Advanced findingsin

Phytochemicalsfor control of

HYPERTENSION(HTN – I)

Presented by Dr. Sudhakar KokateDirector PPRC, India

Hypertension

Also known as high blood pressure / arterial

hypertension

One of the most prevalent disorder

Chronic medical condition, Silent killer

Primary cause of stroke, kidney failure and

blindness

PPRC/INDIA 01

Hypertension

Common disease in today’s fast life

Disease of many symptoms

Two types:

1. Primary hypertension

2. Secondary hypertension

PPRC/INDIA 02

Primary Hypertension

Most common form of hypertension

90 – 95 % cases of hypertension

BP arises with ageing & due to environmental

factors

PPRC/INDIA 03

Blood

Blood, a bodily fluid delivers nutrients and oxygen

to the cells and transports metabolic waste from

same cells

pH: 7.35 – 7.45 slightly basic

below 7.35 too acidic

above 7.45 too basic

PPRC/INDIA 04

Composition: blood cells suspended in blood.

Plasma which constitutes 55% of body fluid, is

mostly water (92% of volume) contains proteins,

glucose, mineral ions, hormones and carbon

dioxide

Blood cells constitute RBC (erythrocytes) &

WBC (leucocytes and platelets)

Blood

PPRC/INDIA 05

Albumin: main protein in blood

RBC: most abundant containing haemoglobin,

an iron containing protein

WBC: Soldiers of the body

Blood circulated through blood vessels by

pumping action of the heart

Blood

PPRC/INDIA 06

Supply of oxygen to tissues

Supply of nutrients

Removal of waste

Circulation of WBC

Functions of Blood

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Coagulation

Regulation of body pH

Transportation of hormones and signalling of

tissue damage

Regulation of core body temperature

Functions of Blood

PPRC/INDIA 08

Quantity: one micro litre

1. Male: 4.7 – 6.1 million erythrocytes

2. Female: 4.2 – 5.4 million erythrocytes

3. 4,000 – 11,000 leukocytes

4. 200,000 – 500,000 thrombocytes

Contents of Blood

PPRC/INDIA 09

Anaemia

Aplastic anaemia

Deep vein thrombosis

Fanconi anaemia

Haemochromatosis

Blood diseases

PPRC/INDIA 10

Haemolytic anaemia

Haemophilia

Pernicious anaemia

Thalassemia

Thrombocytopenia

Von willebrand disease

Blood diseases

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Classification of blood based on the presence or

absence of inherited anti-genic substances on the

surface of RBCs

33 major blood group systems are recognised by

ISBIT in Oct. 2012

Blood group

PPRC/INDIA 12

Blood Pressure (B.P.)

Arterial blood pressure

The pressure exerted by circulating blood upon

the walls of blood vessels

One of the principal vital signs

During each heartbeat, blood pressure varies

between maximum (Systolic) and minimum

(Diastolic) pressure

PPRC/INDIA 13

Blood Pressure (B.P.)

Arterial blood pressure

B.P. in Circulation is principally due to the

pumping action of the heart

B.P. varies as in healthy people and animals

Blood volume, resistance and viscosity are

physical factors that influence B.P.

PPRC/INDIA 14

Blood Pressure (B.P.)

Arterial blood pressure

Blood pressure pathologically is:

1. Low – hypotension

2. High – hypertension

PPRC/INDIA 15

Blood pressure in children

AGESYSTOLIC (mm Hg)

DIASTOLIC (mm Hg)

1 – 12 months 75 - 100 50 – 70

1 – 5 years 80 – 110 50 – 80

6 – 12 years 85 – 120 50 – 80

13 – 18 years 95 – 140 60 – 90

PPRC/INDIA 16

B.P. in Adult

CATEGORY SYSTOLIC (mm Hg)

DIASTOLIC (mm Hg)

Hypotension < 90 < 60

Desired 90 – 119 60 – 79

Pre-hypertension 120 – 139 80 – 89

Stage 1 hypertension 140 – 159 90 – 99

Stage 2 hypertension 160 – 179 100 – 109

Hypertensive emergency ≥ 180 ≥ 110

PPRC/INDIA 17

Prevalence of Age factor & BP.

YEAR - AGE % B.P.

20 – 30 4

31 – 40 5

41 – 50 10

51 – 60 14

> 61 16

PPRC/INDIA 18

Secondary Hypertension

Can be caused by endocrine conditions such as

Cushing’s syndrome, hyperthyroidism,

hypothyroidism, acromegaly, Conn’s syndrome

or hyperaldosteronism, hyparathyroidism and

pheochromocytoma

PPRC/INDIA 19

Secondary Hypertension

Reasons to contribute: obesity, sleep apnea,

caratation of the aorta, excessive liquorice and

heavy dose of medicines

PPRC/INDIA 20

Complications of high B.P.

