Homeopathy for Resistant Hypertension
Cardiovascular diseases (CVD) account for large number of deaths worldwide. Unfortunately, India holds the second position in the world. Emerging burden of CVD in developing countries like India ishighly alarming.[1] Hypertension is the most responsible factor for mortality from 57% of stroke and 24% of coronary heart diseases in India.[2]As per a recent study 25-30% of urban and 10-20% of rural India is reported to be suffering from hypertension. According to World Health Report 2002, cardiovascular diseases (CVDs) will be the largest cause of death and disability in India by the year 2020. In 2020, the mortality rate of coronary heart disease is expected to be 2.6 million which would constitutearound 54.1 % of all CVD deaths.
Resistant Hypertension
It is one of the common clinical problems faced by general physicians and specialist alike across the medical systems. It is defined as a failure to achieve a targeted blood pressure of<140/90 mmHg in patients despite the use of different types of conventional antihypertensive drugs. The exact cause of prevalence of resistant hypertension is unknown. National Health and Nutrition Examination Survey (NHANES) of US recently had conducted a study on individuals suffering from hypertension which showed that only 53% were controlled to levels <140/90 mmHg by antihypertensive drugs.[3]
Causative factors, symptoms and complications
The cause of resistant hypertension is undefined. Sometimes secondary hypertension may be the cause of resistance hypertension. Genetic factors, aberrant sympathetic nervous system activation and altered renal sodium and water regulation due to changes in the renin-angiotensin-aldosterone system are the likely factors responsible for resistance hypertension. Heaviness of head, dizziness, headache, chest pain, nose bleeding, etc., are some of the common indications. Uncontrolled blood pressure damages the end organs like heart, kidney, eye, etc. Heart failure, stroke, ischemic heart disease and renal failure may be the consequences of untreated hypertension.
Lifestyle modification
Dietary regulation and physical exercise play a very important role in overcoming resistant hypertension. Itis often recommended to eat foods that are low in sodium and salt, and high in potassium.Scientific reports have indicated lifestyle as a major factor for increased cholesterol and triglyceride levels. Lifestyle and food habits have changed drastically in metros and urban areas in the last few decades as compared to the rural India. Quantity of high fibre diet like fruits, vegetables, sprouts, etc., has gone down. On the other side, quantity of fried foods, fats and carbohydrate rich food have increased. Physical activitiesare reduced and sedentary habits have increased. These result in increased number of people with hypercholesterolemia and high blood pressure which in turn increases the risk of heart diseases.As per some studies and reports, more than 30% of total daily calories should not be obtained from fat, more than 300mg cholesterol should not be taken in a day, and more than 1500mg of sodium should not be taken in a day. Foods like apples, bananas, oranges, fish rich in omega-3 fatty acids, brown rice, whole-wheat pasta, broccoli and carrots helps to reduce hypertension. Red meat, fat, sweet, alcohol, and high sugar contained drinks should be avoided. Smoking and alcohol drinks should be stopped. Physical activity is another important factor to manage high blood pressure. Management of stress by meditation and stress relieving exercises and activities should be included in daily routine.
Homeopathic remedies and their indications[4],[5],[6]
Recently a study had been conducted to find out the effectiveness of individualizedhomeopathic remedy. A double‑blind, randomized, placebo‑controlled, parallel‑arm clinical trial was conducted at the outpatient department of Mahesh Bhattacharyya Homeopathic Medical College and Hospital, West Bengal. Out of 233 hypertensive patients, 150 cases were enrolled and randomized. After six months of treatment, mean Systolic Blood Pressure (SBP) reduction was 26.6 mm Hg in the homeopathy group and SBP increased by 3.6 mm Hg in the placebo group whereas Diastolic Blood Pressure (DBP) in the homeopathy group reduced by 11.8 mm Hg and increased by 1.6 mm Hg in the placebo group. Most prescribed remedies were Natrum muriaticum, Calcareacarbonica, Sulphur, Thujaoccidentalis, Acidumnitricum and Medorrhinum.[7] Below are some of the remedies that are useful in managing resistant hypertension.
