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Hypertension and its Management

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Error! Style not defined. (iii)

VEGETABLES AND
HUMAN HEALTH

DR. M.K. RANA

Professor
Department of Vegetable Science
CCS Haryana Agricultural University
Hisar-125 004, Haryana, India
(iv) Vegetables and Human Health

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Hypertension and its Management 287

22 Hypertension and its Management

Mohd. Tariq Salman1, Sabahuddin Ahmad2 and Mohd. Naved Ashrafi3
1
Department of Pharmacology, Era's Lucknow Medical College, Sarfarazganj, Hardoi Road,
Lucknow- 226003, Uttar Pradesh, India E-mail: <mtariqsalman@gmail.com>
2
Department of Botany, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
E-mail: <ahmad.sabahuddin@yahoo.com>
3
Dialysis Therapist and Alumnus of Department of Medicine, Jawahar Lal Nehru Medical College,
Aligarh Muslim University, Aligarh, Uttar Pradesh, India E-mail: <navedashrafi@gmail.com>

Blood pressure is the force with which blood The human heartbeat has two distinct phases,
pushes against the artery walls as it travels through i.e., (i) the Systole, when the heart beats and gives
the body. Hypertension is a word coined for high higher reading on sphygmomanometer, and (ii) the
blood pressure. It is not a disease in itself but is one Diastole, when the heart is at rest and gives lower
of the leading causes of mortality and morbidity in reading on sphygmomanometer. The normal values
the world today. The most important point to be of systolic and diastolic blood pressures are up to
considered here is that this condition is very 120 mm Hg and 80 mm Hg respectively.
dangerous, as the patient does not realize that he or
The eighth report of Joint National
she is suffering from this condition until it may
Committee of United States of America on
become too late. This is also the reason why this
prevention, detection, evaluation and treatment of
disorder is also called silent killer. It can damage
high blood pressure and World Health Organization
various target organs like eyes, liver, brain, kidneys
and International Society of Hypertension (WHO
and even the heart, which can ultimately lead to
and ISH, 2003) guidelines have defined
death of a person.
hypertension to be 140 mm Hg systolic and 90 mm
Hg diastolic, though risk appears to increase even
What is Hypertension? above 120/80 mm Hg. Hypertension is classified as
As stated above, hypertension means high blood under in Table 1:
pressure. It is the condition when the pressure of
Table 1: Classification of hypertension
the blood caused by the pumping of the heart goes
much beyond normal values. Sr. Class Systolic Diastolic
The heart pumps blood into the arteries with No. (mm Hg) (mm Hg)
much force to push blood to distant organs from top 1. Normal <120 <80
of the head to bottom of the feet. Blood pressure is
the pressure of blood, which it exerts on the walls 2. Pre hypertension 120-139 80-89
of the arteries as it circulates in the body. Blood 3. Hypertension stage I 140-159 90-99
pressure is highest as it leaves the heart through the
4. Hypertension stage II 160 or 100 or
aorta and gradually decreases as it enters smaller
higher higher
and smaller blood vessels.
288
All the patients with blood pressure readings
greater than 120/80 should be encouraged to make
lifestyle modifications, such as eating a
healthier diet, quitting smoking and getting
more exercise.
High blood pressure is an individualistic
disorder. It cannot be transmitted from one person
to another through contact or by any other means
but cases of high blood pressure do run in families.
Hypertension can affect several regions of
the body. Several complications are reported when
the blood pressure becomes too high. Some of these
are hypertensive retinopathy, hypertensive
nephropathy, hemorrhage, stroke and myocardial
infarction (MI). Capillaries supplying blood to the
retina of eye are very narrow. Due to the high
pressure, they can rupture, causing bleeding inside
the eyes and can lead to blurred vision or even loss
of vision. This condition is called as Hypertensive
Retinopathy. In some cases, the arteries supplying
blood to the brain may also be ruptured. Cerebral
hemorrhage can lead to paralysis. High blood
pressure is very commonly associated with
myocardial infarctions, i.e., heart attacks. Rampant
hypertension causes an increase in heart size, a
phenomenon called as Cardiomegaly. Similarly, if
hypertension is left untreated for a long time, it may
Figure 1: Global distribution of disease burden attributable to six major risk factors
and DALYs, disability-adjusted life years (Courtesy of WHO)
Vegetables and Human Health
lead to Hypertensive Nephropathy in which the
nephrocytes (the kidney cells making urine) are
damaged and lose the function of urine formation
and waste expulsion. To overcome the problem, the
existing nephrons increase in size, which causes an
increase in average kidney size. Hypertensive
nephropathy ultimately paves the way for chronic
renal failure or chronic kidney disease.
