Hypertension or high blood pressure is considered as a Vata disorder in Ayurveda. Hypertension is a result of abnormal functioning of Vata causing a condition known as Raktagata vata. Since Rakta and Pitta are always affecting each other, here pitta is also deranged. The treatment approach to every disease in Ayurveda involves identification of Doshas and the extent of derangement; the same philosophy is employed in the management of hypertension.

As it is evident that hypertension can be due to many etiological factors and the ultimate manifestation of various changes like stress, hormonal insufficiency, disorders like kidney disease can cause an increase in blood pressure. Ayurveda targets the correction of doshas involved in the process.

TREATMENT

1. Nidana parivarjanaTreatment always begins with identification and correction of the factors responsible for the disease. Causes for the manifestation of hypertension are unhealthy lifestyle, diet and sleep patterns not in tune with nature's rhythm, incompatible food, excess intake of processed food, smoking, alcohol consumption and hereditary factors.

1. • Maintenance of the healthy BMI, reducing the excess weight from the body by increase in physical activity with moderate intensity.
   • Diet containing fruits and vegetables in good amounts and restricted amounts of fat and unsaturated oil should be followed.
   • Reduction in intake of table salt. Reducing the amount of sodium and increasing the amount of food containing magnesium and potassium.
   • Alcohol consumption and smoking should be restricted.
   • Following Dinacharya (healthy daily regimen) and Ritucharya (regimen according to the season) as directed in Ayurveda will help bring positive change in the body as a whole.
   • Stress should be reduced through various methods such as pranayama, meditation and yoga.

2. Samprapti BhangaTo assess the pathogenesis of the disease by understanding exactly the dosha involved in the manifestation of the disorder and working towards the correction of the same. Here the methods of treatment will be Shodhana (Panchakarma) and Shamana (Medications)

Shodhana chikitsa - In Raktagata vata, the vata affects the rakta and in turn vitiates pitta.

• Virechana or the medicated purgation is the process to remove the vitiated pitta from the body. Virechana eliminates the pitta and corrects the metabolism to bring about lightness in the body. Pitta in the blood is also corrected by this process.
• Basti or the medicated enema helps in bringing the vata under control which plays a major role in causing the disorder.
• Raktamokshana or the bloodletting therapy to let out the contaminated blood from the body.

Shamana Chikitsa - Medications advised for oral intake

• Single herbs which help in reduction or control of hypertension are-

• Most popular form for usage of the single drugs is the Ksheera paka (milk preparation). The herb or herbs (in this preparation) are boiled in specified quantities of milk and water until only milk remains. By the time the water content of the preparation evaporates, the milk would be saturated with medicinal properties. The final milk recipe obtained after filtering off the herbs is called Ksheerapaka.
• Different formulations according to the doshas are advised by the Ayurvedic physician. Few of the formulations

  Hridayarnava rasa	Shiva gutika
  Arjunarista	Prabhakara vati
  Pravala pishti	Mukta vati
  Punarva mandura	Vasavaleha
  Rasapachak	Rakthapachak
  Narasimha Rasayan	Brahma Rasayan
  Mahakalyanaka ghruta	Saraswatharista
  Brahmi gutika

Other external therapies used

1. Takra dhara - Medicated butter milk is poured over the forehead in a continuous procedure. Shiro dhara reduces the stress hormones such as adrenaline and noradrenaline and relaxes the body as well as mind. It is employed in treatment of many psychosomatic disorders, stress, anxiety and depression.
2. Shiro dhara with oil - Medicated oil is poured over the forehead for a specific amount of time. This not only takes care of vitiated vata by virtue of its procedure, the application of oil in any form is said to pacify vata.
3. Shiro pichu - Swab dipped in medicated oil is kept on the posterior fontanelle region. This procedure has the same effect as shiro dhara but to a lesser extent.
4. Shirolepa - Paste of herbal medicines is applied on the head. The herbs are picked with care to achieve the desired effect.
5. Avagaha - Tub bath with herbal decoction.

With a comprehensive approach Hypertension can be managed very well so that it does not cause further damage to major organs in the body.