Hypertension

Elevation of systolic and/or diastolic BP, either primary (essential hypertension) or secondary.


A differentiation must be made between elevated blood pressure with no obvious medical cause (primary or essential hypertension), and that
due to an underlying pathology such as kidney, endocrinological or cerebral disease(secondary hypertension). This discussion is concerned
with essential hypertension.

There are over 35 million hypertensives in the USA, with twice the occurrence in Afro-Americans than
Caucasians. The reasons for this are not known. A common problem in our culture, hypertension is rare in cultures that are relatively
untouched by the western life-style. Life-style plays a major role in causing and maintain hypertension. Dietary, psychological and social
factors must all be addressed for any real change to occur.

Hypertension is typically free of symptoms until complications arise.
The symptoms associated with the condition can be caused by other problems as well, and include: dizziness, flushed faces, headache,
fatigue, epistaxis (nosebleed), nervousness. Observable changes in retinal blood vessels are diagnostic indicators of the degree of damage
caused to the body by the hypertension. Diagnosis must be based on finding that both systolic and diastolic blood pressure are usually, but
not always, higher than normal and that other causes have been excluded. Hypertension is considered to be a blood pressure reading
greater than 140/90 mm HG, but normal must be considered as a range rather than a specific figure for the whole population.

Temporary
increase in blood pressure is a common and normal response to the ups and downs or life. Sustained hypertension is caused by increased
peripheral vascular resistance. This is initiated by increased arteriolar tone and then followed by the damaging structural changes of
arteriosclerosis.


Actions indicated for the processes behind this disease

Hypotensives
are a broad range of remedies that have the observed effect of lowering elevated blood pressure. They appear to work in a variety of ways,
including most of the actions listed below.

Cardiac Tonics play a fundamental role is strengthening and toning the whole C-V
system when under such literal pressure. Used in the correct way they facilitate beneficial changes in both the pattern & volume of cardiac
output.

Peripheral Vaso-dilators will lessen high resistance within the peripheral blood vessels, thus increasing the total volume
of the system and so lowering the pressure within it.

Diuretics help remove any excessive build up of water in the body and
overcome any decrease renal blood flow that might accompany the hypertension.

Vascular Tonics will help nourish the tissue
of the arteries and veins.

Nervines address the tension and anxiety that will be associated with any stress component in the
patients etiology. There will also be an increase in tension due to hypertension itself, which will be eased with the appropriate nervine. As
most nervines are also anti-spasmodic the following applies for them as well.

Anti-spasmodics will ease peripheral resistance to
blood flow by gently relaxing both the muscles that the vessels pass through, and the muscular coat of the vessels themselves.

Circulatory Stimulants may help through an increase in peripheral circulation.

System support

The cardio-vascular system needs tonic support, and this is supplied by the core hypotensive remedies. Other areas that need attention
include the nervous system and potentially the lungs, beyond that it will depend upon the individual case.

Specific Remedies

A number of herbs have a reputation as being specific for hypertension, usually working because of their impact on one or other
of the processes involved in the conditions development. The hypotensives fit this description. The most important plant remedy within
western medicine is Hawthorn, probably followed by Linden. European mistletoe and Olive leaves are other well known plants thought of as
specifics. However the multi-factorial etiology of hypertension limit the value of the concept of a specific in its treatment.

One
possible prescription:


Hawthorn — 2 parts
Linden Blossom — 1 part
Yarrow — 1 part
Cramp Bark — 1 part
Valerian — 1 part
2.5ml of this tincture combination 3 times a day
Garlic should be used as a dietary
supplement.

This supplies:

  • hypotensive (Hawthorn, Linden Blossom, Yarrow, Cramp Bark, Valerian)

  • cardiac Tonic (Hawthorn, Linden Blossom)

  • diuretic (Yarrow, Hawthorn, Linden Blossom)

  • anti-spasmodic (Linden Blossom, Cramp Bark , Valerian)

  • vascular tonics (Hawthorn, Linden Blossom, Yarrow)

  • nervine relaxant (Linden Blossom, Cramp Bark , Valerian)

Other plants would come to mind depending upon the
individuals specific symptom picture. For example if headaches are part of the picture of the patients hypertension then include Wood Betony
as part of the prescription. If there are palpitations associated add Motherwort. Stress as a factor would indicate increasing the nervine content
and possibly including an adaptogen.

Thus:

A possible prescription for Hypertension with stress as a major factor:


Hawthorn — 2 parts
Linden Blossom — 1 part
Yarrow — 1 part
Siberian Ginseng — 1 part
Skullcap — 1 part
Cramp Bark — 1 part
Valerian — 1 part
to 2.5ml of tincture combination 3 times a day
Garlic should be used as a dietary supplement.