Worldwide hypertension is estimated to
cause 7.1 million premature deaths and 4.5% of the
disease burden (64 million disability-adjusted life
years (DALYs). The proportion of global disease
burden attributable to hypertension is considerably
substantial (Figure 1).
Furthermore, the rates of decline of
deaths from coronary heart disease (CHD) and
stroke have slowed in the past decade. In
addition, the prevalence and hospitalization rates of
heart failure (HF), wherein the majority of patients
have hypertension before developing heart failure,
have continued to increase (Figure 2 and 3).
Moreover, there is an increasing trend in End-Stage
Renal Disease (ESRD) by primary diagnosis.
Hypertension is second only to diabetes as the most
common antecedent for this condition (Figure 4).
Hypertension and its Management 289

Figure 2: Prevalence of CHF by race and gender, age 25 to 74: United States, 1971 to 1974 to 1999 to 2000,
age-adjusted to 2000 US census population. White and African American in 1999 to 2000 exclude
Hispanics. Source: National Heart, Lung and Blood Institute. Morbidity and Mortality: 2002 Chart Book on
Cardiovascular, Lung and Blood Disease (Courtesy of American Heart Association, Inc. USA)

Figure 3: Hospitalization rates for congestive heart failure, ages 45 to 64 and 65+: United States,
1971 to 2000 (Courtesy of American Heart Association, Inc. USA)
290
Figure 4: Trends in incident rates of ESRD, by primary diagnosis (adjusted for age, gender and race).
Disease categories were treated as being mutually exclusive (Courtesy of American Heart
Association, Inc. USA).
Types of Hypertension
Essential hypertension: Essential hypertension has
no specific origin but it is strongly associated with
lifestyle and responsible for 90 to 95% of
diagnosed hypertension. It is more common in the
people who have crossed their middle age of life.
This condition can be very well controlled with the
proper precautions. It is treated with stress
management, changes in diet, increased physical
activity and medication if needed. People with
essential hypertension can live long by making
themselves aware of the malady. It is also known as
primary hypertension.
Secondary hypertension: The secondary
hypertension is responsible for 5 to 10% of
diagnosed hypertension, which is caused by a
preexisting medical condition such as congestive
heart failure, kidney failure, liver failure, or damage
to the endocrine (hormone) system. This may be
fatal, and hence, it is very essential to get the
remedy as soon as possible.
Pregnancy-induced hypertension (PIH): It may
appear otherwise in healthy women after the 20th
week of pregnancy. It is more likely to occur in
women who are overweight or obese. The
pregnancy-induced hypertension may be mild or
Vegetables and Human Health
severe, and it is accompanied by water retention
and protein in the urine. About 5% of the PIH cases
progress to preeclampsia, which is characterized by
dizziness, headache, visual disturbance, abdominal
pain, facial edema, poor appetite, nausea and
vomiting. Severe pre-eclampsia affects the mother's
blood system, kidneys, brain and other organs. In
rare cases, it may lead to death.
The other types of hypertension include
malignant hypertension, isolated systolic
hypertension, white coat hypertension and resistant
hypertension.
Causes of Hypertension
Hypertension can be caused due to a number of
reasons. It can be due to mental anxiety, tensions,
stress and worries and can be a resultant of strong
emotions such as anger, shock, hatred and jealousy.
In such instances, steroids like mineralocorticoids
and glucocorticoids are supposed to be responsible
for hypertension. It may also be due to
malfunctioning of the vital organs.
