Hypertension
Definition
Western
Hypertension, commonly known as high blood pressure, is defined as a medical condition in which blood pressure in the arteries elevates beyond the normal range of 140mmHg for systolic blood pressure and 90mmHg for diastolic blood pressure for a substantial period of time. Complications of hypertension may develop and in turn increase risk of damage to vital organs in the body [1].
Traditional Chinese Medicine (TCM)
There is no equivalent term in TCM that is associated with hypertension as mild to moderate condition is largely asymptomatic for many years [1]. However, patients may be diagnosed according to the main symptoms displayed, such as the elevation of the functions in the Liver system, with the type of headaches (tou tong), dizziness (xuan yun) and occasionally, heart palpitations (xin ji) [20] experienced. Xuan Yun may also be a predecessor to stroke (zhong feng) [20].
Classifications or Symptoms Displayed in TCM Context
Acute Syndrome
Headaches or dizziness may be instigated by anger and depression, ringing in the ears, easily irritable, flushed face, bitter and dry taste in the mouth, insomnia and unsettled sleep or tremors in the limbs [20].
Chronic Syndrome
Feeling of heaviness in the head, drowsiness, chest tightness, nausea, expectoration of sticky phlegm, loss of appetite, fatigue, tongue with white, greasy coating [20].
Poor Circulatory Syndrome
Memory loss, insomnia, heart palpitation, lethargic, pale face and purplish lips or tongue [20].
Weak Body Constitution Syndrome
Headaches or dizziness may worsen with exercise, shortness of breath, fatigue, palpitations, insomnia, loss of appetite and bloated sensation in the abdominal region [20].
Weaken Functions of the Kidney System
Lethargic, ringing in the ears, weakness in the lower back and knees, insomnia or dream-disturbed sleep, memory loss, impotency or nocturnal emission, dry mouth, reddened tongue with weak pulse [20].
Causes and Risk Factors
Hypertension can be classified as essential or secondary hypertension. Genetic or environmental factors such as high salt consumption, stress, obesity, smoking and physical inactivity may interplay to affect cardiac output and peripheral resistance, which are the two core determinants of blood pressure [3]. Secondary hypertension has specific causes and usually occurs following other diseases such as renal parenchymal disease and Cushing’s syndrome [1]. There is also a higher risk of hypertension in people with family history of high blood pressure, smoking, obesity, and diabetes [4].
Treatments
Herbs commonly used in prescriptions for hypertension includes:
1. Gou Teng – 钩藤
|
English/ Common name
|
Gou Teng [21]
|
|
Latin species
|
Uncariae rhyunchophylla (Miq.) Jacks [21]
|
|
Park of plant used
|
Hooks and stems [21]
|
|
Action/s
|
Helps to exert vasodilating effect [6] and protect blood vessels endothelium against injuries caused by hypertension [7].
|
|
Precaution/s
|
Mild side effects of slow heart rate, dizziness, rashes and little menstrual discharge, which can alleviate by itself after some time [21].
|
2. Du Zhong – 杜仲
|
English/ Common name
|
Du Zhong [21]
|
|
Latin species
|
Eucommia ulmoides Oliv. [21]
|
|
Park of plant used
|
Bark of tree [21]
|
|
Action/s
|
Helps to reduce systolic blood pressure [8].
|
|
Precaution/s
|
No significant side effects have been reported [9].
|
3. Shan Zha – 山楂
|
English/ Common name
|
Hawthorn [10]
|
|
Latin species
|
Crataegus pinnatifida Bge. [21]
|
|
Park of plant used
|
Fruit [21]
|
|
Action/s
|
Found to have vasodilatory effect [11] by helping to decrease diastolic blood pressure [12], as well as reduce anxiety [12].
|
|
Precaution/s
|
Generally safe when consumed for short periods of time [10]. Side effects are usually mild such as upset stomach, headaches, and dizziness [10]. Pregnant women should avoid consumption as it may cause bleeding [10].
|
4. Sheng Jiang - 生姜
|
English/ Common name
|
Ginger
|
|
Latin species
|
Zingiber officinale Rosc.
|
|
Park of plant used
|
Rhizomes
|
|
Action/s
|
Helps in protecting the mucosa of gastric wall and relieves nausea [15]. Also has anti-bacterial [8] and anti-inflammatory effects [9-10].
|
|
Precaution/s
|
No significant side effects.
|
5. Dan Shen – 丹参
|
English/ Common name
|
Dan Shen [21]
|
|
Latin species
|
Salvia miltiorrhiza Bge. [21]
|
|
Park of plant used
|
Roots [21]
|
|
Action/s
|
May induce vasodilation by stimulating eNOS in attempt to reduce blood pressure [18].
|
|
Precaution/s
|
May inhibit platelet aggregation and increase the risk of bleeding and so patients with bleeding disorders and prior to surgery should avoid this herb. Some people may experience stomach discomforts, reduced appetite, or itching. Danshen should be avoided during pregnancy and breastfeeding [19].
|
6. Bai Shao – 白芍
|
English/ Common name
|
Bai Shao [21]
|
|
Latin species
|
Paeonia lactiflora Pall. [21]
|
|
Park of plant used
|
Roots [21]
|
|
Action/s
|
Helps to reduce pulmonary artery hypertension [5].
|
|
Precaution/s
|
Should not be used with li lu (Veratrum nigrum L.) [21].
|
Other treatments for hypertension include acupuncture [13-14], therapeutic massage [15] and qigong [16-17].
