Salt and the tongue have been in love with each other for centuries. The tongue is so much used to salty taste that to separate the two is to make lives saltless, a proverb commonly used to indicate that all pleasures have departed form life.
In the Roman Empire part of the salary was paid in “salt” and this is how the word “salary” took origin. Those who, as a matter of habit, consume more salt have a higher average blood pressure that those who consume less salt. Too much sodium, an unwanted ingredient in salt, is the principal cause of high blood pressure. Too much sodium also causes the body to excrete much needed potassium salts. The load on the kidneys increases when we take in more salt.
Salt helps to retain water in the body. it is common to consume two to three or even more times salt than it is needed for the body. Now it is clearly acknowledge that more salt is injurious to health. Do not take more than 4 gms of salt in a day. Cutting down on salt will bring down blood pressure. Spicy food helps to consume more salt. It affects the wall of arteries and makes them more sensitive to stimulation. Generally, the palate is conditioned to salty foods. Cut down, gradually, on salt. Instead, use herbs like dhania leaves pudina leaves and curry leaves and mild spices, like onion garlic, radish or even mild masala like jeera, dhania, haladi and mustard seeds etc. Avoid processed food and pickles which are known to have too much salt.
Slow -moving rural folk, who are in close contact with nature have less problems with blood pressure. A study of Pacific Islanders showed that the group in closer contact with the modern ways of society have higher blood pressure that those found in communities from where they migrated. Even if food remains the same. Smoking: cigarette smoking not only increases blood pressure and heart rate but also affects the quality and quantity of blood reaching the heart. Nicotine in cigarette increases heart rate and blood pressure. Carbon monoxide which is inhaled along with the smoke affects blood as far as the release of oxygen, is concerned. Nicotine constricts coronary arteries. It reduces blood supply reaching the heart.
Exercise is beneficial in hypertension. It reduces heart rate and blood pressure. The collateral blood supply to the heart increases, increasing the total amount of blood reaching to the heart musculature. To help the heart, stop smoking cigarettes and start doing exercise. A good physician always checks blood pressure. If a patient is found to be suffering form high blood pressure he should be advised to check his blood pressure regularly. Unfortunately many cases are detected very late after the onset of heart attack or stroke or after death.
Treatment : To treat a patient with high blood pressure is difficult. It needs understanding, friendly inspiring and a polite physician. It is important to explain to him his disease, why one gets high blood pressure, what damage it can cause and how long it will take for blood pressure to harm the body. Most patients suffer form mild to moderately high blood pressure. These are patients who are not benefited by medication to bring down blood pressure. Most deaths which occur in such cases are due to heart attack. In none of the individual clinical trials carried so far, no significant benefits were noted after long terms proper treatment by medication. It will not be wise to assume that new drugs which have come into the market will be safe and effective till they have been tried for several years.
These drugs only lower the blood pressure, nut do not do anything to reverse the process of progressive damage being done to the body. it is important to know the significant role played by diet, exercise, relaxation and the beneficial effects of non-smoking. The aim of treatment is to reduce the risk of getting a heart attack to stroke. What should be the treatment will depend on the level of the blood pressure and the number of risk factors it carries. If blood pressure is high the immediate need is to reduce it. We can think of other measures to be taken later on. In a majority of cases where blood pressure is mild, to moderately high, giving up cigarettes and starting a proper diet can work wonders.
If you are obese, a reduction in body weight will help to bring down blood pressure. Be prepared for a long journey of diet control, less fat, less salt, less sugar, complex carbohydrates and more fibres. Take sugarcane juice, jaggery and honey, instead of sugar. Use whole wheat flour instead of white flour. Take a lot of fibres in the form of salads, green vegetables and fruits in the diet. Cut down on milk and milk products. All this is to enable you to cut down calorie intake and reduce weight.