Essential hypertension is idiopathic and its
cause is unknown. However, there are number of
risk factors, which are strong predictors of the
disease. One of the most important of these factors
is aging, due to which there is hardening of arteries
Hypertension and its Management
leading to increased systolic. Another factor is diet,
such as one rich in fried and salty food items, and
the hereditary factors are also responsible for this
type of hypertension. Hereditary factors are passed
on to the new generation from parents.
Secondary hypertension can be caused due to
a host of problems with the vital organs like brain,
liver and the kidneys. Renal fibrosis, Cushing’s
syndrome, adrenal gland tumors, Wilm’s tumor are
just some of the conditions that can cause
hypertension. However, the most prevalent causes
are kidney problems such as renal failure, renal
vascular obstruction and glomerulonephritis.
Furthermore, hypertension may also be
caused due renal artery stenosis, a condition in
which renal arteries supplying blood to kidneys
become narrowed due to deposition of plaque on
inner walls of the arteries and the patient suffers
from high blood pressure.
Pregnancy-induced hypertension (PIH) may
appear in otherwise healthy women after the
twentieth week of pregnancy. It is more likely to
occur in women who are overweight or obese.
Pregnancy-induced hypertension may be mild or
severe, and it is accompanied by water retention
and protein in the urine. About 5% of PIH cases
progress to preeclampsia, which is characterized by
dizziness, headache, visual disturbance, abdominal
pain, facial edema, poor appetite, nausea and
vomiting. Severe preeclampsia affects the mother's
blood system, kidneys, brain and other organs. In
rare cases, it may lead to death.
The other types of hypertension include:
z Malignant Hypertension
z Isolated Systolic Hypertension
z White Coat Hypertension
z Resistant Hypertension
Risk Factors for Hypertension
Risk factors for hypertension include being
overweight, having diabetes, being a male over the
age of 45 and a female over 55, being of African
American descent and eating a lot of salty food
291
articles. Hypertension is worsened by smoking,
excessive alcohol consumption, prolonged and
poorly managed stress, a diet high in fat and /or salt
and lack of exercise.
Symptoms of Hypertension
People with hypertension may have to suffer
several problems. There are a number of symptoms
for this disorder. The person feels giddiness,
dizziness and instability. Palpitations are also
commonly reported. Patients of hypertension are
generally insomniacs, i.e., they cannot sleep well at
night. The patient’s digestive system may play
truant and there may be regular constipation.
Bulging of eyes, swelling of face and continuous
headache in early morning, which later disappears
after one or two hours are the other symptoms.
Diagnosis
Hypertension is generally diagnosed based on a
persistently high blood pressure. Usually, this
requires three separate sphygmomanometer
readings at least one week apart. If the elevation in
the blood pressure is extreme, or if the symptoms of
organ damage are present, then the diagnosis may
be made and treatment started immediately since
any delay in the treatment can lead to patient’s
death.
Once the diagnosis of hypertension has been
made, physicians will attempt to identify the
underlying cause based on risk factors and other
symptoms, if present. Secondary hypertension is
more common in preadolescent children, with most
cases caused by renal disease. Primary or essential
hypertension is more common in adolescents and
has multiple risk factors, including obesity and a
family history of hypertension.
Laboratory tests can also be performed to
identify possible causes of secondary hypertension
and to determine if hypertension has caused
damage to the heart, eyes and kidneys. Additional
tests for diabetes and high cholesterol levels are
usually performed because they are additional risk
292
factors for the development of heart disease require
treatment.
Renal Function (serum creatinine and blood
urea) Testing is done to determine if kidney disease
is present, which can be either the cause or result of
hypertension. In addition to this, testing of urine
samples for protein is used as a secondary indicator
of kidney disease. Glucose testing is done to
determine if diabetes mellitus is present.
Electrocardiogram (EKG/ECG) testing is done to
check for evidence of the heart being under strain
from high blood pressure. It may also show if there
is thickening of the heart muscle (left ventricular
hypertrophy) or has experienced a prior minor heart
disturbance such as a silent heart attack. A chest X-
ray may be performed to look for signs of heart
enlargement or damage to heart tissue. Test for
thyroid and thyroid stimulating hormone (TSH) is
also done.
