HYPERTENSION

AND
HOMOEOPATHic
approach
DR PUKHRAMBAM IBOTON SINGH
HOMOEOPATHIC PHYSICIAN (MHS-IV)
50-BEDDED INTEGRATED AYUSH HOSPITAL,
LAMPHELPAT
Hypertension also known as high or raised
blood pressure, is a condition in which the
blood vessels have persistently raised
pressure, putting them under increased
stress. The condition is said to arise when the
systolic blood pressure is equal to or above
140 mm Hg and/or a diastolic blood pressure
equal to or above 90 mm Hg.1
In India. 2,3 HTN is directly responsible for 57% of
all stroke deaths and 24% of all coronary heart
disease (CHD) deaths in India. 4
1 World Health Organization - Q&As on hypertension; Geneva, Switzerland: 2015[cited 30th May 2016. Updated
September 2015 ] Available at http://www.who.int/features/qa/82/en/
2 Leeder S, Raymond S, Greenberg H, Liu H. A race against time. The challenge of cardiovascular disease in
developing economies. New York:Columbia University; 2004
3 Srinath Reddy K, Shah B, Varghese C, Ramadoss A. Responding to the threat of chronic diseases in India. Lancet
2005; 366:1744–174
4 Gupta R. Trends in hypertension epidemiology in India. J Hum Hypertens 2004; 18:73–78
CLASSIFICATION 5
On the basis of aetiological involvement hypertension can be
classified into the following categories:-
1. Primary or Idiopathic: Due to almost unknown aetiology
which may be further categorised into:-
i) Essential hypertension (80-95% ): –
(a) Benign: – This is a most common type of hypertension
which mainly occurs due to familiar condition i.e. if both the
parents are sufferers, chances are higher.
(b) Malignant: – This occurs due to an untreated case of benign
hypertension.
(ii) Toxaemia of pregnancy:-This is also considered as an
essential hypertension.
2. Secondary Hypertension (5-20%) – This occurs mainly below
the age of 30 years and may be due to the under lying causes:
Under lying causes of Secondary Hypertension
1.Renal Causes:– Acute glomerulonephritis, Chronic glomerulonephritis, Chronic pyelonephritis,
Polycystic kidney, Renal tumour, Renal artery stenosis
2.Endocrinological Causes:–Thyrotoxicosis, Cushing’s syndrome.
3.Neurological Causes:-Cerebral tumour, Pseudo bulbar palsy, Bulbar poliomyelitis, Cerebro-Vascular
Disease
4.Metabolic Causes:- Diabetes Mellitus, Chronic Gout, Atherosclerosis
5. Iatrogenic Causes:- Use of oral contraceptives pills, Prolonged steroid therapy i.e. in bronchial asthma
6.Miscellaneous Causes:- Coarctation of aorta Psychogenic, SLE, Polyarteritis nodosa

Joint National Committee (JNC-VII) classification 6

Type Systolic BP(mm of Hg) Diastolic BP (mm of Hg)
Normal BP <120 <80
Pre 120-139 80-89
Hypertension
Stage –I 140-159 90-99
Stage - II >160 >100

