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Blessed with a solid build and bulging biceps, the ruddy-faced Kheng, an entrepreneur in his mid-30s, looks like he’s in the pink of health. Many people are thus surprised to learn that the fit father of one, who counts fencing and jogging among his hobbies, has been grappling with hypertension for over a decade.
“I first realised that I suffered from borderline hypertension during my pre-National Service enlistment medical check-up,” Kheng recalls. According to the World Health Organization (WHO) standards, a normal adult’s systolic blood pressure should be lower than or equal to 140mmHg (18.6kPa), while his diastolic blood pressure should be lower than or equal to 90mmHg (12kPa). He invested in a blood pressure monitor and kept to a healthy diet and exercise routine. However, as stress built up over the years, his condition deteriorated. At 31, after suffering from a double whammy of work-related stress and his mother’s death, Kheng found himself in the hospital when his systolic blood pressure shot past the 180mmHg mark.
Since then, he has been popping Atenolol daily to curb it. “But once I miss a dose, my blood pressure goes right up, laments Kheng. Although he is still faithfully taking his medicine, he is hoping to find alternative treatments to complement and, hopefully, cure his hypertension. NATURA asks Traditional Chinese Medicine (TCM) and Ayurveda practitioners how they can help Kheng and other patients with hypertension.
*Not his real name
According to Mr VC Ajith Kumar, a physician with Ayush Ayurvedic who has 24 years of experience, blood pressure varies from person to person depending on the age, gender and amount of physical and mental work one does.
Males, the aged and those who are exposed to more mental and physical work normally maintain higher blood pressure than others. Physiological conditions, such as fear, anger and excitement, also cause blood pressure to rise. Conversely, a person who is resting or sleeping will maintain a lower blood pressure,” explains Ajith.
Ayurvedic practice also believes that blood pressure rises because of the Vitiation of Vatha (vatha is one of the three doshas, which maintain harmony in the body). Excessive intake of salt, lack of exercise, worry, sleeplessness, kidney diseases and other conditions corrupt the vatha and result in high blood pressure. This is particularly evident in old age, especially when the kidney is affected. The Principal of the Singapore College of Traditional Chinese Medicine, Dr Xiang Ping, a veteran Chinese physician who has 44 years of experience under his belt, shares several other risk factors for hypertension. These include family history (when both parents have high blood pressure), excessive fat intake, long-term excessive alcohol consumption, smoking and obesity. In addition, long-term mental stress due to occupational and environmental factors (such as constant exposure to noise) and even adverse visual stimulation can also raise one’s blood pressure.
As a result, a patient with hypertension usually can’t sleep well and may experience palpitation, headaches, vertigo and insomnia. He may also suffer from numbness of the limbs, exhibit forgetfulness and an inability to concentrate. When high blood pressure becomes chronic, the capillaries supplying blood to the eyes, especially to the retina, are affected, which results in local bleeding and impairment of vision. Arteries supplying blood to the brain may even rupture, causing cerebral haemorrhage and resulting in paralysis. “Repeated bleeding may occur in different parts of the body,” warns Dr Xiang.
As hypertension is a silent disease, some patients may not notice symptoms for years. However, diagnosis is simple, and appropriate treatment can greatly improve a patient’s quality of life.
Medicines that alleviate vayu, (or breathing) and strengthen the nervous system are useful, says Mr VC Ajith Kumar, a physician with Ayush Ayurvedic.
These include garlic and Sarpagandra (rauvolfia serpentine).
Sirodhara therapy may also be considered. Boiled medicated oils with sida rhombifolia (白背黄花稔) and milk are used in this therapy. This oil is kept in a vessel hanging from the pedestal or the roof of the house. The patient lies on the ground on his back and the medicated oil drips from a small hole at the bottom of the vessel onto his forehead, between the eyebrows. This helps the patient sleep soundly at night, and can lead to lowered blood pressure.
As for the diet, avoid hot and spicy foods, salt and hydrogenated oils. Cook with almond oil and eat plenty of vegetables—especially bitter gourd, patola and bimbi—to ‘smoothen’ your bowels. Avoid colicasia and yellow varieties of pumpkin. Instead, choose dried fruits, orange, banana, guava and apples to improve your condition.
In terms of lifestyle, avoid late nights and mental strain, and rest as much as possible. While the patient can undertake physical exercise, lifting of heavy weights is to be avoided. Keep to regular meals and bowel movements. Ajith also recommends devoting time for meditation to gain mental peace and tranquility.
TCM calls for a comprehensive regime to tackle the root of the problem. Dr Xiang Ping, the Principal of the Singapore College of TCM, recommends complementing anti-hypertensive drugs with Chinese medicines, prescribed according to your afflictions. For example, those with deficiency in the liver-yin and kidney-yin can try Liuwei Dihuang pills (六味地黄丸), while those who have deficiencies in both yin and yang may benefit from Guilu Erxian glue (龟鹿二仙胶) and Jingui Shenqi pills (金匮肾气丸).
Dr Xiang also advises patients to keep calm, maintain a disciplined lifestyle and an appropriate exercise regime, such as walking, gymnastics, taiji and qigong. Stick to a light diet rich in vitamins and protein, but cut down on salt and cholesterol, and avoid smoking and alcohol. Dr Xiang recommends incorporating more potassium-rich vegetables such as celery and carrots, and calcium-rich items such as milk, walnuts and fish. A simple diet he recommends includes three bananas daily, a ‘snow soup’ cooked with 100g of jellyfish head and 250g of water chestnut, and taking 200g of tomatoes on an empty stomach every morning.
Liu Xing, a senior physician from Eu Yan Sang Premier TCM Centre with 29 years’ experience, says treating hypertension with prescriptions is not enough. “There’s a saying that goes ‘30% medication, 70% maintenance’,” she reveals. “It is just as important to change one’s lifestyle.”
Senior Physician Liu encourages everyone to stop smoking and cut down on alcohol and salty, fatty foods. Instead, one should take more lean protein and fibre. One should also take up a suitable exercise such as walking, swimming or taiji, especially if one is overweight.
Her dietary tips come in groups of threes: three vegetables (eggplant, celery and shitake mushroom), three fruits (water melon, apple and water chestnut) and three teas (hawthorn berry, chrysanthemum and cassia seed). For TCM herbs, she recommends Gastrodia (tianma) and Gambir Vine (gouteng) (for those with weak yin and strong yang), Ji Ju Di Huang Tang, a soup containing Chinese wolfberry, chrysanthemum and foxglove root (for those with weak liver and weak yin), and Er Xian Tang (for those weak in both yin and yang). However, you should always consult a TCM practitioner for a personalised formulation.
Liu warns, “If symptoms of hypertension are not addressed, coronary heart disease, heart failure, stroke, renal dysfunction and diabetes can develop.” She also advises older folks to be particularly careful. “According to a 2004 National Health Survey, 60% of males and 85% of females above the age of 70 suffer from hypertension.”
Photo courtesy of Thinkstock. This article first appeared in NATURA magazine issue No.2.