Changes in Lifestyle to Treat High
Blood Pressure
A critical step in preventing and treating high blood
pressure is a healthy lifestyle. One can lower
his/her blood pressure with the following changes
in lifestyle:
z Losing weight if overweight or obese
z Quitting smoking
z Eating a healthy diet including the DASH
diet (eating more fruits, vegetables, and
low fat dairy products, less saturated and
total fat)
z Reducing the amount of sodium in diet to
less than 1,500 milligrams a day
z Getting regular aerobic exercise (such as
brisk walking at least 30 minutes a day,
several days a week)
z Limiting alcohol intake
z In addition to lowering blood pressure,
these measures enhance the effectiveness
of high blood pressure drugs if used.
Vegetables and Human Health
Prevention and Basic Care during
Hypertension
Prevention is better than cure is a well-established
fact. The person suffering from this disorder must
be very much careful. Any aggravation of the high
blood pressure can result in death of the patient.
He/she must take number of precaution in this case.
He/she should try to maintain his/her diet according
to the doctor’s advice. Taking rest as much as
possible will relieve him/her from stress. He/she
should go to bed early at night and wake up early in
the morning. One should try to get at least eight
hours of sleep.
In case of hypertension, laughter therapy is
considered a good medicine. Physical aerobic
exercise can be done to maintain the circulation of
blood. In fact, it is the best way to keep
hypertension at bay. Walking/jogging is a good
exercise as it helps in reducing weight and burn
extra calories stored in the form of fat in our body.
Care must be taken during exercise not to do very
heavy exercise. Simple breathing exercise will help
in calming down the mind. One should adopt
breathing exercise whenever he/she is tensed,
nervous, or anxious.
The most important thing that should be kept
in mind is to avoid all mental stress at all costs.
Meditation and yoga will be very helpful to relieve
the brain from mental stress. Intake of salts in diet,
coffee, tea and tobacco should be minimized as
soon as possible.
Blood Pressure Monitoring at Home
Measuring one’s blood pressure at home and
keeping a record of the measurements will show the
patient and the doctor how much the blood pressure
changes during the day. The doctor can use the
patient’s record of measurements to see how well
the medicine is working to control high blood
pressure. In addition, measuring ones own blood
pressure is a good way to take part in managing
ones own health and recognizing changes. The
American Heart Association and other
Hypertension and its Management 293

organizations recommend anyone with high blood physicians for people with hypertension or pre-
pressure to monitor his or her blood pressure at hypertension. The DASH diet-eating plan has been
home. To measure your blood pressure at home, proven to lower blood pressure in studies sponsored
you do it manually using a mercury manometer, an by the National Institutes of Health, United States
aneroid monitor, or a digital monitor. One should of America. It is based on an eating plan rich in
choose the type of monitor that best suits his or her fruits and vegetables, and low fat or non-fat dairy
needs. with whole grains. It is a high fiber, low to
The aneroid monitor has a gauge, which is moderate fat diet, and is rich in potassium, calcium
read by looking at a pointer on a dial. The cuff is and magnesium. It is a healthy plan, designed for
placed around the upper arm and inflated with hand the whole family and not just for the patient.
by squeezing a rubber bulb. Digital monitors have New research continues to show additional health
either manual or automatic cuffs. The blood benefits of the plan. The dietary approaches to stop
pressure reading flashes on a small screen. Manual hypertension are given below:
blood pressure monitors use a stethoscope and an Table 2: Dietary plan to stop hypertension
inflatable arm cuff connected by a rubber tube to a
gauge that records the pressure. To measure the Type of food Number of Servings
blood pressure, you inflate the cuff that goes around servings for on a 2000
your arm by pumping a bulb at one end of the tube, 1600 - 3100 calorie diet
and then, you check your blood pressure with a calorie diets
stethoscope listening to the sounds of blood flow Grains and grain
through the main artery in your upper arm as the products
pressure decreases in the cuff. Manual monitors are (include at least 3
usually less expensive as compared to digital whole grain foods
monitors but these are more difficult to use. each day) 6-12 7-8
Fruits 4-6 4-5
Dietary Requirements Vegetables 4-6 4-5
Diet to be followed by hypertension patients should Low fat or non fat
be in such a way that it may reduce the body weight dairy foods 2-4 2-3
and excess fat, and therefore, reduces the blood
Lean meats, fish and
pressure. The patient suffering from hypertension
poultry 1.5-2.5 2 or less
must avoid hot and spicy food, which will be
difficult to digest. He/she should incorporate Nuts, seeds and 3-6 per 4-5 per
vegetarian diet that includes garlic, lemon, parsley, legumes week week
bitter gourd, drumstick, etc., which are ideal in Fats and sweets 2-4 Limited
hypertension.