5. Hart, JT (1980).Hypertension. Library of General Practitioner Series by Churchill Livingstone.

6. Martin J. Hypertension guidelines: Revisiting the JNC recommendations, The journal of Lancaster general hospital, 2008; volume 3(3):91-97.
Predisposing factors
Even though there is no definite cause for essential hypertension, it is closely
related with several factors:
1. Type A personality: Common among Type A personality. Highly ambitious, active,
responsible,fastidious, and industrious.
2. Genetic influence: One parent -25% .Both parents - 60%.
3. Stress: Mental stress, job, family, etc. Constant stress results in increased
production of cortisone and adrenalin, which increases cardiac activity and
narrows the blood vessels resulting in high BP.
4. Menopause: Estrogen starts decreasing which in turn increases BP.
5. Age: Age advances, the blood vessels become hard, this favours high BP.
6. Common salt: Increase in blood volume as a result of water retention by the
sodium is responsible for high BP.
7. Drugs: Steroids, immuno-suppressive drugs, painkillers, oral contraceptives, anti
depressants, NSAIDs, etc. can increase blood pressure.
8. Addictions: Tobacco products, alcohol, coffee, cocaine, etc.
9. Lack of sleep: It increases the production of stress hormones . Sleep apnoea
10. Obesity/Fat: Excess of fat can narrow the blood vessels leading to
high BP.
CLINICAL FEATURES
The symptoms of hypertension are usually variable and at times very vague.
There may be no symptoms and the disease may be diagnosed accidentally
during routine examination. Due to a wide range of variability of clinical
features of hypertension, it can be categorized into three stages:-
1. Hypertension: – This may be mainly asymptomatic.
2. Hypertensive disease: – During the attacks the symptoms are usually
psychogenic but some common symptoms are also present such as: a.
Headache, often occipital and occurring in the morning b. Easy fatigability,
c. Insomnia, d. Lack of concentration e. Loss of memory, f. Breathlessness,
g. Occasional palpitation.
3. Hypertensive disease with complications:-At a later stage as different
target organs of the body are involved, various additional sign and
symptoms may develop usually as a part and parcel of complication. The
main target organs are heart, brain, kidney and eyes.
Acute Complications: Cerebral haemorrhage , Hypertensive encephalopathy,
SAH, Acute MI, Acute LVF
Chronic Complications: Angina pectoris, Congestive cardiac failure, CAD, CRF
 Prevention
It is essential to maintain a normal blood pressure, because when
the BP is normalised, we can reduce heart attack by 25% and
stroke by 40 %. An ‘Excess input’ can always favour high BP. Once
we control all predisposing factors related to BP, it can definitely
change the situation.
1. Make life free from Hurry worry and curry.
2. Avoid overuse of gravy, 3. Avoid fast foods and tinned items.
4. Decreased salt intake, 5. Healthy Diet, 6. Avoid animal fats
7. Regular exercise , 8. Avoid excess intake of tea and coffee.
9. Avoid drugs that result in high BP
10. Avoid suppression of diseases right from the childhood.
11. Meditation and yoga can also help.
Investigations: Routine investigation of the hypertensive patient
should include: a. Chest X-ray, b.ECG, c. Echocardiogram, d.
Urinalysis, e. Fasting blood for lipids and glucose, g. Serum urea,
creatinine and electrolytes
MANAGEMENT
Unless the patient has severe or malignant hypertension, there should be a
period of assessment. During the assessment period secondary causes of
hypertension should be excluded, the target organ effect of hypertension
should be evaluated, and any concomitant conditions (e.g.dyslipidaemia or
diabetes) identified. The assessment period is in three stages-
1. Repeated blood pressure measurement combined with advice
2. Non pharmacological treatment and management depends upon the lifestyle
modification and (i) Non-modifiable risk factors: (A). Age (B). Sex (C). Genetic
Factors (D). Ethnicity (ii) Modifiable risk factors: (a). Obesity (b). Salt intake
limit salt intake to 6 grams per day. (c). Alcohol Consumption (d). Physical
activity . Behavioral techniques, meditation and yoga should be promoted. All
these factors are considered as modifiable risk factors by WHO, because just
modifying these can control a vast majority of hypertensive cases.
3. Pharmacological treatment and management: The decision to commence
drug therapy should usually be made only after a careful period of
assessment. The aim of drug treatment is to reduce the risk of complication
of hypertension which should be carefully explained to the patients.
 Homoeopathic Approach
The blood is a fluid connective tissue, specially organised 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 the autonomic nervous system and the hormones
