Ask Physician

Hypertension in TCM

 

Physician Teo Hwee Chin (TCMPB Reg. No. T0101288B)

What is high blood pressure (HBP)?

• High blood pressure means that the force of the blood pushing against the sides of your arteries is consistently in the high range. This can lead to stroke, heart attack, heart failure or kidney failure.

Despite the advances in the treatment of hypertension, effective management remains poor, the combined use of multiple drugs strategies fails to regulate blood pressure and chronic use of those agents caused severe side effects. Patients who have already been exposed to antihypertensive drug therapy. The most common complaint of those patients are fatigue, dizziness, weakness, headache, and joint pain, sleeping problems. Cold hands and feet, edema, depression.

Side Effects of Anti-Hypertension Drugs

• Although treated with intensive medication, uncontrolled hypertension related symptoms (including headache, dizziness, and fatigue) and
• Side effects of antihypertensive drug therapy (including headache, flushing, dry cough, edema, and sexual dysfunction, exhaustion, dizziness, weakness, joint pain, sleeping disorders, a feeling of coldness in the extremities and depression) are still the major problems confronting modern medicine.

 How does high blood pressure increase stroke risk?

• High blood pressure damages arteries throughout the body, creating conditions where they can burst or clog more easily. Weakened arteries in the brain resulting from high blood pressure, put you at a much higher risk for stroke.
• High blood pressure is the single most important risk factor for stroke because it’s the leading cause of stroke. HBP adds to your heart’s workload and damages your arteries and organs over time. Compared to people whose blood pressure is normal, people with HBP are more likely to have a stroke.

TCM interventions:

• Antihypertensive therapy is currently widely used, but due to the potential side effects and intolerance of antihypertensive drugs, natural herbal products have been favored by people all over the world. Chinese herbal formula has made great contributions to the health and well-being of the people for their unique advantages in preventing and curing diseases, rehabilitation and health care. Currently, with increasing popularity of TCM, more and more systematic reviews (SRs) and meta-analysis have been conducted to assess the efficiency of TCM.

TCM Concept for Hypertension

The implication of all this is that the head is the area of maximum potential of Qi and therefore intrinsically prone to rising of energy (or pathogenic factors) to the top, for example, the rising of Liver-Yang, Liver-Fire, Liver-Wind, or Heart-Fire. Conversely, clear Yang Qi failing to rise to the top may lead to the obstruction of the head by Phlegm or Dampness.

Head is called "the confluence of Yang" or "the Palace of Yang" or "the Palace of clear Yang"

• The head is also the area of concentration of Yang energy as all the Yang channels directly meet and join up in the head. Only Yang channels reach the head.
• However, Yin Qi obviously also reaches the head but only internally. - Heart and Liver reach the head internally (deep pathway). All the other Yin channels reach the head indirectly via their divergent channels as each Yin divergent channel merges with its related Yang divergent channel at the neck area. Thus both the clear Yang from the Yang organs and the pure essences from the Yin organs reach the head.
• In TCM, it is very important for the head energy to be clear and steady, where the brain and nerve system send signals to the body and thus promote the overall body functions.
• Acupuncture and Chinese Medicine has been proved effective for patients suffering from antihypertensive effects of western drug (including headache, flushing, dry cough, edema, and sexual dysfunction, exhaustion, dizziness, weakness, joint pain, sleeping disorders, a feeling of coldness in the extremities and depression).

Diet Tips for Hypertension patients:

• Eat less salt, sugar, and saturated fats (mainly from meat and poultry). Avoid artificial trans fats (often found in processed foods that have “hydrogenated” ingredients). Eat more fiber, fruits, and leafy green vegetables.
• Get to a healthy weight. A big belly, compared with your hip size, is one sign of too much fat on your body.
• Stop smoking. If you already smoke, quitting will help lower your odds for stroke
• Limit alcohol. Drinking too much can raise your blood pressure.
• Exercise regularly. Aim for 30 minutes of activity, such as brisk walks, 5 times a week, but for patients with qi-deficiency, I will suggest them to do only moderate exercise.
• Lower your stress. Studies show constant stress makes you more likely to have a stroke or a TIA.
• Sleep with quality and quantity. At least 7-8 hours of sleep is important for patients’ blood pressure maintenance.
• Less cooling food and cold water - as cold food and drinks will slow blood circulation and bring down body metabolism, and thus affecting blood pressure. More efficient blood flow can have benefits ranging from improved blood pressure to decreased risk of heart disease.
• Blood pressure generally is higher in the winter and lower in the summer. That's because low temperatures cause your blood vessels to narrow — which increases blood pressure because more pressure is needed to force blood through your narrowed veins and arteries. Thus, those with high blood pressure should monitor more closely during cold seasons.

气血足，百病消！

饮食：

• 低盐、低脂、高维生素饮食，宜多食蔬菜，增加膳食纤维，保持大便通畅，忌暴饮暴食，忌加工食品，忌烟、酒，
• 认真控制主食量，要定时定量，不宜吃油炸、煎炒、烧烤

运动：

• 运动应该有规律，可选择太极拳，瑜伽，快步走，活动量不宜过大，不可过劳。

情绪：

• 中医讲的情志内伤，与西医糖尿病神经、内分泌和免疫等系统功能紊乱学说一致情绪波动，精神紧张，心理压力都可能引起胰岛素分泌增加，血糖升高，诱发或加重糖尿病
• 中医养生之道就是注重调理五脏六腑功能，使到营养得以吸收和转化为气血，这就是中医最擅长的部分。Eg 末端神经 伤口愈合快 肌肤甲错

中医也非常注重体质调理，不同体质就有不同的调理方试。

 

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Traditional Chinese Medicine generally divides diseases into different syndrome types, some are with deficiency/with excess, some are cold/heat. For "Dysmenorrhea", the syndrome types are to be first identified.  When the qi and blood are weak, the liver and kidneys functions are depleted, and the essence and blood are weak, the uterine is not properly nourished by qi and blood, therefore leading to pain.  When the daily routine is not in a proper manner, or emotion in distress, or due to other external reasons, the uterine qi and blood do not flow smoothly, therefore leading to pain.

The classification of dysmenorrhea can be simplified as follows:

Dysmenorrhea Type	Cold in nature	Hot in nature	Neither Cold nor hot/ Cold and hot coexist
Deficiency syndrome	Yang deficiency with inner cold (inner cold)	Liver and kidney functions depleted	Weak Qi and Blood
Excess syndrome	Stagnation of cold and dampness (external cold)	Damp heat and stasis	Stagnant Qi and Blood

In Singapore, patients with dysmenorrhea due to "cold uterus" are quite common, but there are also patients with other causes/syndrome types.

"Cold uterus"(“宫寒Gong Han”) can be understood as “ the uterus is cold“.  In Traditional Chinese Medicine, "the uterus" consists of the internal reproductive system organs of women and their physiological functions. "Cold uterus" has a certain connection with Dysmenorrhea. The "cold" can be divided into "external cold" (causing excess syndrome) and "inner cold" (causing deficiency syndrome).

External cold refers to the fact that the blood in the body is slowed down by cold pathogens from outside the body. Instances such as over-consumption of cooling food and beverages, wearing thin clothes, exposure to long-term air conditioning, and dampness in residence lead to poor blood flow and blockage to the meridian around the uterus, resulting in dysmenorrhea, menstrual disorder/amenorrhea, etc.

Inner cold refers to the lack of yang qi in the body. Cold is generated internally, which leads to dysfunction of the viscera and affects the uterus, resulting in symptoms such as dysmenorrhea, irregular menstruation/amenorrhea.

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