Another diet plan, which has been shown to
Another main thing in diet to be cared of is be very beneficial in hepertension in several
salt intake. It should be curtailed in the diet. It had studies, is the Mediterranean diet. The
been found that salt is the biggest culprit in patients Mediterranean diet is rich in cereals, fruits,
suffering with high blood pressure. Red meat, vegetables, nuts, whole grains, fish and olive oil.
chocolates and sweets must be avoided. Ghee and Although it is the traditional diet of the
butter prepared from cow’s milk can be given but Mediterranean region, it has garnered interest all
one should avoid the buffalo milk. over the world in recent times since a scientific
The Dietary Approaches to Stop spotlight has been trained on the health benefits it
Hypertension (DASH) diet is recommended by can confer. Recent research has indicated that the
294
diet may have benefits for arthritis, Alzheimer’s
disease, hearth health and blood pressure, diabetes,
asthma, lung disease and allergies. Studies suggest
that adhering to a Mediterranean type diet
contributes to the prevention of age-related changes
in blood pressure. Another recent study found that a
diet rich in olive oil, fruits and vegetables was
associated with a significant reduction in the
incidence of hypertension.
Bitter gourd and drumsticks are very helpful
but Colocasia and yellow pumpkin must be avoided
in the diet. Coffee should be avoided because it
contains caffeine. One should avoid the usage of
hydrogenated oils. Fresh fruits like Indian
gooseberry, grapes, banana, apples, guava and
watermelon are considered beneficial. Dry fruits are
also considered very beneficial in this case.
The easiest natural way to reduce the
problem of high blood pressure is to add tomatoes
in our daily diet. The tomatoes are efficient in
lowering the rate at which our heart pumps the
blood to a correct and appropriate level. The
addition of tomatoes in your daily diet can decrease
the blood pressure. Two tomatoes in every meal can
help a lot.
Bananas are piled high with potassium. The
potassium works alongside sodium to help in
controlling the fluid balance. Studies show that five
bananas a day can lower the blood pressure to half.
It is not recommended that one should eat five
bananas a day due to the reason that some people
are susceptible to high sugar levels in bananas.
Therefore, a person should eat two bananas in a day
or according to the advice of physician.
A lean and healthy fish can lower the high
pressure. Salmon is high in the greasy acid omega
3. This greasy acid is very beneficial for our heart
since it lowers the blood pressure. It also stops and
even reverses the heartburn. One should restrict the
salmon intake to once every week due to the high
mercury levels.
Fish oil reduces blood pressure. Several
studies have revealed that a large amount of fish oil
(5-15 grams/day) lowers the blood pressure
Vegetables and Human Health
significantly in hypertensive individuals. According
to researchers, if we take low doses of fish oil
regularly, it will be indeed effective in lowering the
blood pressure in mildly hypertensive patients. The
important point of consideration is that there is no
adverse effect on cholesterol level of the blood. The
fish oil supplementation is a safe and very effective
method to lower the blood pressure, especially in
patients who have mild hypertension.
Celery is probably the strongest single food
that can be eaten to lower the high pressure. Celery
contains unique oil that relaxes the muscles that
regulate blood pressure, improving flow and
lowering pressure. Just four stalks in a day (or some
celery juice) helps a lot. It is a natural diuretic
without any dangerous side effects. Celery contains
a chemical Pthalide, which helps in lowering the
blood pressure. Eating raw celery dilates the wall of
blood vessels, and thereby, allowing the blood to
flow easier.