Natrum muriaticum: Itis indicated for individuals suffering from hypertension afterchronic worries, grief and depression, etc. Tendency to weep, desire to be alone and dwell constantly on unpleasant incidents of the past. History ofprolongedintake of excessive salt.Hypertension with headache as if a thousand little hammers were knocking on the brain, in the morning on awakening, after menstruation, from sunrise to sunset. Craving for salt and strong thirst..Sticking sensation in cardiac orifice. Increased pulse rate. Sensation of coldness of heart. Heart and chest feel constricted. Fluttering and palpitation with intermittent pulse. Heart’s pulsations shake body.
Barytamuriatica:This remedy is linked to aging or hypertrophy where there are certain vascular degenerations.It is reported to be effective in arresting hypertension especially when associated with arteriosclerosis, aneurism and cardiac dilatation in old people.
CalcareaCarbonica: Shortness of breath, especially on going upstairs. Rush of blood to head with heat, redness and puffiness of face worse from alcoholic drink, in morning when waking upand after mental exertion.Appetitepoor, with an aversion to meat and a craving for boiled eggs, salt and sweets.Tremulouspulsation of heart worse after eating, at night, with anguish.
Cactus grandiflorus: It acts on muscular fibres of the heart and is indicated for high blood pressure with anxiety due to heart affections with congestive headaches, constriction in the chest, acute stabbing pains in the heart and weak heart. It is also indicated for low blood pressure. Constriction in chest, as if bound, hindering respiration.When the breath stops there is violent palpitation, and something seemed to be whirling up from chest to brain, and all arteries seems to be throbbing.Irregular palpitation of heart at night; when lying on left side or turning in bed, better from an upright posture and deep inspiration.
Crataegusoxyacantha: Hypertension with arteriosclerosis. It is said to have a solvent power upon crustaceous and calcareous deposits in arteries.Itis used for stage 2 and 3 hypertension and its symptoms like extreme dyspnoea and exhaustion at the least exertion, angina pectoris, valvular murmurs, irregular pulse, cyanosis, cold extremities and oedema.
Convallariamajalis: It increases the heart’s action and renders it more regular. Greatsoreness in the uterine region with sympathetic palpitation of the heart.It is used when ventricles are over distended or dilated and venous stasis is marked. It is indicated for dyspnoea, dropsy, tobacco heart, orthopnoea, angina pectoris, palpitation and tachyarrhythmia. Sensation as if heart had ceased beating, then starts very suddenly. Palpitation worse from the least exertion.Tobacco heart, especially due to smoking cigarettes.
Coffeacruda: It is indicated for hypertension with palpitation and suppression of urination. It acts on violent irregular palpitations especially after sudden stress, intolerable pain, restlessness and sleeplessness. Violent irregular palpitation especially after excessive joy orsurprise.
Gloninum:In hypertension, it is indicated in those of a nervous temperament who suffer from severe congestion and hyperemia of the brain. Congestive and throbbing headache are usually associated symptoms. Violent palpitation of heart, with throbbing carotids, pulsating headache in forehead and between the temples. Blood seems to rush to heart and mount rapidly into head.Sensation of pulsation throughout body.
Lobelia inflata: It is a vaso-motor stimulant and helps to increase blood pressure. It increases the activity of all vegetative processes. It is indicated for conditions with constriction of the chest and epigastrium, leading to dyspnoea, vertigo, nausea and vomiting, and arrhythmia. Dyspnoea and suffocation from every rapid movement, attended with vertigo, threatened loss of consciousness and a peculiar confusion of head.Profuse salivation, with good appetite.
Prunus spinose: It is indicated for hypertension with tachycardia, which is exacerbated with the slightest motion, dyspnoea, feeling of oppression of the chest and angina pectoris.Furious beating of heart, even at rest, and great danger of suffocation from slightest motion. It has been used to treat problems of urination and shooting headache.
Rauwolfiaserpentina: Many researchers have found that the active constituents of Rauwolfiaserpentina works by controlling nerve impulses along certain pathways that affect heart and blood vessels, thereby lowering the blood pressure.
Spartiumscoparium: It is used as palliative to combat arterial hypertension in large doses of mother tincture. Spartein sulphate in the tincture increases the strength of the heart, slows it and reduces the systolic and diastolic pressures. It has specific action upon the kidneys, enabling them to eliminate and relieve the distress upon the heart.Hypertension due to bad effects of tobacco use.
Valeriana officinalis: It is indicated for over-sensitiveness, nervous affections, spasms and convulsive movements of the diaphragm.
