This document provides an overview of hypertension, also known as rakta chapadhikyata in Ayurveda. It defines both conditions and discusses their prevalence, etiology, classification, signs and symptoms, differential diagnosis, complications and management. Hypertension is a global health issue that is increasing due to changes in lifestyle. It is classified as essential or secondary hypertension based on its underlying causes. While often asymptomatic, common symptoms seen in patients include headache, dizziness, shortness of breath and chest pain.

1. HYPERTENSION VIS-À-VIS RAKTA CHAPA
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BY-DR.P.B.RATHOD
Asst.Proffessor
Dept.of Swasthavritta
B.L.D.E AVS AMV Vijaypur

2. Contents
• Introduction
• Definition
• Prevalence
• Nidana/Etiology
• Bheda/Classification
• Poorvaroopa
• Roopa/signs and symptoms
• Sapeksha Nidana/Differential Diagnosis
• Upadrava/Complications
• Sadhyasadhyata
• Chikitsa/management
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3. INTRODUCTION
• Hypertension(HTN) being a chronic illness constitutes
an important public health challenge because of its
prevalence and concomitant increase in the risk of
cardiovascular diseases. In India 14 % of people suffer
from hypertension, and majority of them have essential
hypertension.
• It is estimated that 1billion people are affected
worldwide.
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4. • As most of the patients suffering from abnormally
elevated blood pressure are asymptomatic, diagnosis is
either missed or delayed. Being imperative to the
health and longevity of man, the study of
Hypertension continues to be one of the most
intellectually stimulating challenges.
• Inspite of increasing public awareness and rapidly
expanding array of antihypertensive medications,
Hypertension remains one of the most frequent risk
factors for cardiovascular / cerebrovascular morbidity
and mortality.
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5. • Modern style of living might have given man all
comforts that he craven for, but in the mean time it
has darker side too, and one of them is suffering of
diseases. To mention few are Obesity, Diabetes,
Hypertension, etc.
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6. DEFINITION
• It is a condition charecterized by an increase in the arterial
pressure of the individual.
• “Blood pressure is the pressure exerted by blood, on the wall
of blood vessels.”
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7. DEFINITION OF RAKTACHAPADHIKYATA
• The word Raktachapadhikyata is formed out of union of three
distinct words. -Rakta, Chapa and Adhikyata.
• Rakta refers to Shareerastha saptadhatwantargata dhatu
vishesha
• Chapa refers to pressure or squeezing
• Adhikyata refers to high or increased
• This is a coined terminology which literally means High
Blood pressure.
But here, the word Raktachapadhikyata is used to denote
Essential Hypertension.
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8. PREVALENCE
• WHO has estimated that HBP causes 1 in every 8
deaths, making HTN the third leading killer in the
world. Globally there are one billion hypertensives
and 7.1 million people die as a direct impact of HTN
every year.
• According to recent survey in USA about 1 in 3
adults have HBP. HTN is directly responsible for
57% of all stroke deaths and 24% of all CHD deaths
in India. World hypertensive league recognized that
more than 50% of hypertensive populations are
unaware of this condition.
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9. • Community surveys carried out in India in different
geographical locations, often with small population
samples have reported prevalence rate of 10% in rural
and 25% in urban population.
• Increasing HTN in India is related to adiposity levels.
• The prevalence dramatically increases in patients older
than 60 years. In many countries, 50% of individuals in
this age group have hypertension. In females the
prevalence is closely related with age, with a substantial
increase occurring after age 50.
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10. • In Atharva Veda, asuddha rakta vahinis
are considered as sira and shuddha
raktavahinis are termed as dhamani.
• Charaka samhita is more of the opinion
of considering rohini siras or
asrugvaha sira as the artery.
• Sushruta samhita has used the word
Sira Pratana, to describe the plexus of
arteries or veins.
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11. MEASUREMENT OF BLOOD
PRESSURE
The diagnosis of Hypertension depends upon
quantitative measurements of Blood pressure which
inturn depends on accurate recording of Blood pressure.
Indirect measurement of Blood pressure can be done
with three common devices namely;
• Sphygmomanometer
• Electronic devices
• Automated ambulatory Blood pressure devices