There are thirty foods, which have proved to
lower and prevent high blood pressure. These are
tomatoes, potatoes, carrots, broccoli, collard greens,
green beans, artichokes, spinach, whole wheat
bread, muffin, grits, bananas, oranges, raisins,
orange juice, melons, mangoes, peaches,
pineapples, raisins, strawberries, fat-free or low fat
milk, fat-free or low fat yoghurt, lean meat, fish,
poultry (broil, roast, or boil, not fried one),
almonds, mixed nuts, peanuts, kidney beans,
sunflower seeds, walnuts, amla and shatvari
(asparagus).
Drugs to Treat High Blood Pressure
Followings are the firs line drugs used to treat high
blood pressure:
z Angiotensin- converting enzyme (ACE)
inhibitors
z Angiotensin- receptor blockers (ARBs)
z Diuretics
z Beta-blockers
z Calcium channel blockers
Hypertension and its Management
Yogic Way of Life to Treat
Hypertension
Cultivation of right attitudes: The most important
part of managing hypertension is cultivation of
right attitudes towards every part of life. This is
vital to reduce the stress, which is more often an
inner over-reaction than the response to any
external stimuli. The attainment of clarity of mind
is to be inculcated. The importance of taking the
opposite view towards negative thoughts and
actions should be emphasized.
Healthy diet: It is important to have a diet, which
is of a healthy nature. Meals should be taken
regularly and there should be adequate amounts of
green vegetable salads, fresh fruit juices and
sprouts. There should be the minimum possible
amount of salt in the diet since salt leads to water
retention and a rise in blood pressure. The diet
should have adequate potassium and calcium that
are present in fruits and low fat dairy products. A
loss of body weight will help in reducing blood
pressure too.
Breath-body movement coordination practices:
Practices that enhance mind-body harmony using
breath-linked movements should be emphasized.
Yoga Asanas: Modified versions of the following
Asanas as per physical condition and other
associated health problems of the patient may be
used. Standing postures such as Tada Asana,
Trikona Asana, Padottana Asana, Hasthapada
Asana, Padangushta Asana and Mehru Asana are
useful in controlling blood pressure. Prone postures
that are of benefit include Bhujanga Asana and
Ardha Shalaba Asana, while the useful sitting
postures include Vakra Asana, Gomuka Asana,
Ushtra Asana, Shashaha Asana and Yoga Mudra
Asana. The supine postures include Matsya Asana,
Pavana Mukta Asana, Eka Asana and Dwipada
Uttanpada Asana. Topsy Turvy (inverted) postures
may help in resetting baroreceptor reflex
mechanisms, which regulate blood pressure. This
may also be achieved by the head-below-heart
postures that can do the same if the patient cannot
295
do inverted postures like Sarvanga Asana and
Sethubanda Sarvanga Asana.
Treatment of Hypertension through
Plants
Hypertension can be controlled naturally with the
help of simple herbs, which are easily found in
grocery stores or in the garden. There are number of
plants, which are quite useful for us. Many diseases
are cured with the help of some plants. These plants
may be either medicinal or simple plants cultivated
for the ornamental purpose.
Salt restriction: Keeping restriction of salt in ones
diet is most important factor, which controls the
high blood pressure. Combination of fish oil
supplementation and salt restriction is seen to be
very effective in reducing blood pressure,
especially people aging between 60 to 80 years.
Vitamin C (ascorbic acid): It is also very effective
in combating with hypertension. Oral
supplementation with 500 mg/day of ascorbic acid
is useful for blood pressure control in patients with
high blood pressure. Therefore, the patients should
take the food items rich in vitamin C like amla,
orange, lemon, tamarind, etc.
Sour milk: It reduces blood pressure. Researchers
have discovered that sour milk is very effective in
lowering blood pressure. Reports show that daily
supplementation with sour milk is a very useful and
practical way of reducing blood pressure in patients
with this disorder. Calpis sour milk is used
traditionally in Japan from the time being. It is
prepared by fermenting soar milk with a starter
culture containing Lactobacillus helveticus and
Saccharomyces cerevisiae.
