Correlation Between Blood Pressure Variability and Plasma Renin–Angiotensin–Aldosterone Levels in Patients With Essential Hypertension at Different Ages

Background To study the correlation between blood pressure variability (BPV) and plasma renin activity (PRA), angiotensin II (AngII), aldosterone levels in patients with essential hypertension. Methods A total of 300 patients with mild to moderate essential hypertension were analyzed retrospectively. The subjects were divided into 3 age groups: 100 patients aged 18–44 years (young group), 110 patients aged 45–64 years (middle-aged group), and 90 patients aged over 65 years (elderly group). PRA, AngII, and aldosterone levels were assessed. Blood pressure (BP) was measured by 24-hour ambulatory BP monitoring. The relationships between BP variability and the PRA, AngII, aldosterone levels were compared among the 3 groups. Results Supine and upright PRA and aldosterone levels were significantly higher in the young group than those in the middle-aged and elderly groups. The coefficient of variation (CV) of 24-hour systolic (24hSBPCV), diastolic BP (24hDBPCV), CV of daytime systolic (dSBPCV), diastolic (dDBPCV), and nighttime systolic BP (nSBPCV) in the elderly group was higher than those in the young group and the middle-aged group (all P < 0.05). Spearman correlation analysis showed that in the young and middle-aged groups, BPV was significantly correlated with the levels of PRA, AngII, and aldosterone (all P < 0.05). In the elderly group however, only 24hDBPCV, nDBPCV, and nSBPCV were correlated with AngII and aldosterone levels (all P < 0.05). Conclusions BPV is correlated with plasma renin–angiotensin–aldosterone levels in young and middle-aged patients with mild to moderate essential hypertension.

A Comparative clinical evaluation of Sirodhara with Sukhosnajala, Tila Tailam and Brahmi Tailam in the management of mild to moderate essential hypertension

In worldwide 25% of population is suffering with Hypertension. As it is an instrumental disease, asymptomatic in nature, it was named as Silent killer. The causative factors of Essential hypertension were Genetic predisposition and environmental factors but these factors are triggered by stress hence it comes under stress related psycho-somatic disorder. In Hypertensive patients, Decrease in 5mm of Hg in SBP and DBP results in decrease in cardiovascular risk, stroke which decreases mortality rate worldwide. The management aspect of modern medical science remains symptomatic with troublesome side effects. The Joint National Committee (JNC 8) guideline advise higher blood pressure goals, less use of several types of antihypertensive medications and suggests lifestyle modification and relaxation are the best initial therapy. In Ayurveda, Shirodhara is one of the panchakarma therapy meant for relaxation and stress reducing procedure mentioned in Dharakalpaas a preventive and curative treatment for many stress related disorders. So, Present study is planned as “A Comparative clinical evaluation of Shirodhara with Sukhos̩n̩ajala, Tila tailam and Brahmitailamin the management of mild to moderate essential hypertension”was selected. This paper is going to describe about conclusion drawn from the study i.e. effect of three types of dhara on Objective parameters SBP, DBP, PP, and MAP.