A possible prescription for Hypertension with associate headache:

Hawthorn — 2 parts
Linden Blossom — 1 part
Yarrow — 1 part
Cramp Bark — 1 part
Valerian — 1 part
Wood Betony — 2 parts
to 2.5ml of tincture combination 3 times a day
Garlic should be used as a dietary supplement.

A possible prescription for Hypertension with palpitations:

Hawthorn — 2 parts
Linden Blossom — 1 part
Yarrow — 1 part
Motherwort — 1 part
Cramp Bark — 1 part
Valerian — 1 part
to 2.5ml of tincture combination 3 times a day
Garlic should be used as a dietary supplement.
From here it is possible to fine tune an individuals’ medications to address their unique situation. The possibilities are as endless as people are diverse. From depression, debility, digestive problems, to bronchitis or P.M.S., the phytotherapists’ formulation can readily embrace their treatment.

A possible prescription for Hypertension with depression:

Hawthorn — 2 parts
Linden Blossom — 1 part
Yarrow — 1 part
St. Johns Wort — 1 part
Cramp Bark — 1 part
Lavender — 1 part
to 2.5ml of tincture combination 3 times a day
Garlic should be used as a dietary supplement.

Broader Context of Treatment

There are a plethora of factors that have been identified as being important in the cause and treatment of essential hypertension. However it must be remembered that causation is always multi-factorial and statements about alcohol or calcium are often too simplistic. For example, one study failed to show any association between heavy coffee consumption and long term hypertension. Such coffee drinkers tend to be heavy smokers as well and this in turn may be associated with a lower body weight and thus a lower blood pressure- but with increased risk of heart attack!

Dietary factors must be taken into account and include:

  • Dietary salt: the average western salt intake is about 15 times that needed by the body. A low salt diet is strongly indicated.

  • Potassium: the relative balance between sodium and potassium is crucial for many C/V factors. In addition to restricting salt intake, elevate to potassium levels in the diet by eating potassium rich foods, and using cooking methods that do not wash this essential mineral away.

  • Calcium and magnesium: supplementation with these minerals can have a marked hypotensive effect.

  • Obesity: a well known link exists between obesity and hypertension, as well as risk of heart attack, diabetes, gallstones, osteoarthritis and kidney disease. Weight reduction is essential, and often lowers blood pressure more effectively than drug treatment.

  • Sugar: in some individuals a heavy sugar intake may raise blood pressure, possibly by causing sodium retention or by a direct effect upon the stress response hormone system.

  • Alcohol: there appears to be a link between alcohol and hypertension, but not a simple one. Statistics show that people who drink a little have a tendency to lower BP than teetotalers or those who drink a lot. Alcohol withdrawal causes a temporary increase in BP before there is a fall. All in all it is safe to say that individuals with a tendency to hypertension should avoid alcohol.

  • Caffeine: tea, coffee and cola drinks will aggravate hypertension because of the stimulating effect of caffeine and other alkaloids they contain. This also goes for the herbal stimulant products upon the market.

  • Tobacco: experts disagree about the connection between tobacco and hypertension, but as there is no doubt about the impact of smoking upon the heart it should be avoided.

  • Saturated Fats: quite separate from the impact upon blood cholesterol and other lipids, there appears to be an association between too high levels of saturated fats and hypertension. As with all C-V conditions, increasing the ratio of polyunsaturated fats to saturated fats will help the healing process.

  • Vegetarian diets: a diet free of animal products definite lowers blood pressure and is strongly advised for hypertensive patients. At the very least there should be an avoidance of red meat.

  • Drugs: a number of medication raise blood pressure as an unwanted side effect. Check on all prescription drugs being used, and note that even OTC non-steroidal anti-inflammatories may cause mild water retention that can elevate BP.

  • The contraceptive pill: controversy still rages over the side effects of the ‘pill’! One such area of debate is its hypertensive effects. Bear this in mind when taking the case history.

Life style can often be the key in reversing this condition. Exercise, massage and other approaches to the body are important as are relaxation techniques and meditation. The nature of the individuals work, relationships, world view, self image etc. etc. all may contribute the hypertension, creating a challenging job for the herbalist! Please refer to the section on stress management for are view of techniques that might prove helpful.

Aroma therapy has much to offer with the appropriate oils being used in the context of relaxing massage. Hypotensive oils to consider include Lavender, Marjoram and Ylang-Ylang. Relaxing oils may be used if the individuals situation call for it, for example Chamomile, Rose, Bergamot or Neroli.

David L. Hoffmann BSc Hons MNIMH Written by David L. Hoffmann BSc Hons MNIMH

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