China rose (Hibiscus rosa-sinensis): It is
commonly known as Gurhal and chiefly cultivated
for the ornamental purpose, but at the same time, it
is also very useful for the treatment of the high
blood pressure. The plants leaves are boiled just
like tea, and then, taken either as a cold or hot
drink, after addition of some amount of sugar. The
taste of this drink resembles cranberry juice.
296
Ginseng (Panax quinquefolium): It is used
generally for relieving a person from stress and
fatigue but it also helps a lot in reducing the
pressure of blood, if taken in low doses over a long
period. The plant also has some side effects like
irritability, anxiety, headache and palpitations.
Therefore, it should be used carefully.
Juniper (Juniperus communis): It is commonly
called Dhoopchandan. It is also very helpful in
controlling hypertension. It does its work by
removing excess liquid from the blood, thereby
decreasing blood volume, and consequently, blood
pressure. Essential oil obtained from the ripe
berries is safe. Owing to the contradictory nature of
different studies, caution is required in taking
juniper oil during pregnancy or be used by the
supervision of the qualified physicians.
Mistletoe (Viscum album): It is another natural
remedy for high blood pressure. A teaspoon of its
leaves and branches, if grounded and brewed into a
tea can be very beneficial. However, the over doses
can be harmful for our body.
Hawthorn (Crataegus laevigata): It is Opuntia
Nagphani family plant. It has positive effect on
heart and vascular system. Hawthorn stabilizes the
collagen in blood vessels. This in result keeps it
thin and healthy, and thereby, making it more
efficient in moving blood to its destination.
Garlic (Allium sativum): It is commonly called
lahsun, which reduces the blood cholesterol level
and in this way lowers blood pressure. Garlic helps
in the thinning of the blood by discouraging
platelets from sticking together. This in turn
naturally lowers the blood pressure. Garlic is the
most effective herb used in the treatment of
hypertension. It also reduces the pressure and
tension in the arteries. It slows the pulse down and
modifies the heartbeat rhythm. It relieves dizziness
and shortness of breath brought on by high blood
pressure. It also relieves gas that can form in the
digestive tract due to high blood pressure. Garlic
can be included in the daily diet with consistency.
About two to three cloves before every meal can go
a long way in the home treatment of hypertension.
Vegetables and Human Health
Olive (Olea europaea) oil: It is also very potent in
lowering the blood pressure. Researchers at the
University of Naples report that olive oil is highly
effective in controlling hypertension. The studies
speculate that the high content of polyphenols in
olive oil is the major factor in its beneficial effects.
Jaundice berry (Berberis vulgaris): it is known as
Amarbaris in Hindi. It is the herb used primarily for
the treatment of jaundice but it has also been
reported that this herb plays an effective role in the
treatment of high blood pressure. It works by
dilating the arteries. In this way, the blood pressure
of the patient is lowered with the help of this herb.
Alfalfa (Medicago sativa): It is also very beneficial
in treatment of hypertension. The fresh leaves of
alfalfa, when taken with carrot juice are very
beneficial for all kinds of heart ailments, and this
includes, those brought on by hypertension.
Bloodwort (Achillea millefolium): This herb acts
in a unique manner to treat high blood pressure. It
induces sweat and brings blood towards the skin,
and thereby, better circulation reduces high blood
pressure.
Parsley (Petroselinum crispum): Parsley, if taken
as a beverage skimmed with water, several times a
day, helps in maintaining the small arteries and the
capillaries in healthy circulatory condition, and
thereby, useful in its own way.
Chinese traditional medicine also uses
several herbs for the treatment of hypertension. A
recent study showed that the ‘calming the liver and
restraining the Yang’ formula shows favorable
efficacy in lowering blood pressure on the patients
with mild or moderate degree of essential
hypertension. It can reduce the clinical symptoms,
improve the quality of life and regulate blood lipid
metabolism. Its mechanism may be related to the
functional relieving of inflammatory reaction and
inhibition the activity of renin-angiotensin-
aldosterone system (RAAS). Taking Xuezhikang
capsule 600 mg twice a day caused reduction in
both systolic and diastolic blood pressures.
