management and staying active are the keys to keep your BP within a healthy range.”

According to him, standing positions are recommended for people with high BP. But avoid inversions like Downward-Facing Dog and Headstand. He says, “When the heart is lower than rest of the body, gravity pulls the blood down and BP increases. This can be dangerous for people with high BP. Similarly, people with low BP should avoid inversion. When head is at a lower level than the heart with low blood pressure, the blood readily rushes to the head. When the head is lifted, the blood speedily leaves the brain causing of dizziness and nausea. We would advice students with BP to train under yoga experts.”

Recommended Pranayams for High BP are Bharamari or (Humming Bee Breath), Sheetli/ Sheetkari, while the asanas are Pawanmuktasana and Bidal asana (Cat pose). On the other hand, for low BP the recommended Pranayams are Bhastrika Pranayama (Bellows Breath) to be done on light stomach, Suryabheda (at least 10—15 times a day) and Kapalbhati, while the asanas are Suryanamaskars, Uttanasana (Standing Forward Bend) into Tadasana and Dynamic Halasana.

This article was first published in Eve’s Times magazine and has been reproduced here with the permission of the editor, Swati Amar.