Hypertension is the most common cardiovascular disease. It has been estimated that after the age of 40,about one third of men and one fifth of women suffer from hypertension. Elevated arterial pressure causes pathological changes in the vasculature and also cause hypertrophy of the left ventricle. As a result hypertension is the principal cause of stroke, coronary artery disease, myocardial infraction and sudden cardiac death. Hypertension is broadly grouped into two categories
1. The essential or primary hypertension, the exact cause of which is not known but there is generally a narrowing of blood vessels.
2. Secondary htpertension due to the involvement of some organs or systems such as kidneys, adrenal glands, disorders like toxaemia of pregnancy.
In seconcary hypertension the cause can be removed and the B.P. is brought back to normal. The diagnosis is based on repeated, reproducible measurements of elevated blood pressure. The sevrity of hypertension is classified based on diastolic pressure. For the purpose of clinical management, essential hypertension is divided into mild(90-104 mm Hg), moderate(105-114 mm Hg) and servre(more than 115 mm Hg) based on diastolic pressure. The aim of drug therapy is to lower the elevated blood pressure to within normal range. The antihypertensive therapy effectively controls the blood pressure, prevents the complications and prolongs the life of the patients.
Some fifty years back we did not have any drug which could lower blood pressure in hypertensive patients. The drugs which are described in this section have all been developed in the last 30 years or so. In the ayurvedic medicine the roots of Rauwolfia gave been used for verious aliments. The alkaloid reserpine separated from these roots was found to have blood pressure lowering properties and has been used in the treatment of hypertension .However with the discovery of a large number of drugs which are safer and have lesser side effects,the use of reserpin has declined. The drugs described here do not eliminate the cause of the hypertensive state but they do allow a person to lead a near normal life and also prevents the worsening of his cardiovascular system.
Wednesday, February 27, 2008
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