DEFINITION OF HYPERTENSION
Hypertension is the medical name for high blood pressure.
HISTORICAL REVIEW OF HYPERTENSION
Blood exerts pressure. That fact was first discovered by the English physician William Harvey (1578–1657) in the 1600s.
Until nearly a century later, no one actually tried to measure blood pressure.
The English clergyman and physiologist Stephen Hales devised the first blood pressure measuring device. He cut open the blood vessel in various animals and inserted a metal pipe into the vessel. He then connected the pipe to a long glass tube. Blood was pushed out of the vessel into the glass tube. The blood rose to different levels in the tube for different animals.
It took another century for physicians to find a way to take blood pressure without actually cutting into a blood vessel.
In 1876, the German physician Samuel Siegried von Basch (1837–1905) invented the first sphygmomanometer.
DESCRIPTION OF HYPERTENSION
The two stages of high and low blood pressure have special names-
Systolic Blood Pressure
The highest pressure reached by blood in the arteries is called the systolic pressure. It is the force of blood in the arteries as the heart beats. It is shown as the top number in a blood pressure reading.
Diastolic Blood Pressure
The lowest pressure reached by blood in the arteries is known as the diastolic pressure. It is the force of blood in the arteries as the heart relaxes between beats. It’s shown as the bottom number in a blood pressure reading.
TYPES OF HYPERTENSION
The two major types are-
- PRIMARY OR ESSENTIAL HYPERTENSION- It has no known cause, is diagnosed in the majority of people.
- SECONDARY HYPERTENSION- It is often caused by several reversible factors. The other types include-
- MALIGNANT HYPERTENSION- This is the most severe and progressive form of hypertension. It rapidly leads to organ damage. Unless properly treated, it is fatal within five years for the majority of patients. Death usually comes from heart failure, kidney damage or brain haemorrhage.
- ISOLATED SYSTOLIC HYPERTENSION- In this type, the systolic blood pressure, is consistently above 160 mm Hg, and the diastolic below 90 mm Hg. This may occur in older people, and results from the age-related stiffening of the arteries. The loss of elasticity in arteries, like the aorta, is mostly due to arteriosclerosis. The Western lifestyle and diet is believed to be the root cause.
- WHITE COAT HYPERTENSION- It is also called anxiety-induced hypertension, it means blood pressure is only high when tested by a health professional.
- RESISTANT HYPERTENSION- If blood pressure cannot be reduced to below 140/90 mmHg, despite a triple-drug regime, resistant hypertension is considered.
CAUSES OF HYPERTENSION
PRIMARY HYPERTENSION
- Family history
- Advancing age
- Sleep apnea
- Race (most common in blacks)
- Obesity
- Tobacco use
- High sodium intake
- High saturated fat intake
- Excessive alcohol consumption
- Sedentary lifestyle
- Stress
- Excess renin
- Mineral deficiencies (calcium, potassium, and magnesium)
- Diabetes mellitus.
SECONDARY HYPERTENSION
- Chronic renal disease (most common)
- Coarctation of the aorta
- Renal artery stenosis and parenchymal disease
- Brain tumor, quadriplegia, and head injury
- Pheochromocytoma, Cushing’s syndrome, hyperaldosteronism, and thyroid, pituitary, or parathyroid dysfunction
- Hormonal contraceptives, cocaine, epoetin alfa, sympathetic stimulants, monoamine oxidase inhibitors taken with tyramine, estrogen replacement therapy, and nonsteroidal anti inflammatory drugs
- Excessive alcohol consumption
- Pregnancy-induced hypertension, also called gestational hypertension or preeclampsia.
SYMPTOMS OF HYPERTENSION
Most people with primary hypertension don’t have any obvious symptoms at all. The symptoms of hypertension vary from person to person. These symptoms could also be symptoms of other health problems; however the more common symptoms of hypertension are-
- Chronic headaches
- Dizziness or Vertigo
- Blurry or double vision
- Drowsiness
- Nausea
- Shortness of breath
- Heart palpitations
- Fatigue – general tiredness
- A flushed face
- Nosebleeds
- A strong need to urinate often (especially during the night)
- Tinnitus (a ringing or buzzing in the ears)
DIAGNOSIS OF HYPERTENSION
Because hypertension does not produce symptoms it is important to have regular BP checkups.
