Human circulatory system is a hydraulic circuit consisting of a pump (heart), branched pipelines (arteries, capillaries, veins), and regulation. Its main task is to supply oxygen to the tissues. The main conditions of proper blood supply to any organ are generally two:
- sufficient cardiac output
- unobstructed feeding arteries
Blood pressure regulation body for the short run is not a priority. That is the oxygen supply. This is understandable - failure of oxygen supply to the brain would result in immediate unconsciousness and rapid death. Relying on mechanical strength of arteries, body allows temporary increase in blood pressure during exercise, stress, entry into the cold water, etc. Blood pressure increase three main mechanisms:
- heart overstimulation (eg. stress)
- contraction of blood vessels (e.g. cold)
- clogged arteries (atherosclerosis, thrombosis ...)
In hypertension (hypertensive disease), high blood pressure occurs at rest, with no load. Hypertension is very common in population and usually (95% of cases) has no apparent cause - in this case, it is called primary or essential hypertension. The remaining 5% of cases is secondary hypertension - having apparently caused by another disease.
Cause of primary hypertension is not known. Primary hypertension is often associated with atherosclerosis , suspected the stress and adrenaline / epinephrine ( Floras1992egh ), but it is correct to say that the real cause is unknown ( Shimbo2010edr , Wilkinson2009aag , Krieger1991mbh ). Primary hypertension is about 30% of hereditary rest can be influenced lifestyle. The main risk factors for primary hypertension are:
- Sodium intake (salt, sodium glutamate):
- sodium directly irritates and contracts vascular smooth muscles
- sodium activates natriuretic hormone, which further increases vascular irritability
- Arteriosclerosis and atherosclerosis - by almost a natural part of aging .
- Obesity and insulin resistance (= II diabetes. Type) - cells of obese patients cease to respond to insulin, the body of despair abnormally increasing the levels:
- Insulin increases the level of sodium in the body
- insulin itself increases blood pressure by activating other hormones
- Insulin causes hypertrophy of vascular smooth muscles
- insulin exacerbates arteriosclerosis
- Stress - in people with sensitive cardiovascular system, stress first increases cardiac activity, later vascular resistance (reducing the lumen of blood vessels), stress also contributes to obesity trends .
- Civilization addiction (alcohol, caffeine, smoking, various "pills" and others).
Risk factors listed above are mutually reinforcing, and that because earned a group name metabolic syndrome. In addition primary hypertension, metabolic syndrome should obesity, diabetes mellitus (diabetes) and overload of nitrogen metabolism. However, hypertension can easily afflict also slim persons with completely healthy lifestyle. Blood pressure meter concerns everyone. Hypertension and cardiovascular disorders develop often unnoticed, and their first symptom is often to myocardial infarction or stroke.
In lesser number (5%) of cases of high blood pressure apparently caused by another disease: coarctation (narrowing) of the aorta, renal disease, overproduction of hormones (catecholamines, corticosterone, aldosterone, cortisol, thyroxine, growth hormone, parathyroid hormone, renin, endothelin .. .), pregnancy, drugs (certain antibiotics, antidepressants, oral contraceptives), brain disease (trauma, inflammation , poliomyelitis, tumors, etc.).
In the treatment of hypertension is an important factor for the correct diagnosis. Although the pressure alone can measure some may, but differential diagnosis of cases of secondary hypertension should always be in the hands of a doctor.
Treatment of primary hypertension
Disease processes leading to atherosclerosis and primary hypertension are not entirely clear. Treatment of primary hypertension has been empirically determined: weight reduction ( Sorof2002ohc ), aerobic exercise ( Duijnhoven2010ibr ), prevention of atherosclerosis, reduction of salt, reduction of caffeine, smoke, alcohol, max. 30 g per day, enough minerals (K, Ca, Mg), reduction of saturated fatty acids and cholesterol. With a hint of exaggeration to say that the treatment of hypertension should start 30 years before the first symptoms. Cardio-vascular system has considerable reserve, so the symptoms of its progressive deterioration may not be noticed. When the regulatory reserve of the circulatory system is exhausted and rest hypertension appears, it means that for us the fight for healthy cardiovascular system and begin the fight against an impending vascular event.
Medicines for high blood pressure (antihypertensives)
The purpose of the vast majority of drugs administered in hypertension is not to eliminate the cause, only symptomatic reduction in blood pressure, which is to prevent complications, especially stroke. Common used for this purpose:
- Calcium channel blockers (e.g. amlodipine) - takes out the main activation pathway of the vascular muscles
- Blockers, angiotensin convertase - discard angiotensin (hormone to increase blood pressure).
- Diuretics reduce blood volume.
complications of hypertension
Lowering blood pressure with medication is mainly palliative symptomatic effect. But it is important because it protects against sudden vascular events. Hypertension itself threatened stroke (bleeding into the brain) . Hypertension also aggravates the course of atherosclerosis . Atherosclerosis itself threatened by blockage of blood vessels and heart attacks, especially myocardial infarction. Patients with advanced atherosclerosis should avoid physical strain, which goes against the requirement of aerobic exercise in the prevention of hypertension. Current medicine is not able to treat sclerotic vessels.
(Unless otherwise stated, the source of this information largely from an anonymous lecture "Arteriální hypertenze a hypotenze" freely accessible on the website of the Institute of Pathophysiology Faculty of Medicine, Charles University .)