12. However mercury sphygmomonometer remains
the Gold standard for measurement. The cuff of the
sphygmomanometer should be of proper size, the
bladder width within the cuff should encircle at least
80% of the arm circumference. The Blood pressure
recording is done with two methods.
Auscultatory method
Palpitatory method
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13. METHOD OF MEASUREMENT OF BLOOD PRESSURE
Patient should be rested comfortably, back supported
in sitting / supine position for atleast 5 minutes, arm
supported at heart level, they should not have smoked or
ingested caffeine within 10 minutes of measurement.
The Blood pressure should be estimated initially by
palpitatory method. While palpating the radial artery, the
cuff is inflated until the pulse is no longer palpable. After
inflating cuff to further 30mm of Hg is then slowly deflated
and the pressure at which the pulse is palpable is the
estimated Systolic Blood pressure.
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14. This method of estimation is called palpitatory
method with which only systolic Blood pressure can be
recorded. To measure both systolic and diastolic pressure,
by auscultatory method, the badder is then inflated to 30mm
Hg mercury above the previously estimated Systolic Blood
pressure and then slowly deflated at the rate of 2 to 3mm Hg
per second, after placing the stethoscope over the brachial
artery near medial cubital fossa on either of the arm,
preferably left.
The sound heard while deflating are termed as
korotkoff sounds which appear in five phases named after
Russian Surgeon Korotkoff who observed for the first time.
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15. Magnitude
• Hypertension is a global problem.In India,it is
estimated to range from 4 to 8 percent and the
the trend is increasing due to changes in life
style .A recent report indicates that nearly 1
billion adults globally had HTN in 2000 and this
is predicted to increase to 1.56 billion by 2025.
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18. Modifiable Risk Factors
• Occupation:
• Socio economic Status
• Physical Activity
• Obesity
• Diet
• Disease
• Lifestyle(Habits)
• Other factors
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19. BHEDA / CLASSIFICATION
Hypertension can be classified in several ways.
• Systolic and diastolic Hypertension
• Essential and secondary Hypertension
• On the basis of severity
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20. Systolic and Diastolic Hypertension
• The Blood pressure is recorded in terms of systolic and
diastolic pressures.
• In Hypertension these may raise individually or together
depending upon the pathogenesis.
• When there is rise of only systolic Blood pressure it is termed
as systolic Hypertension.
• When there is rise of only diastolic Blood pressure it is termed
as diastolic Hypertension.

21. Essential and Secondary Hypertension
This classification is made based on the causative factors
involved.
• Essential Hypertension is also called as primary
Hypertension where the cause is unknown. About 90–
95% of cases are categorized as
• The remaining 5–10% of cases (secondary hypertension)
are caused by other conditions that affect the kidneys,
arteries, heart or endocrine system.
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22. Classification of Blood Pressure on the basis of
Severity(W.H.O)
Category Systolic (mm hg) Diastolic (mm hg)
Normal <130 <85
High normal 130-140 85-90
Hypertension
Stage I Hypertension (mild) 140-159 90-99
Stage II Hypertension
(Moderate)
> 160 -179 > 100-109
Stage III Hypertension
(Severe)
>180 >110

