Blood Pressure

According to Ayurveda, improper food habits, stress and sedentary lifestyle provoke and vitiate all the Tridoshas, to trigger the pathogenesis of hypertension. Sometimes it is accelerated with genetic predisposition. Hypertension is understood by many Ayurvedic scholars as the spread of impaired Doshas from their specific sites along with Blood in their disturbed states (Prasara-Avastha)

The specific doshas which impair and contribute are Vyana Vata, Prana Vata, Sadhaka Pitta and Avalambaka Kapha.

What is Blood Pressure

The blood first ejected out of the heart, is then distributed to all parts of the body, and, thereafter, is returned back to the heart through the blood vessels. Blood Pressure is the lateral pressure exerted by the flow of blood on the walls of the arteries. Systolic BP attained during contraction of the heart is controlled by Vyana Vata and Prana Vata, which denote the nervous control of circulation

Blood Pressure in the body is regulated by multiple mechanisms. Short-term Neural mechanisms and Long-term Renal, Hormonal and Local vascular mechanisms. Following are the main driving factors.

Determinants of Blood Pressure

The heart has its pacemaker that generates electrical impulses which make the heart contract ( via Vyana Vata). The rate of its impulse generation is controlled by the autonomic nervous system originating in the brain (via Prana Vata). This directs the pulse rate and pulse pressure and effectively the systolic blood pressure

The basal metabolic rate (via Pachak Pitta) also has a direct albeit imperfect correlation with the pulse rate and pulse pressure of the heart.

The blood volume and viscosity can be determined by the quality and quantity of the Rasa and Rakta Dhatus. These also determine the cardiac output. Kidneys excrete water and sodium through urine to bring down the blood volume to regulate the blood pressure.

The diastole is attained when the heart muscles relax, diastolic blood pressure is due to blood flowing through the narrow structures of the chambers of the heart and arteries and there is no active push by the heart.

This is mainly influenced by the diameter and elasticity of the blood vessels (via Avalambaka Kapha). The vascular tone is also controlled by the autonomic nervous system which alters the diameter of the arteries as and when required (via Prana Vata)

The Kidneys secrete Renin in response to low blood pressure as a result of which Angiotensin II is secreted to bring about vasoconstriction, thereby increasing blood pressure.

Above three and hence the blood pressure are directly regulated by central nervous system and the endocrine system (via about 15 different hormones - Adrenalin, Nor-Adrenalin, Thyroxin, Aldosterone, Vasopressin, Angiotensins, Serotonin, Bradykinin, Prostaglandins, Histamine, Acetylcholine, Atrial Natriuretic Peptide etc).

Why does Blood Pressure Increase

Under the influence of risk factors one or more of the different regulatory mechanisms of blood pressure gets hampered causing the blood pressure to increase. For this, there should be increase in either cardiac output or peripheral resistance.
Excess Salty and Pungent Diet: Leads to defects in renal Sodium homeostasis, causing decreased Na excretion leading to increased salt and water retention. This increases the plasma and extra cellular fluid thus increasing the cardiac output.
Hormonal Defects: Increased functional vasoconstriction due to impaired hormonal actions, leads to increased peripheral resistance. This may be understood as Pitta Dushti due to endocrinal defects.
Excessive Emotional Distress: Leads to Vitiation of Prana Vata, hence an impaired functioning of the autonomic nervous system causing rise in blood pressure.
Blood Vessel Defects: Due to defects in the vascular smooth muscles (atherosclerotic changes caused by factors like hyperlipidemia), the blood vessels lose their normal tone and this increases peripheral resistance, thus causing hypertension. This pathology may be due to the vitiation of Kapha Dosha.

Managing and Cure

Improper life-style and food habits, psychological stress factors like Atichinta (excess worry), Bhaya (fear), Krodha (anger), Alasya (dullness) etc., with or without genetic predisposition provokes and vitiates all the three Doshas to trigger the pathogenesis of hypertension.

The cure is to manage these through lifestyle and diet changes. One can also take herbs and therapies that work on balancing the dosha which has been impaired. E.g. for stress related triggers one can take Jatamansi, and go for Shirodhara. For Pitta impairments there are several formulas, e.g. Sutasekhar or Avippatikar. Good massage therapy also helps with reducing the Pitta impairments.

Holistic Plan

Evaluating the entire history of the patient . Depending upon how the lifestyle and eating habits are, the treatment is planned.
Stress, insomnia, erratic lifestyle lead to vitiation of Vata. So treating Vata induced hypertension with daily Abhyanga , shirodhara , takradhara, nasya and herbs like Jatamansi, Brahmi ,Ashwagandha, Gokshur, Sarpagandha help.
Pitta related hypertension could be due to faulty eating and sleeping habits. Shirodhara, Takradhara and daily Abhyanga , internal medication like mauktik pishti, Sootshekhar, shatavari, Ashwagandha , yashtimadhu, Raktapachak help.
Hypertension can be a symptom of underlying disease as well and needs lifestyle and dietary correction for complete relief.
Yogasanas like pranayama, shavasana are beneficial.

References

https://www.sciencedirect.com/science/article/pii/S0975947617302954

Resistance Offered by Blood Vessels

Blood Volume

Heartbeats and Rhythm