Thickening of the heart muscle

Increased workload of the heart

May lead to – heart attack

stroke

renal failure

loss of vision

PPRC/INDIA 21

DRUG THERAPY

Allopath treatmenta list of 107

synthetic chemicalsfor

Hypertension

PPRC/INDIA 22

High B.P. drugs

Acebutolol

Acetazolamide (Aceact 250 mg)

Aliskiren (Rasilez 300 mg)

Aliskiren and Amlodipine

Aliskiren and hydro chlorothiazide

Aliskiren and valsartan

PPRC/INDIA 23

Aliskiren, amlodipine & hydrochlorothiazide

Amiloride and hydrochlorothiazide

Amlodipine

Amlodipine, hydrochlorothiazide and olmesartan

Amlodipine and benazepirl

High B.P. drugs

PPRC/INDIA 24

Amlodipine and enalapril

Amlodipine and lisinopril

Amlodipine and losartan

Amlodipine and olmesartan

Amlodipine and valsartan

Amlodipine, valsartan and hydrochlorothiazide

High B.P. drugs

PPRC/INDIA 25

Atenolol

Atenolol and chlorthialidone

Azilsartan medoxomil

Azilsartan medoxomil and chlorthalidone

Benazepril

Benazepril HCl and hydrochlorothiazole

High B.P. drugs

PPRC/INDIA 26

Benidipine

Bisoprolol

Bumetanide

Candesartan

Candesartan cilexetil hydrochlorothiazide

Captopril

High B.P. drugs

PPRC/INDIA 27

Captopril and hydrochlorothiazide

Carvedilol

Chlorothiazide

Chlorthalidone

Clevidipine

Clonidine

High B.P. drugs

PPRC/INDIA 28

Diltiazene

Doxazosin

Enalapril

Enalapril and hydrochlorothiazide

Epinephrine

Eplerenone

High B.P. drugs

PPRC/INDIA 29

Eprosartan mesylate hydrochlorothiazide

Esmolol

Ethacrynic acid

Felodipine

Fenoldopam mesylate

Flosequinan

High B.P. drugs

PPRC/INDIA 30

Fosinopril

Furosemide

Furosemide and Amiloride

Guanabenz

Guanethidine monosulfate

Guanfacine

High B.P. drugs

PPRC/INDIA 31

Hydralazine

Hydrochlorothiazide

Hydrochlorothiazide and spironolactone

Hydrofluemethiazide

Imidapril

Indapamide

High B.P. drugs

PPRC/INDIA 32

Irbesartan

Irbesartan and hydrochlorothiazide

Isradipine

Ketamine

Labetalol

Lacidipine

High B.P. drugs

PPRC/INDIA 33

Lisinopril

Lisinopril and hydrochlorothiazide

Losartan

Mannitol

Mecamylamine

Methyclothiazide

High B.P. drugs

PPRC/INDIA 34

Methyldopa

Metolazone

Metoprolol

Minoxidil oral

Moexipril HCl hydrochlorothiazide tablets

Moexipril hydrochloride

High B.P. drugs

PPRC/INDIA 35

Nebivolol

Nicardipine

Nitrendipine

Olmesartan

Olmesartan medoxomil and hydrochlorothiazide

Perindopril

High B.P. drugs

PPRC/INDIA 36

Perindopril and Indapamide

Phenoxybenzamine

Phentolamine mesylate

Pindolol

Procainamide

Propranolol

High B.P. drugs

PPRC/INDIA 37

Quinapril

Quinapril HC-hydrochlorothiazide tablets

Reserpine

Spironolactone

Telmisartan

Telmisartan and hydrochlorothiazide

High B.P. drugs

PPRC/INDIA 38

Terazosin

Timolol ophthalmic

Timolol oral

Torsemide

Trandolapril

Trandolapril - verapamil

High B.P. drugs

PPRC/INDIA 39

Ubiquinone

Valsartan

Valsartan and hydrochlorothiazide

Verapamil

Xipamide

High B.P. drugs

PPRC/INDIA 40

Trying to lower blood pressure too much can

actually increase your risk of both heart

problems and death – Dr. Mercola

Hypertension: Just cure it within some weeks,

leaving behind you all medications and all side

effects

PPRC/INDIA 41

“Allopathic medicine will not find the cure

to any heart related ills because they are

not really looking for them. They are

looking for new ways to manage diseases

perpetually and to keep their patients sick

enough to require drugs, but still live”

- The Health Wyze ReportUSA

PPRC/INDIA 42

Side-effectsof

Medicationsused to treat

Hypertension

PPRC/INDIA 43

DIURETICS

Extra urination

Erection problems

Weakness, leg cramps / fatigue

Decrease the body’s levels of the mineral potassium

Intense and sudden foot pain

PPRC/INDIA 44

BETA-BLOCKERS

Asthma symptoms

Cold hands and feet

Depression

Erection problems

Insomnia and sleep problems

PPRC/INDIA 45

ANGIOTENSIN CONVERTING ENZYME (ACE)

A dry, hacking cough that does not go away

Skin rash

Loss of taste

ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs)