MEASURING BLOOD PRESSURE
It is done with a Sphygmomanometer. Certain levels of the condition are set depending on the person’s blood pressure-
- Normal Blood Pressure: In the range 130/85
- High Normal: In the ranges 130–140/85–90
- Mild Hypertension: In the ranges 140–160/90–100
- Moderate Hypertension: In the ranges 160–180/100–110
- Severe Hypertension: In the ranges 180–210/110–120
- Very Severe Hypertension: Higher than 210/120
Patients with higher-than-normal blood pressure may then be given other tests. These include:
- MEDICAL AND FAMILY HISTORIES- These help a doctor find out if the patient has risk factors in his or her family. If hypertension is common in the family, the patient is likely to be at higher risk for the condition.
- PHYSICAL EXAMINATION- Sometimes other health problems may be discovered during a physical examination that explain the patient’s high blood pressure.
- EXAMINATION OF THE BLOOD VESSELS IN THE EYES- High blood pressure may cause blood vessels in the eyes to become thick or narrow. Bleeding in the eyes may also be visible.
- CHEST X RAY- This is used to check for an enlarged heart, other heart disorders, and lung disease.
- ELECTROCARDIOGRAPH (ECG)- This test measures the electrical activity of the heart. It can determine whether the heart muscle is functioning normally.
- BLOOD AND URINE TESTS- These help determine the general health of the patient.
PROGNOSIS OF HYPERTENSION
The major goal of treatment is to avoid the most serious complications of hypertension, such as heart disease and strokes. Homoeopathic Medicines can completely cure the hypertension if prescribed on the basis of similimum.
PREVENTION OF HYPERTENSION
- Reduction in salt intake.
- Reduction in fat intake.
- Losing weight.
- Regular exercise.
- Quit smoking.
- Reduction in alcohol consumption.
- Learning how to manage stress.
TREATMENT OF HYPERTENSION
Homoeopathy does miracles if prescribed on the basis of similimum.
HOMOEOPATHIC THERAPEUTICS
ACONITUM NAPELLUS
-Great distress in heart and chest.
-Dreadful oppression of the precordial region.
-Inward pressing in the region of the heart.
-Palpitation with great anxiety and difficulty of breathing. Anguish with dyspnoea.
-Sensation of something rushing into head, with confusion and flying heat in face.
-Sudden attacks of pain in heart, with dyspnoea.
-Aconite is ANXIOUS; restless; with fears : Fear of death.
-Sudden acute conditions from chill, shock, fright.
-All ailments and fears worse at night.
-“Sits up straight and can hardly breathe. Aconite has such a violent cardiac irritation, pulse fluttering, weak, full and bounding; sits up in bed, grasps the throat, wants everything thrown off; before midnight a hot skin, great thirst, great fear – everything is associated together ….
-Sudden attacks of pain in the heart with dyspnoea… breaks into a profuse sweat awful
anxiety”. – Kent.
APIS MELLIFICA
-“The lancinating, darting pains, palpitation, orthopnoea, have rendered Apis invaluable in cardiac inflammations and dropsy”.
-Sudden oedema, dyspnoea, and sudden lancinating or STINGING pains, restlessness and anxiety.
-Think of Apis for burning and stinging pains – anywhere.
-Apis is generally thirstless.
-Is worse after sleep : from warm room, and heat : better cold air, cold room, cold applications. (Reverse of Ars.).
-“Skin alternately dry and hot, or perspiring”.
ARNICA MONTANA
-Pain in region of heart, as if it were squeezed together (Cact., Lil. tigr.), or had shock or blow.
-Heart first rapid, then extremely slow.
-Stitches in cardiac region : stitches left to right.
-Pulse feeble – hurried – irregular.
-Horror of instant death with cardiac distress in the night.
-One of our greatest remedies for tired heart : dilated after strain or exertion.
-Tired out from physical or mental strain.