Tests & Diagnosis
Periodic monitoring of blood pressure on different occasions should be performed prior to any treatments [4]. Tests to detect organ damages, such as echocardiogram [4], urinalysis [4], ultrasound of kidneys [4] and fundoscopy [3] may also be done to evaluate prognosis of hypertension [3].
Home Remedies
Carrot juice + Spinach juice + Shan Zha
a) Soak Shan Zha with drinking water
b) Grind spinach, carrot and Shan Zha to extract its juice
c) Mix well.
d) Take a glass twice daily, morning and evening
References
1. Tierney, L.M., S.J. McPhee, and M.A. Papadakis, Current medical diagnosis & treatment 2007. 2007, New York London: McGraw-Hill Medical; McGraw-Hill [distributor]. xix, 1931 p.
2. Natural Home Remedies. Home remedies for high blood pressure. [cited July 2010; Available from: http://www.natural-homeremedies.com/homeremedies_high_blood_pressure.htm].
3. Kumar, P.J., Clinical medicine 7th ed. ed. 2009: Saunders Elsevier. 1,343 p.
4. Medline Plus Medical Encyclopedia. Hypertension. [cited June 2010; Available from: http://www.nlm.nih.gov/medlineplus/ency/article/000709.htm].
5. Sun Peizhong, S.P., Zhang Qingxian, Zhong Xiumei, Xu Xiufang, Wang Shujun, Wang Jing Du Juan Study of reducing pulmonary artery hypertension in chronic cor pulmonale by Injecting Paeonia lactiflora. Journal of Zhengzhou University (Medical Sciences), 1992. 4.
6. Goto, H., et al., Vasodilator effect of extract prepared from Uncariae ramulus on isolated rat aorta. American Journal of Chinese Medicine, 2000. 28(2): p. 197-203.
7. Goto, H., et al., Effect of Uncariae ramulus et Uncus on endothelium in spontaneously hypertensive rats. American Journal of Chinese Medicine, 1999. 27(3-4): p. 339-345.
8. Lang, C., et al., Effect of Eucommia ulmoides on systolic blood pressure in the spontaneous hypertensive rat. American Journal of Chinese Medicine, 2005. 33(2): p. 215-230.
9. Nutrafem Research & Ingredients. Eucommia Ulmoides Fact Sheet. [cited June 2010; Available from: http://www.nutrafem.ca/index.cfm?Fuseaction=article&ArticleID=490].
10. National Centre for Complementary and Alternative Medicine. Herbs at a glance: Hawthorn. [Cited June 2010; Available from: http://nccam.nih.gov/health/hawthorn/].
11. Chang, W.T., J. Dao, and Z.H. Shao, Hawthorn: Potential roles in cardiovascular disease. American Journal of Chinese Medicine, 2005. 33(1): p. 1-10.
12. Walker, A.F., et al., Promising hypotensive effect of hawthorn extract: a randomized double-blind pilot study of mild, essential hypertension. Phytotherapy Research, 2002. 16(1): p. 48-54.
13. Chiu, Y.J., A. Chi, and I.A. Reid, Cardiovascular and endocrine effects of acupuncture in hypertensive patients. Clinical and Experimental Hypertension, 1997. 19(7): p. 1047-1063.
14. Flachskampf, F.A., et al., Randomized trial of acupuncture to lower blood pressure. Circulation, 2007. 115(24): p. 3121-3129.
15. Olney, C.M., The effect of therapeutic back massage in hypertensive persons: A preliminary study. Biological Research for Nursing, 2005. 7(2): p. 98-105.
16. Lee, M.S., et al., Qigong for hypertension: a systematic review of randomized clinical trials. Journal of Hypertension, 2007. 25(8): p. 1525-1532.
17. Lee, M.S., H.J. Kin, and S.R. Moon, Qigong reduced blood pressure and catecholamine levels of patients with essential hypertension. International Journal of Neuroscience, 2003. 113(12): p. 1691-1701.
18. Kim, D.D., et al., Endothelial nitric oxide synthase is a molecular vascular target for the Chinese herb Danshen in hypertension. American Journal of Physiology-Heart and Circulatory Physiology, 2007. 292(5): p. H2131-H2137.
19. MedlinePlus Supplements. Danshen (Salvia miltiorrhiza). [cited July 2010; Available from: http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-danshen.html#Safety].
20. Zhou, Z.Y., 中医内科学. 2 ed. 2007: 中国中医药出版社. 521.
21. Gao, X.M., 中药学. 1st Ed 2002: 中国中医药出版社.