Start on morning walks, jogging and exercise. You will use up more calories by the help of exercise. Exercises helps reduce heart rate and blood pressure. Did you know that the athletes have a slower pulse rate than a normal person. Slow down the pace of life learn to relax, do savasana as advocated by the late Dr. K.K. Datey, eminent Mumbai cardiologist. Do meditation to help bring down blood pressure. Studies have shown that during meditation there is 25 percent decrease in cardiac output, compared with a 20 percent decrease during sleep. The heart rate falls by about 5 beats a minute. Researchers have found evidence of reduction of blood pressure. Meditation helps in two ways – first it induces a relaxed state of your body and mind which is useful in moments of stress. Second, although, this is less clear, it seems to have some direct physiological effects which are beneficial to those who are prone to coronary diseases.
Do not expect miracles to happen overnight. It takes years for blood pressure to develop and it takes months to control it and reverse the process to the damages caused by blood pressure to the body. work hard with a strong mind. Be prepared to hold your destiny in your hands. Things are difficult to start with, once you get started, pursue your aim with a strong mind and with the passage down, and in due course you will walk back on the path of good health and a future when the danger of imminent heart attack and stroke is not hanging over your head.
As you progress, blood pressure will come down. Blood cholesterol and glycerides will start falling, moving towards normal levels. Frelation between the physician and patient is important. A or all this, a close patient who knows well is likely to follow the advice more keenly. Many patients drop out and are not seen on the next appointment. Few will do by deliberate rejection of therapy, but in most cases is because of less proper understanding of the disease. A well run clinic should have a proper record of attendance and issue reminder, if required.
Drugs for high blood pressure
Diuretics: (chlorothiazide and related drugs) they are important as they help in the excretion of extra salt from the body. The same job can be done if we adopt a low salt diet. The disadvantage with a diuretic is that needed potassium salt are also excreted out simultaneously and must be supplemented with fruit juices or potassium supplements. Drugs normally used are chlorthalidone ( Hygroton), Furosemide (lasix), Metolazone (zaroxolyn) etc.
Side effect: May cause impotency in men, potassium depletion, rise in uric acid levels, nausea, dizziness, rashes, numbness, pins and needles, may increase diabetes. Regular check of blood for sugar and urates should be done.
Beta blockers (practolol & propranolol) : they reduce the rate and force of the contraction of heart and reduce the cardiac output.
Side effects : breathless and swelling of the ankles. May cause asthma, cold extremities. You may have vivid dreams and insomnia. Long term use may elevate tryglycerides and lower high density cholesterol which is good for heart.
Vasodilators ( Hydralazine and Minoxidil ) : Main cause of high blood pressure is constriction of peripheral blood vessels. These drugs help o dilate them and bring down blood pressure. They increase the heart rate and force the contraction of the heart, should not be given if the patient is suffering form angina pectoris or myocardial infarction.
Side effects: flushing of skin, headaches, palpitation, gastrointestinal disturbances, dizziness and fluid retention.
Centrally acting drugs (Methyldopa and Clonidine): These drugs cause drowsiness, and dry mouth, anaemia, diarrhoea, skin rash even drug induced fever after 15 days. Clonidine, in addition to above side effects, may also cause constipation, tremor, sweating and insomnia.
Adrenergic Neuron Blocking drugs: (Guanethidine and Bethanidine): they are very effective in reducing blood pressure. They may cause substantial fall on standing and after exercise.
Side effects: Ejaculation during sexual intercourse in males may be inhibited. May cause diarrhoea, slow heart rate, weakness and nasal stuffiness.
Reserpine: it is derived from a plant Raulfia Serpentina used in India for centuries. It has tranquilizing effect on the mind.
Side effects: Slow heart rate, aggravation of peptic ulcer, diarrhoea, drowsiness, depression etc. These drugs have a different mode of action and several side effects. They are quite often given in combination so that their doses can be reduced and thus the side effects. It will also depend on the age, season, profession of patient etc.
Before we start the treatment is should be well understood that it is a life long treatment. If they are stopped, blood pressure will come back to pre-treatment level or even a little more. Generally, blood pressure is treated with the hope to prevent a stroke or heart attack. Various studies have shown however that it hardly alters the course of terminal disease.
If you important to remember it may cause an abrupt rise in the blood pressure (as clonidine). Other drugs stopped suddenly may worsen angina pectoris or even cause myocardial infarction. It is important to remember that if we are on a drug for a long time it is always advisable to gradually reduce it and then stop it though it may take weeks or months. The benefit of medicinal treatment to reduce high blood pressure is still doubtful inspite of a lot of research.