secreted by the endocrine glands, which is under the control of the mind.
Individual Drug Response Approach: Homoeopathic treatment depends upon the
symptom syndromes of the disease condition and individual character of the
patients. As the disease is severe and related to severe complications, its
management is also essential. There are certain drugs which may be helpful for the
management of cases of hypertension with or without constitutional medicines
depending upon the nature and degree of disease condition such as.
i) Natrum Muriaticum-Tachycardia with intermittent pulse < when lying down.
Fluttering palpitation which shakes the whole body. This drug is recommended as
the best remedy in high potency for Essential Hypertension where taking too much
salt is the main etiological factor.
ii) Rauwolfia Serpentina-This is known as a general remedy for hypertension. This
drug is more beneficial for systolic hypertension than the diastolic one. This drug is
recommended as the best remedy for systolic hypertension where anxiety is the
main aetiological factor.
iii) Convallaria Majalis– Palpitation from least exertion. Tobacco heart
especially due to cigarette smoking. Hypertension with marked
dyspnoea especially orthopnoea.
iv) Baryta Muriatica– This drug is highly effective in systolic hypertension
where arterio-sclerosis is the main aetiological factor. Increased
tension of pulse where a high systolic pressure with a comparatively
low diastolic pressure is attended with cerebral and cardiac symptoms.
v) Aurum Metallicum– Palpitation with rapid pulse. Hypertension due to
arterio-sclerosis. According to William Boerick 30 potency is quite
effective.
vi) Uranium Nitricum– Hypertension with degeneration of vital organs
like liver and kidney. The therapeutic keynote symptoms are great
emaciation, debility and tendency to ascites with general dropsy.
vii) Lycopus Verginicus – Lowers the blood pressure, reduces the rate of
heart and increases the length of systole to a great degree. In cases of
thyrotoxicosis where pulse pressure is high and heart action is rapid, in
physiological dose (further research required).
viii) Allium sativa - Useful in hypertension along with history of
raised cholesterol.
ix) Amyl nitrosum - Useful in hypertension associated with angina;
can dilate the blood vessel.
x) Glonoine - High blood pressure from bad effects of sunstroke.
xi) Viscum album - Useful in renal hypertension.
xii) Craetegus - Heart tonic, lowers down the blood pressure, for
arteriosclerosis and angina pectoris, has a solvent power upon
the crustaceous and calcareous deposits in arteries.
Conclusion
As per homoeopathic philosophy any drug can be indicative for
the case depending upon the totality of symptoms Along with
suitable remedy, a repeated and strong suggestions and advice
regarding diet and regime is very essential.
Research in homoeopathy16,17,18,19,20,21,22,23,24 on hypertension shows
benefits from medication however long term benefits require to
be studied.
Research in homoeopathy16,17,18,19,20,21,22,23,24 on hypertension
16 Mehra P. Usefulness of homeopathy in essential hypertension: an exploratory
interventional trial. Homeopathy,Jan2014 ;103(1): 88
17 Poruthukaren KJ, Palatty PL, Baliga MS, Suresh S.Clinical evaluation of Viscum album
mother tincture as an antihypertensive: a pilot study,Eur J Heart Fail. 2003 Jun;5(3):319-26
18 SchröderD, WeiserM, KleinP.Efficacy ofa homeopathic Crataegus preparation compared
with usual therapy for mild (NYHA II) cardiac insufficiency: results of an observational
cohort study.JEvid Based Complementary Altern Med. 2014 Jan;19(1):31-5
19 Saha S. Koley M , Hossain S I , Mundle M , Ghosh S , Nag G , Datta AK, et al.
Individualized homoeopathy versus placebo in essential hypertension: A double-blind
randomized controlled trial,Indian Journalof Research in Homoeopathy 2013:7(2):62-71.
20 Baig H, Singh K, Sharma A, Kaushik S, Mishra A, and Chugh S. Essential Hypertension.
Clinical Research Studies - Series II,CCRH. 2009:29-41
21 Lakhera BC, Dhawan IM, Manjushree, Kaushik S, Mishra A, and Chugh S. Essential
Hypertension (Drug related study) Clinical Research Studies-Series II. :CCRH.2009:43-9
22 Rastogi D.P. , Baig H. Rauwolfia serpentina (Aqua): A New Approach in the Treatment of
Hypertension in Homoeopathy:CCRH.1996: 18(1&2):22-24
23 A. Mahmoudian. Homeopathy effect on high blood pressure, Journal of Research in
Medical Sciences. 2004: Vol 6:315-316
24 Singh R. K., Kasliwal R.R. Efficacy of homoeopathic drugs in the treatment of essential
hypertension: A study in a specialized cardiac hospital; Focus on Alternative and
Complementary Therapies. 2003:8(4)
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