Relaxing effect of saponin fractions of ginseng on blood vessels were known already in the 70s ( Hah1978epg , kang1995gpg ). The hypotensive effect of the water extract of ginseng was confirmed in conscious rats ( Chow1976psc ) hypertensive rats ( Jeon2000ekr ) and also in human patients with essential hypertension ( Han1998erg , Sung2000erg ). These results confirm the newer experimental ( Lee2016aek , Zhao2015epn , Lee2014rmp ) and clinical ( Jovanovski2014erk ) study.
The advantage of ginseng in treating hypertension is that the reduction in blood pressure caused by it is not one-sided. In patients with normal or reduced pressure, namely ginseng does not cause hypotension. Therefore can be used as a tonic - for example, to enhance physical performance in athletes ( Ping2011eas , Liang2005pns ). In patients with hypotension after dialysis ginseng increases blood pressure ( Chen2012krg ). This dual, contradictory action that returns physiological parameters back to health, regardless of the direction of displacement is typical for the category of adaptogens , whose creation was inspired ginseng.
Ginseng acts on a cascade of nitric oxide (NO)
Investigation of the influence on panaxosidů pathway of nitric oxide (NO) began to discover that they increase the level of NO in blood vessels ( Chen1996cpg ) and that this effect can be blocked by inhibitors of nitric oxide synthase. For this effect are responsible ginsenosides Rb 1 ( Yu2007spn ) Rg 1 ( Lu2004gra ) and R , but mainly Rg 3 , which effect against hypertension is the strongest of all panaxosidů ( Kim1999grm , Kim2003gri , Kim2006seg ). Panaxosidy activates NO synthase as allosterically ( Xia2011grp ) and increased gene expression ( Furukawa2006grm ). Gssd. Rg 3 when there is a dual, opposed to the effect of inflammatory NO synthase 2, which inhibits ( Yoon2015grr ) and vascular NO synthase 3 which activates ( Hien2010gri ). Gssd. Rg is 3 (as most panaxosidů) chiral, the effects of the S epimer and the R epimer is different ( Jeong2004sgr ).
Ginseng combats stress and generally heals
In the prevention of hypertension plays a big role in the effect of ginseng against stress , ie. A stabilizing effect on generalized adaptation syndrome (hence the prefix "ADAPTO"). Anti-stress effect has gssd. Rb 1 ( Churchill2002npg ) Majonosid R2 ( Huong1998aem ) gssd. Rc ( Kim2003egs ) and strong vasorelaxant gssd. Rg 3 ( Kim2003iii ). According to the textbooks stress causes hypertension transitional first, which later leads to a thickening of the vessel wall muscles, increased peripheral vascular resistance and hypertension permanent. Stress hormone blockers (β-blockers) are therefore increased blood pressure, commonly prescribed.
Ginseng protects the internal organs (heart, liver, kidneys, brain, retina ...) prior to oxidative damage . The essence of action is radical scavenging, but protection against apoptosis and supports tissue regeneration, vascular and vascular endothelial ( He2007peg , Chen2012peg ). Red ginseng accelerates regeneration of capillaries already in doses of several grams per day ( morisaki1995mae ) bearer of this effect is mainly gssd. Rg 1 ( Sengupta2004may , Chen2012peg ).
Other adaptogens against hypertension
With hypertension joins a number of other lifestyle diseases, or diseases of longevity. On those pages you will find notes on the effectiveness of adaptogens against atherosclerosis , diabetes and its complications , obesity and autoimmune problems that diabetes and atherosclerosis secretly related.
Bajkalin of Šišák Baikal counteract the progressive thickening of the walls of the pulmonary arteries, which is the essence of pulmonary hypertension ( Zhang2014bih ). A similar effect was found for salidrosidu Rhodiola rosea ( Chen2016sep ). Rhodiola moreover directly lowers blood pressure by increasing the level of β-endorphin in plasma ( Lee2013rei ).
As adaptogens in the treatment of hypertension to enjoy
Antihypertensive adaptogens achieve reduction of blood pressure, relaxation of vascular smooth muscle, as well as acting allosterically Paracelsian drugs . Adaptogens parallel but also act at the level of gene expression, in particular of endothelial NO synthase third adaptogens is therefore necessary to take a longer time and their effect waits longer. My comments on the use of ginseng can be found here .
Treatment of hypertension requires continuous measurement of blood pressure and have it lead graduated doctor. Good doctors are already versed in the basics of medical botany and adaptogens in the treatment of high blood pressure will be welcomed. If not, they can be victims of outdated information, such as the often-mentioned information on the interaction of ginseng with warfarin . The available experimental data agree that ginseng is safe interaction with warfarin there , respectively. is irrelevant ( Zhu1999pig , Vaes2000iww , Lee2010ibw ). The same is true about the interaction of ginseng with amlodipine ( Ryu2014npi ). As I mention also for stroke, ginseng has a antiokoagulační effect ( Jin2007aaa , Yu2006aaa , Yun2001ekr ) and cardiac patients is a traditional, highly efficient ( Jia2012cgm ) drug, either alone ( Gai2012egr , Li2012srg , Maslov2009ica ), or in combination, for example, safflower ( Han2013eai ).