Viscum album: It lowers the blood pressure. It has a calming effect on palpitation and accelerated pulse. It also relieves weight and oppression of heart and dyspnoea. It is used for cardiac hypertrophy with valvular insufficiency.
Rare mother tinctures and other remedies in lower potency
Acoruscalamus:It is also known by the name Sweet flag. It is an Indian drug, found almost in all parts of the country. But especially it is common in Manipur and Naga hills. Though it is a drug used for dysentery and other gastrointestinal problems, recent research reports indicate that it has sedative analgesic effects with moderate depression of blood pressure.
Arnica montana:It is a drug well-known for injury and as hair tonic, but less known for its effects on heart. It affects the blood and vascular system. Symptoms occur after any trauma or overuse. Apart from hypertension, it has effect on arteriosclerosis and weakness of the heart muscle. It has tonic effects on blood vessels and the heart.
Arsenicumiodatum3x& 6x: It has specific action on arteriosclerosis, myocardial degeneration and senile heart, thus reduces the blood pressure. It is also indicated for associated symptoms such as vertigo, irregular and rapid pulse, tremulous sensation in the cardiac region and enlargement of heart.
Aurummuriaticumnatronatum3x& 6x: It is used in hypertension and arteriosclerosis. Other associated symptoms include pressure in the chest behind sternum, irregularity in heart beats accompanied by anxiety and shortness of breath. It is also useful in lowering of cholesterol in some cases.
Boerhaaviadiffusa:It regulates blood pressure and strengthens the heart. It is also indicated for frequent palpitation, intermittent throbbing pain in cardiac region, irregular pulse and hypertrophy of heart.
Ceanothusamericanus:It is a well known spleen remedy and hair tonic, but less known drug for it action on heart. It has marked blood pressure reducing powers. Indicated fordisordered heart, with palpitation and dyspnoea accompanied by enlarged spleen.
Chloralumhydratum: It is a powerful cardiac depressant, thus has a blood pressure lowering effect. Reported to be useful in angina, cardiac dropsy, tachycardia, irregular heartbeats, cardiac enlargement and weak heart.
Ginkgo biloba: It is a circulatory stimulant. Literature suggests its role in high blood pressure and arteriosclerosis.
Secalecornutum:It causes fall of the blood pressure due to the direct action upon the heart muscles. Also useful in angina, dyspnoea and oppression, boring pain in chest, precordial tenderness, palpitation, with contracted and intermittent pulse.
Terminalia arjuna:It is not only indicated in hypertension, but also for other diseases of the heart, both organic and functional angina pectoris, accompanied by suffocation, vertigo and palpitation.
Thyroidinum 3x &6x: It covers many cardiac symptoms associated with hypertension like tachycardia, weak, frequent pulse, with inability to lie down, palpitation from least exertion, severe heart pain and weak heart.
Uranium nitricum4x: It is indicated in hypertension with therapeutic keynote of great emaciation, debility and dropsy.
References:
[1]Global Burden of Diseases 2013 Mortality and Causes of Death Collaborators. Global, regional, and national levels of age -sex specific all -cause and cause -specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 385: 117-171.
[2]Gupta R, Guptha S, Sharma KK, et al. Regiona variations in cardiovascular risk factors in India: India Heart Watch. World J Cardiol 2012; 4:112-120.
[3]Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000.JAMA.2003; 290: 199–206.
[4]W. Boericke, New Manual of Homeopathic Materia Medica& Repertory [with Relationship of Remedies], Second Re-Augmented & Revised Edition Based on Ninth Edition, Reprint Edition 2002, B. Jain Publishers, New Delhi.
[5]HERING’S GUIDING SYMPTOMS of our Materia Medica By Calvin B. Knerr, M. D. B Jain Publishers Pvt Ltd;New Delhi
[6]H.C.Allen, Allen’s Keynotes and Characteristic Materia medica, B Jain Publishers Pvt Ltd, New Delhi
[7]SubhranilSaha, MunmunKoley, SeikhIntaj Hossain, Malay Mundle, Shubhamoy Ghosh, Goutam Nag, Achintya Kumar Datta, PrasantaRath, Individualized homeopathy versus placebo in essential hypertension: A double‑blind randomized controlled trial, Indian Journal of Research in Homeopathy / Vol. 7 / Issue 2 / Apr-Jun 2013