-Feels bruised, beaten, sore : bruises easily.
-Restless because bed feels too hard.
-Does not wish to be touched : fears approach.
ARSENICUM ALBUM
-Useful in advanced and desperate heart cases.
-Palpitation, with anguish; cannot lie on back : worse going up stairs; walking. Heartbeats irritable.
-Palpitation and tremulous weakness after stool.
-Angina pectoris; sudden tightness above the heart; agonizing precordial pain; pains extend into neck and occiput; (Latrodect. and Kalm. to left arm and hand); breathing difficult; fainting spells. Least motion makes him lose his breath; sits bent forward, or with head thrown back.
-Worse at night, especially 1 to 5 a.m.
-Rheumatism affecting heart, with great prostration, cold, sticky sweat; great anxiety and oppression; burning about the heart.
-Pulse small, rapid, feeble : intermittent.
-Valvular disease, with dyspnoea, anasarca.
-Hydropericardium with great irritability, anguish and restlessness.
-N.B. – The cardinal symptoms of Ars. are generally present : extreme restlessness, driving out of bed, or from bed to bed.
-Thirst for small quantities, often. Aggravation from cold : relief from heat. (Reverse of Apis. But one has seen Ars. rapidly curative in a desperate case of hydropericardium, where these were absent.
AURUM METALLICUM
-Frequent attacks of anguish about the heart, and tremulous fearfulness.
-Violent palpitation of the heart.
-Rheumatism that has gone to heart (Kalm.).
-Acute rheumatism with desperate heart conditions; extreme dyspnoea; impossible to lie down.
-A queer symptom – heart seems to shake, as if loose, when walking.
-The Aurum mental state is profound despondency and melancholy.
-Disgust of life. Tendency to suicide.
-Absolute loss of enjoyment in everything.
-Pains wander from joint to joint and finally settle in the heart.
AURUM MURIATICUM
-Is also very valuable in heart troubles.
-Hering (Guiding Symptoms) says, “Angina pectoris (next to Arnica indispensable)”.
-Heaviness, aching, sensation of rigidity in heart. Cardiac anguish.
-Sticking in heart.
CACTUS GRANDIFLORUS
-Palpitation of the heart : heart squeezed.
-Sensation of constriction in the heart, as if an iron band prevented its normal movement.
-Several violent, irregular beats of the heart, with sensation of pressure and heaviness.
-Small, irregular heart-beats, with necessity for deep inspiration.
-Congestion in chest.
-Painful constriction lower chest; “a cord tightly bound round false ribs, obstructing breathing”.
-Great constriction (sternum) “compressed by iron pincers”.
-“It is the nature of Cactus to constrict.
-Tightness and constriction about head – chest – diaphragm – heart – uterus : – clutchings.
-Chest as if filled with hot gushes of blood.
-“Cactus has a profound curative action upon the heart”.
-Fear and distress. Violent suffering.
-Screaming with the pain.
-Strong pulsations felt in strange places – stomach – bowels – even extremities.
-“11 o’clock remedy : 11 a.m. and 11 p.m. “
CRATAEGUS OXYACANTHA
-“Weak heart muscles”.
-Pulse irregular, feeble, intermittent.
-“Must be used for some time to obtain good results”. -Boericke.
DIGITALIS PURPUREA
-Sensation as though heart stood still, with great anxiety : must hold breath, dare not move.
-Pulse very slow: thready, slow, intermittent.
-Sensation as if heart would stop beating if she moved. (Gels. must move or it will stop.).
-Respiration difficult : sighing : stops when she drops off to sleep.
-Digitalis affects heart and liver : jaundice – white stools, with very slow pulse. (Kalm.).
-Diarrhoea and nausea with heart disease.
KALIUM CARBONICUM
-Stitching pains – chest – heart, extort cries.
-Stitches about heart and through to scapula.
-Heart’s action, intermittent, irregular, tumultuous, weak. Mitral insufficiency.
-Leans forward resting on arms to take weight off chest (rev. Spig.).
-Stitching pains (like Bry.), but also independently of motion and respiration (unlike Bry.).
-Worse hours are 2-4 a.m.