23. Severely elevated blood pressure of systolic
≥180mm of Hg or diastolic ≥ 110 mm of
Hg(sometime termed malignant or accelerated
hypertension) is referred to as a "hypertensive crisis",
as blood pressures above these levels are known to
confer a high risk of complications.72
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24. POORVAROOPA
Vata plays important role in the pathology of
HTN. So by considering that vata vyadhi doesn’t
show any poorvaroopa it can be said that roopa in
milder form is the poorvaroopa.
Even Prodromal symptom has not been explained
for essential Hypertension in western science. If at all
present, the vague symptoms like headache,
giddiness, Insomnia, Palpitation may be present in
milder form.
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25. RUPA/ SIGNS AND SYMPTOMS
Essential Hypertension is an asymptomatic disease, until
it attain severity. Generally a few symptoms are recognized
occasionally. Some of the common symptoms with which
normally a patient goes to hospital and unexpectedly gets
diagnosed as Hypertensive patient are described here.
SYMPTOMS-
Headache
Dizziness
Shortness of breath
Nausea, vomiting
Anxiety
Pallor
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26. Headache
• The most frequent symptom ,headache is also very non-
specific sub occipital pulsating headaches,occurring early
in the morning and subsiding during the day are said to be
characteristic,but any type of headache may occur. In
22% of cases patients are more likely to report headache.
Giddiness
• Giddiness may be a symptom of hypertension and it
should be distinguished from vertigo,which is more
feeling of unsteadiness.This is the initial symptom
experienced by the patient and also frequently observed.
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27. Tachycardia
• This is troublesome feeling to the patients.A
history or recurrent episodes of tachycardia may be
due to intrinsic cardiac disease, anxiety,
thyrotoxicosis or excessive alcohol consumption.It
indicates the intensity of working heart.
Vomiting
• 15% of the patients suffering from malignant
hypertension are likely to present with vomiting
along with other symptoms.
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28. Insomnia
• Is a result of psychological strains like anxiety stress.
Chest pain
• Chest pain also may be due to complication of
hypertension (i.e angina or heart attack).this symptom
is observed later in the course of disease.
Fatigue
• Its feeling of exhaustion without doing work.
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29. SIGNS
Physical finding depend upon the cause of Hypertension, its
duration, severity and the degree of effect on the target
organs. These include;
• Elevated Blood pressure.
• Forcible pulse.
• Thickened and hardened arteries.
• Apex beat will reflect the underlying hypertrophy.
• 4h heart sound due to left atrial hypertrophy.
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30. SAPEKSHA NIDANA/ DIFFERENTIAL
DIAGNOSIS
Differentiating Essential and Secondary Hypertension
Factors Essential HTN Secondary HTN
Etiology Unknown Renal disease, vascular
disease, endocrine disease,
drug induced
History Strong family history of HTN along
with repeated finding of intermittent
pressure elevation
Often develops before the age
of 35 or after 55. History of
use of steroids or estrogens is
of obvious significance
Pathology Pathogenesis not clearly understood Pathogenesis depends on the
disease that had caused HTN
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31. BP recording Arise in BP when the
patient goes from the
supine to the
standing position
Treatment of the
primary diseases,
reduces the Blood
pressure
Symptomatic Symptomatic
/asymptomatic vague
symptom like
headache, vertigo easy
fatigability etc., will
be present
Symptoms of
underlying disease
Investigation No specific
investigation are
diagnostic
Depending upon the
underlying disease
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32. Prognosis Not bad, when benign
and is controllable with
regular medication
Depends upon the
primary disease
Treatment Non drug therapy
Reduced salt intake
Regular exercise
Weight reduction
avoiding risk factors
Drug therapy
Diuretics
Antiadrenergic agents
Vasodilator
Calcium channel blocker
ACE inhibitors
ACE receptor antagonists
Depends upon the cause
and requires drug therapy
during severe condition
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33. UPDRAVA/ COMPLICATIONS
Complications of HTN depend upon the organ
involved.
The major consequences can be classified under these
headings-
1. Cardiac complications
2.Neurological complications
3.Renal complications
4. Opthalmic complications
5.Vascular complications
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35. 1.CARDIAC COMPLICATIONS:-
a) Left ventricular hypertrophy (LVH)- It is commonly seen in
severe long-term Hypertensive patients.
b)Congestive cardiac failure (CCF)- With failure of cardiac
hypertrophy reserve,left ventricle may go in to failure resulting in to
pulmonary congestion and later on developing of congestive cardiac
failure.
c) Coronary arterial disease (CAD)- In Hypertensive patients
coronary artery disease is two times common than normotensives.
Acute Myocardial infarction (AMI) is twofold incidence as
compared to normotensives .
d)Sudden death may occur due to development of arrhythmia . when
compared Heart failure is four times common in Hypertensive
women and seven times in Hypertensive men.
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36. 2)NEUROLOGICAL COMPLICATIONS: -
a)Hypertensive encephalopathy -a life threating complication
may occur due to chronic Hypertension and accelerated
Hypertension.
b)Cerebrovascular accident is also the most common
neurological complication of Hypertension. It may be due to
cerebral ischaemia, embolism or hemorrhage.
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37. 3)RENAL COMPLICATIONS: -
a)As a sequel of malignant hypertension when the diastolic
pressure is greater than 140 mm of Hg ,the renal function
deteriorates rapidly leading to renal failure.
b)Atheromatous renal artery narrowing or occlusion may occur
as a consequence of high blood pressure in older patients.
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38. 4) OPTHALMIC COMPLICATIONS: -
a) Hypertensive retinopathy- Visual loss occurs due to
thromboembolic phenomenon or atherosclerotic changes
in retinal arteries.
b)Subconjunctival arteriolar hemorrhage is common at all
levels of high BP.
5) VASCULAR COMPLICATIONS: -
a) Aneurysm or dissecting aorta.
b) Obliterative atherosclerotic changes in medium sized
arteries.
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39. Sadhya asadhyata/Prognosis
In general any vyadhi, the course of which is
more than one year is considered kricchrasadhya
vyadhi and moreover effect of HTN is on 3 vital
organs of the body and any vyadhi of trimarma is
considered difficult to treat. So after considering all
these points HTN can be included under yapya
vyadhi.