Dizziness

PPRC/INDIA 46

CALCIUM CHANNEL BLOCKERS (CCBs)

Constipation

Dizziness

Headache

Irregular or very rapid heartbeat (Palpitations)

Swollen ankles

PPRC/INDIA 47

ALPHA-BLOCKERS

Dizziness

Fast heartbeat

ALPHA - 2 RECEPTOR AGONIST

Dizziness

ALPHA BETA-BLOCKERS

Dizziness

Weakness

PPRC/INDIA 48

CENTRAL AGONISTS

Anaemia

Constipation

Drowsiness

Dizziness

Dry mouth

Erection problems

Fever

PPRC/INDIA 49

PERIPHERAL ADRENERGIC INHIBITORS

Diarrhoea

Dizziness

Weakness

Erection problems

Heartburn

Stuffy nose

PPRC/INDIA 50

VASODILATORS

Excessive hair growth

Fluid retention

Headaches

Irregular, very rapid palpitations

Joint aches and pains

Swelling around the eyes

PPRC/INDIA 51

RENIN INHIBITOR

Cough

Diarrhoea

Stomach pain

Heartburn

Rash

PPRC/INDIA 52

“KELP” SIDE EFFECTS

(FUCUS VESICULOSUS)

Thyroid problem

Nausea

Diarrhoea

Allergic reactions

Watery itchy eyes

Shortness of breathPPRC/INDIA 53

TOPROL XL

Chest pain

Heart failure

Drowsiness

Diarrhoea

Dizziness

PPRC/INDIA 54

FLOMAX

Back pain

Blurry vision

Cough

Diarrhoea

Drowsiness

Trouble sleeping

Weakness

PPRC/INDIA 55

NORVASC

Swelling of hands, feet, ankles, lower legs

Headache

Upset stomach

Stomach ache

Dizziness

Drowsiness

PPRC/INDIA 56

NORVASC

Excessive tiredness

Feeling of warmth

Chest pain

Irregular, rapid pounding heartbeat

Fainting

PPRC/INDIA 57

TEVETEN

Runny nose

Sore throat

Cough

Excessive tiredness

Stomach pain

Joint pain

PPRC/INDIA 58

TEVETEN

Depression

Swelling of face, throat, tongue, feet and hands

Hoarseness

Difficulty in breathing

Fainting

Decreased sexual ability

PPRC/INDIA 59

DIOVAN HCT

Headache

Fatigue

Dizziness

Breakdown of skeletal muscle tissue

Kidney failure

Dry mouth

PPRC/INDIA 60

DIOVAN HCT

Jaundice

Dry cough

Skin rash

Back pain

Stuffy nose, tired feeling

Dizziness

PPRC/INDIA 61

ZESTORETIC

(Lisinopril & hydrochlorothiazide)

Dizziness

Headache

Cough

Fatigue

Serious effect – hypotension (Low B.P.)

PPRC/INDIA 62

Hypertension recognised as a main risk factor for deadly consequences

1. Micardis (Telmisartan):

Swelling of face, lips, tongue or throat

Difficulty in breathing

Rare cases – kidney failure

PPRC/INDIA 63

2. Tirofiban (Aggrastat):

Nose bleeding

Black bloody stools

Cough

Vomiting

Chest pain

Sudden weakness

PPRC/INDIA 64

3. Altace (Ramipril) tablets:

During pregnancy, foetal toxicity

Slow heart rate, muscle weakness

Dry mouth, thirst, swelling, urinating less

Jaundice, bleeding in urine

4. Accupril (Quinaprilhydrochloride) tablets:

Foetal toxicity

Swelling of face, lips, tongue, throat

PPRC/INDIA 65

5. Cupoten:

Severe stomach ache

Breathing difficulty

Swelling of face, lips, tongue / throat

6. Isoptin:

Difficulty breathing

Swelling of face, lips, tongue, throat

PPRC/INDIA 66

7. Cardizem:

A red blistering skin rash

Swelling feet / hands

Trouble breathing

Slow heartbeats

Dizziness, Fever, Sore

PPRC/INDIA 67

8. Dopamine:

Chest pain

Heartbeat

Shallow breathing

Burning pain

9. Plendil:

Heartbeat, Chest pain

Short breathing

PPRC/INDIA 68

10. Lopressor:

Short breath

Nausea

Hand & Feet swelling

Fainting

Dark urine

Itching

PPRC/INDIA 69

11. Corzida:

Swelling

Heartbeat

Weakness

12. Coreg:

Chest pain

Slow heartbeat

Loss of bladder

PPRC/INDIA 70

Treatment of hypertension

PROTOCOL

Lifestyle modifications

Introduction of drug therapy

Change or addition in drugs

More drug modifications

PPRC/INDIA 71

Sequence of treatment

Education

Diet, Exercise, massage

Yoga and meditation

Brisk walking

Maintain body weight

Regular check-up

Use of

phytochemicals

&

Home remedies

PPRC/INDIA 72

Thank You!!

“BE WITH US”