-Has profuse sweat. Puffiness about the eyes.
-Complementary to Carbo veg.
-One has seen Kali carb. following a few doses of Carbo veg., bring back to life a dying child, an old mitral case, with pericarditis with effusion, and pneumonia with plural effusion
KALMIA LATIFOLIA
-Violent palpitations of the heart with faint feelings : with oppressed breathing.
-Wandering rheumatic pains in region of heart, extend down left arm. – (Lat. mact., Med.).
-Heart disease, after frequent attacks of rheumatism, or alternating with it.
-Hypertrophy and valvular insufficiency, or thickening after rheumatism; paroxysms of anguish about heart, with dyspnoea and febrile excitement.
-Remarkable slowness of pulse (Dig.). Pulse very feeble : or, heart’s action very tumultuous, rapid and visible (Spig.).
-“When rheumatism has been treated externally and cardiac symptoms ensue”. – Kent.
LACHESIS MUTUS
-Cramp-like pain in precordial region, causing palpitation with anxiety.
-“Heart feels too large for containing cavity”.
-Bluish lips. Cyanosis. (Spongia.).
-Intolerance of touch or pressure on throat – larynx – stomach abdomen.
-As if something swollen in pit of throat would suffocate him.
-Worse after sleep. (Spongia).
-“Lachesis is one of our most useful remedies in heart troubles, acute or chronic; the peculiar suffocation, cough, and aggravation from constriction being the guiding symptoms”. – Nash.
LATRODECTUS MACTANS
-Violent precordial pains extending to axilla and down left arm and forearm to fingers, with numbness and apnoea. Angina.
-Violent precordial pains and pain left arm, which was almost paralysed.
-Pulse uncountable : quick and thready.
LILIUM TIGRINUM
-Dull oppressive pain in heart; sharp quick pain, with fluttering.
-Roused from sleep by pain as if heart were violently grasped, the grasp gradually relaxed, interrupting heartbeat and breathing.
-Sensation as if heart was grasped or squeezed in a vice (Cactus); as if all blood had gone to heart : must bend double; (reverse of Spig.).
-Heart alternately grasped and released.
-Heart feels over-loaded with blood.
-Violent palpitation with throbbing of carotids.
-Depression of spirits. Weeps.
-Characteristics : Hurried feeling, as of imperative duties and inability to perform them.
-Pressure on rectum and bladder. Terrible urging to stool, to urinate, all the time.
-Bearing down with heavy weight, as if whole contents of pelvis would issue through vagina, but for upward pressure of hand.
LYCOPUS VIRGINICUS
-Protrusion of eyes, with tumultuous action of heart. (Spig.).
-Eyes feel full and heavy; pressing outwards.
-Cardiac irritability. Pulse frequent, small, compressible : or quick hard, wiry, not compressible.
-Trembling hands.
NAJA TRIPUDIANS
-A great heart medicine, only proved in low potencies, so we lack the finer indications.
-Heart weak. Post-diphtheritic heart.
-“For a heart damaged by Acute rheumatism”.
PHOSPHORUS
-Palpitation, violent, on slightest motion.
-Violent, lying on left side.
-Precordial anguish from emotion.
-Heaviness, chest, as if a weight lying on it.
-Constriction : pressing sensation about heart.
-Burning pain between scapulae. (Lyc.).
-The Phos. type : tall, fine : fear alone, dark, thunder. Thirst for cold drinks.
PULSATILLA
-Rheumatic irritation of heart, where pains shift rapidly about the body.
-Heart symptoms reflex from indigestion.
-Heaviness, pressure, fullness (heart). Violent palpitation with anguish : sight obscured.
-Patient nervous, weepy, intolerant of heat : craves air and fuss.
SEPIA
-Violent palpitation of the heart and beating of all the arteries, in bed. Stitches in heart.
-Violent palpitations of heart, as if it would force its way through chest wall : relieved by walking a long distance, and walking very fast.
-The Sepia patient is indifferent : hates fuss.
-Tendency to ptosis and dragging down, especially in pelvic organs. – (Lil. tigr.).