40. DIAGNOSIS AND ASSESSMENT
Hypertension is generally diagnosed on the basis of a
persistent high blood pressure. Usually this requires three
separate sphygmomanometer measurements at least one week
apart.
Initial assessment of the hypertensive patient should
include a complete history and physical examination.
Exceptionally, if the elevation is extreme, or if symptoms
of organ damage are present then the diagnosis may be given
and treatment started immediately.
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42. Prevention of hypertension
Goals of Therapy
• The ultimate public health goal of antihypertensive therapy is
to reduce cardiovascular,cerebovascular and renal morbidity
and mortality.
• Treating SBP and DBP to targets that are <140/90 mm Hg is
associated with a decrease in CVD complications. In patients
with hypertension and diabetes or renal disease, the BP goal is
<130/80 mm Hg.
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43. 1.Primary prevention
• Population strategy:
On nutrition:
-Average consumption of salt
-Moderate fat intake
-Prudent diet
-Consumption of Alcohol is discouraged
-DASH Diet –To aviod saturated fats
-To incude MUFA and PUFA
 On weight:
On Behavioral changes:
Self care:
Recreations:
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44. • High risk strategy:
Obesity,Diabetics,Pregnant mothers,Family
history.
2.Secondary Prevention
1.Early diagnosis
2.Instituting non-pharmacological management of
HTN
3.Use appropriate drugs to control the blood
pressure
4.Regular-follow up
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45. 2.Secondary Prevention
1.Early diagnosis
2.Instituting non-pharmacological management of
HTN
3.Use appropriate drugs to control the blood
pressure
4.Regular-follow up
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46. 3.Tertiary Prevention
• Disability limitation
• Rehabilitation
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47. Benefits of Lowering Blood Pressure
• Reduction of the blood pressure by 5–6 mmHg can
decrease the risk of stroke by 40%, decrease the risk of
heart disease by 15–20%.

48. Management of Hypertension is divided in to two
categories
Management Without medication.
Management With anti-Hypertensive medication.
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49. Management without medication:
• On the basis of several research,researchers have settled
some life style measure for lowering the blood pressure.
The effects of implementing these modifications are dose
and time-dependent and could be greater for some
individuals.
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50. Lifestyle Modifications to prevent and
manage Hypertension
Modification Recommendation Approximate SBP
reduction
Weight reduction Maintain body
weight(body mass index
18.5-24.9kg/m2)
5-20mmHg/10kg
Adopt DASH eating plan
(Dietary Approach to
stop Hypertension).
Consume a diet rich in
fruits, vegetables, and
low-fat diary products
with a reduced content of
saturated and total fat.
8-14 mm Hg
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51. *1 drink = 1/2 oz or 15 mL ethanol (e.g., 12 oz beer, 5 oz wine, 1.5 oz 80-proof whiskey).
Dietary sodium reduction Reduce dietary sodium
intake to no more than
100 mmol per day(5gm
sodium or 6g sodium
chloride)
2-8mm Hg
Physical activity Engage in regular aerobic
physical activity such as
brisk walking(at least 30
minutes per day.most days
of the week).
4-9 mm Hg
Moderation of Alcohol
consumption
Men: limit to <2 drinks* per day.
Women and lighter weight persons:
limit to <1 drink* per day.
2-4 mmHg
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52. Adravya Bhoota Chikitsa includes;
• Nidana parivarjana
• Satwavajaya chikitsa
• Yoga and other practices
Nidana parivarjana
Nidana parivarjana refers to abstaining from samanya karanas
responsible for the vitiation of vatadi dosha and dushya, ie., the risk
factors like excess salt intake and excess weight, smoking, alcohol
etc.
Satwavajaya chikitsa
In Raktachapadhikyata manasika karanas also play a important
role, Raja and tama along with tridoshas vitiates hridaya and
raktavaha dhamanis so sadvritta palana and achara rasayana are
advised to prevent mana getting indulged in ahita arthas.

53. Yoga and Other Relaxation techniques
Yoga significantly decreases heart rate and systolic and
diastolic blood pressures. It has been hypothesized that some
yoga exercises cause a shift toward parasympathetic nervous
system dominance, possibly via direct vagal stimulation.
Though stress is associated with Hypertension, its role in
causing Hypertension is very complex, and controversial.
Interpreting stress in terms of chinta, then it is one of the
potent cause which vitiate rasavahasrotas, the moola being
hridaya. Yoga and Pranayama are the most important
measures to combat stresses, strains, anxiety and tensions.
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54. • Yoga helps in raising the threshold of mind to
withstand pressure of stresses and strains. Certain
relaxation techniques like shavasana, etc
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55. SHOWING THE PATYAPATHYA IN
RAKTACHAPADHIKYATA
Pathya Apathya
Ahara
Mudga, masoora, yava, palak,
methi, jambera, carrot, Papaya,
drygrapes, jeeraka, maricha,
jangala mamasa, goksheera,
takra, madhu, purana shali,.
Anupa mamasa, dadhi,
salt, excess fatty
substances, alcohol, junk
foods, bakery foods.
Vihara
Vyayama, dinacharya, sadvritta
paripalana, dharana of shokadi
manasika vega
Ativyayama,
vegadharana,
diwaswapna, atichinta,
atikrodha, ratri jagarana.
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57. THANK YOU
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58. Dr Arshiya ali
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