Hypertension can better be controlled by diet and special relaxation techniques rather than customary medical care. If we control blood pressure and cannot control the other risk factors like smoking, fat consumption, lack of exercise and tension the results are negative. Medical treatment will do more harm than good if we are depending on drugs only and doing nothing to change the lifestyle.
The West has very clearly understood the invalidity of medicinal treatment in prevention of a heart attack or stroke. Death due to heart attack is common in the west due to affluence and all the luxuries available to them. It has arrived in a big way in India. Every year over 3.5 million people die in India due to heart attack, according to leading Mumbai cardiologist, Dr. B.K. Goyal. The west has become more health conscious. The number of people smoking cigarettes is reducing every year. They have taken to jogging and eating a lot of fibre foods like salads, fruits and boiled vegetables and cutting down on meats. For good health’s sake, it is time we became conscious of the way of life as medicinal treatment holds little hope.
Cut down on sugar, oils (including ghee and butter) salt, white flour, tea and coffee. Stop alcohol and tobacco. Eat more vegetables and fruits. Start one week on fruits only. Take fruits with your breakfast, lunch and dinner, preferably one fruit at a time. Take oranges, sweet limes, papaya, apples, pears, mangoes, guava, pineapple, rose apples, raspberry, melon, plums, peaches, strawberries etc., avoid banana and jack fruit.
After a week add mild besides fruits. Cow’s milk is the best. If not available, take any low fat milk (Boil the mild just once). After two weeks add cereals. Take boiled vegetables or cook them in little oil. Salad, curd and chapati made of whole wheat flour for lunch and dinner. Take more green vegetables. Cut down on salt. Cut down on condiments to reduce the requirements of salt. Do not use more than 2-4 gms. salt per day. Salt retains water in the body an increases blood pressure. Avoid overeating.
Eating less will help cut down body weight, will keep blood pressure down. Avoid taking meat and eggs. Cut down on fish and chicken. Remember, twenty percent of your food should come from cereals, milk, nuts, pulses etc. the remaining eighty percent from vegetables and fruits. Take dry fruits like dates, raisins, anjir, manuka etc. In small quantities take cashewnuts, peanuts, almond (badam) etc. Take a glass of fruits or vegetable juice (cucumber, white pumpkin, carrots, cabbage etc.) Do not smoke cigarettes or bidi and do not chew tobacco. Cut down on coffee and tea. Nicotine and caffeine increase blood pressure.
Use a minimum of oil or ghee in cooking. It is likely to get deposited in the lumen of blood vessels as cholesterol. Fat deposits reduce blood supply. Avoid frying food. Do not take sugar. It is high calorie pressure. Drink plenty of water, atleast 2 litres a day. This is to help you to urinate more and excrete waste products from the body. A luke warm water enema if you feel constipated is recommended.
Exercises increase blood pressure, this is why it is better to start with easy exercises. As the body gets used to exercise, blood pressure will be more sustained. Exercise will help increase circulation of blood. There will be less chances of artery getting blocked, causing heart attack. Avoid worry and tension. Blood pressure may go up by 15-20 mm of Hg with tension. Rest and relaxation will bring it down. When very angry or emotionally upset, blood pressure will increase. A blood vessel in the brain can give way and cause a paralytic shock.
Learn to relax. Change your lifestyle. Learn to deal with your business or job effectively if it is causing tension. Try to do the corpse pose (sava-asana) every day, try relaxation techniques. Learn to mediate. It is effective to combat tension. Have good quality sleep, atleast 8-9 hours every day. Take 1-2 hours rest in the afternoon after lunch. Whenever you feel uneasy it is always advisable to take body wash before going to bed if you have problem getting sleep.
Pranayama is good for blood pressure as it ventilates the lungs better and causes relaxation. Water treatment is of help. Take whole body pack twice a week. Steam and sauna should no be taken pressure is high. Anyway, do not take it for a long time preferably for more than 3-6 minutes twice a week. Massage is good but should be done lightly, should be done in the direction away from the heart. Take massage in the sun if it is cold.