-Profuse perspirations, especially axillae.
-General relief from motion – food – sleep.
SPIGELIA ANTHELMIA
-VIOLENT beating of heart that frequently he could hear the pulsation, or that the beasts could be seen through the clothes.
-Palpitation aggravated by sitting down and bending forward (rev. of Kali carb.).
-Heart seemed to be in tremulous motion.
-Worse for deep inspiration, or holding breath.
-“Heart sounds may be audible several inches away”. – Nash.
-Must lie on right side, or with head very high.
-Spigelia’s pains are stitching. Sharp neuralgic pains (chest, head, heart, eyes, etc.).
-Worse for slightest motion.
SPONGIA TOSTA
-Constricting pain (cardiac) with anxiety.
-Attacks of oppression and cardiac pain agg. lying with head low. Anxious sweat.
-Palpitation : violent, with pain, gasping respiration : suddenly awakened after midnight with suffocation, great alarm, anxiety.
-Awoke often in a fright, felt suffocating (Lach.). Lips blue (Lach.).
-Angina pectoris : contracting pain in chest, heat, suffocation, faintness, anxious sweat.
SULPHUR
-Anxious palpitation. Violent palpitation.
-Rush of blood to heart. “Too much blood in heart”. (Cact.).
-Heart feels enlarged.
-Great orgasm of blood, with burning hands.
-Stitches heart and chest; worse deep breathing.
-Sulphur is hungry – untidy – argumentative.
-Worse heat : intolerant of clothing : fond of fat. Dd nosodes
-In cases that do not respond normally to treatment one must not forget the Nosodes. One of Hahnemann’s “chronic parasitic diseases” may be the bar to progress in acute sickness also – and that not only with tubercle, syphilis and gonorrhoea, but also in regard to Scarlet fever, Diphtheria, Small-pox, Measles and all the rest. Therefore, one should remember: –
DIPHTHERINUM
-With history of Diphtheria.
-Feeble, irregular or intermittent pulse, quick or slow, with vomiting and cyanosis.
SYPHILINUM
-Pain and pressure behind the sternum.
-Lancinating pains in heart at night, base to apex (Medorrh. is worse by day).
MEDORRHINUM
-Heart felt very hot : beat fast : with bursting sensation : or feeling of a cavity where heart ought to be.
-Sharp pain at apex, worse motion.
-Great pain, heart, extending to left arm (Latro. mact.) and throat.
-Intense pain, heart, radiates to all parts of left chest : worse least movement.
-The troubles of Medorrh. are worse by day – sunrise to sunset.
-Those of Luet. by night : sunset to sunrise.
-Medorrh. is rich in mental symptoms : Everything seems unreal like a dream.
-Time moves so slowly : things done an hour ago, as if done a week ago. -(Cann. ind.).
-Anguish : introspection : always anticipating evil happenings.
-“Someone behind her”.
-Cannot concentrate : forgets what she is reading; cannot spell simple words. Dd bac., tub.
-Heart cases where there is a family, or past history of tubercular manifestations.
-Palpitation : heaviness : pressure over heart.
-Irritable : irritable on waking : nothing pleases : nothing satisfies.
-“Wants to travel : cosmopolitan condition of mind”. Suffocates in a warm room. (Puls.).
BIBLIOGRAPHY
- Radar 10
- EH
- Hypertension in the Twentieth Century: Concepts and Achievements 2004, by W. Birkenhager
- Comprehensive Hypertension 2007, by Gregory Lip
- Handbook of Hypertension by W.H. Birkenhäger
- Hypertension: A Companion to Braunwald 2007, by William White
- Manual of Hypertension 2002, by Giuseppe Mancia
- Hypertension, An Issue of Clinics in Geriatric Medicine 2009, by Mahboob Rahman
- Clinical Symposia: Hypertension 1991, by Frank Netter
About Author
© Dr. Rajneesh Kumar Sharma
B.Sc., B.H.M.S., M.D. (Homoeopathy), h.M.D. (U.K.), D.I. Hom. (London)
Dr. (Km) Ruchi Rajput
B.Sc., B.H.M.S.