 Hypertension and its Management
Black cumin (Nigella sativa): Kalonji is an annual
herb, which has been used for centuries for
medicinal and culinary purposes. It is used in Arab
folk medicine as a diuretic and hypotensive plant.
Studies have shown that it has hypotensive effect
comparable to Nifedipine. A recent randomized,
double-blind, placebo-controlled clinical trial to
evaluate the efficacy of treatment with an oral
Nigella sativa seed extract supplement in patients
with mild hypertension showed that the extract
administration reduced both systolic and diastolic
blood pressure in a dose-dependent manner.
Meanwhile, the extract also caused a significant
decline in the level of total and low-density
lipoprotein (LDL) relative to baseline data. No
complication caused by Nigella sativa was
observed. The results suggest that the daily use of
Nigella sativa seed extract for 2 months may have a
blood pressure-lowering effect in patients with mild
hypertension.
Strawberries (Fragaria chiloensis): This fruit
represent the main source of ellagic acid derivatives
corresponding to more than 50% of all phenolic
compounds found in the fruit. A recent study
suggested that the ellagitannins and ellagic acid
have good potential for the management of
hyperglycemia and hypertension linked to type 2
diabetes.
Rauwolfia (Rauwolfia serpentina): It is another
important herb for the treatment of high blood
pressure. This is considered the best remedy for
high blood pressure. Half a teaspoon of its powder
taken thrice a day is very beneficial in reducing
high blood pressure. The alkaloids present in
Rauwolfia are known to have some undesirable side
effects. Therefore, it must be taken under
supervision. This herb is commonly found growing
in the western countries.
In this article, we would like to add special
contribution of Dr. Salimuzzaman Siddiqui in
curing hypertension. Dr. Siddiqui is credited for
pioneering the isolation of unique chemical
compounds from the neem (Azadirachta indica),
Rauwolfia also called Sarpgandha/Chand Buti
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(Rauwolfia serpentina) and various other flora. As
the founder director of H.E.J. Research Institute of
Chemistry, he revolutionized the research on
pharmacology of various domestic plants found in
South Asia to extract novel chemical substances of
medicinal importance. He was exposed to United
Kingdom and Germany to learn medicine and
chemistry, respectively. Hakim Ajmal Khan, a
world-known physician, asked him to work on
Sarpgandha/Chand Buti (Rauwolfia serpentina).
Siddiqui's first breakthrough in research came when
he successfully isolated an antiarrhythmic agent in
1931 from the roots of Rauwolfia serpentina. He
named the newly discovered chemical compound as
Ajmaline, after his mentor Hakim Ajmal Khan who
was one of the illustrious practitioners of Unani
system of medicine in South Asia. Later, Dr.
Siddiqui also extracted other alkaloids from
Rauwolfia serpentina that included Ajmalinine,
Ajmalicine (C21H24N2O3), Isoajmaline,
Neoajmaline, Serpentine and Serpentinine. Many of
these are still used worldwide for the treatment of
mental disorders and cardiovascular ailments,
especially as antiarrhythmic agents in Brugada
syndrome. These alkaloids were antihypertensive
and first reported in the world. Now, these
medicines are being prepared in Germany and are
one of the most prominent medicines, used for the
treatment of hypertension and some mental
illnesses and as a tranquillizer. Initially, Dr.
Siddiqui was a researcher associated with the
Aligarh Muslim University. Later on, Pandit
Jawahar Lal Nehru being a super philanthropist and
patron of Indian Science sent him to Pakistan to
establish PCSIR Laboratories.
Since Wilkins and his associates introduced
the drugs into the United States, the preparations of
Rauwolfia serpentina have been used with
increasing frequency in the treatment of essential
hypertension. In 1952, the highly purified alkaloid,
reserpine, was isolated from Rauwolfia
serpentina, and this has been thought to be its chief
active principle. Reserpine was the first potent drug
widely used in the long-term treatment of
hypertension.
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