High Blood Pressure
Hypertension or High Blood Pressure is a common ailment around the world and is known as the silent killer causing strokes and heart attacks. In Hypertension, the force of the blood pushing against the artery walls is consistently too high. The heart has to work harder to pump blood. In general, hypertension is a blood pressure reading of 130/80 ml Hg or higher.
High blood pressure has a number of contributory factors including lifestyle such as diet, lack of exercise, smoking and alcohol intake, it can also be hereditary and or can be instigated via medical adversity.
Hypertension & Obesity in Africa
From different surveys, data has shown that hypertension is common in African countries especially in urban areas. Hypertension risk factors also seem to be more common in African countries than in developed regions.
Risk factors include changes to dietary habits, social stress and an ageing population. Poor access to health facilities, poverty, and the high cost of drugs contribute to poor blood pressure control. The health systems in many countries are inadequate due to poor infrastructure, insufficient funding and the quality and quantity of expertise. Health experts prioritize child and maternal health care, acute disorders and control of communicable diseases.
Symptoms of Hypertension
Most of the people with hypertension do not experience any symptoms. Others may experience severe headache, shortness of breath, nosebleeds, feeling of pulsations in the neck or head or anxiety.
Complications of Hypertension
After a prolonged period, untreated high blood pressure can cause heart disease and related complications such as heart attack, stroke, and heart failure.
Other complications include:
- Fluid build up in the lungsVision loss
- Kidney damage
- Erectile dysfunction
- Memory loss
Hypertension, The Underlying Mechanisms
The exact causes of high blood pressure are not known. Hypertension usually develops gradually over years and probably is a result many different factors such as lifestyle, environment, genetics and age.
Obesity and overweight are a serious health problem that is increasing worldwide. Obesity is associated with a shorter life expectancy and a significant increase in mortality. Stress, inadequate sleep, intake of alcohol, inactivity, unhealthy diet, age, and genetics are some of the risk factors for obesity. Diabetes, heart disease, high blood pressure, hyperlipidemia, and atherosclerosis are obesity-related complications (58).
Obesity can cause or worsen hypertension in a variety of ways. Having obesity can also make it more difficult to treat hypertension because of other related health conditions. The mechanisms through which obesity causes or worsens hypertension include:
- Changes in the function of the sympathetic nervous system, part of the autonomic nervous system in charge of the fight-or-flight response; alterations in the structure and function of the kidneys, many people who have obesity carry a higher proportion of visceral fat. Visceral fat surrounds and puts pressure on the abdominal organs and more stress on the cardiovascular system. This extra pressure often leads to resistant hypertension — uncontrolled blood pressure, according to 2015 research (John E. Hall, Jussara M. do Carmo, Alexandre A. da Silva, Zhen Wang, Michael E. Hall) , despite using three or more blood pressure medications.
- A 2017 review (Monica T. J. Schütten, Alfons J. H. M. Houben, Peter W. De Leeuw, and Coen D. A. Stehouwer) suggests that one of the contributors to high blood pressure is the Renin-angiotensin-aldosterone system. The RAAS helps to regulate blood volume and pressure across the whole body. When the RAAS system is not acting properly, blood pressure can remain elevated for a long time. Another 2017 review (Leggio, M., Lombardi, M., Caldarone, E. Et al) shows that obesity causes the levels of all the hormones in the RAAS to rise. This imbalance leads to high blood pressure.
Conventional Anti-hypertension Medication
Many antihypertensive mediators are used for the treatment of hypertension, such as diuretics, sympatholytic agents, renin inhibitors, angiotensin converting enzyme (ACE) inhibitors, calcium channel blockers, and vasodilators. These drugs have various side effects, including muscle cramps, abnormal heart rate, blurred vision, skin rash, vomiting, kidney failure, extreme tiredness, headache, and edema.
Herbal Remedies in Hypertension
It is within this scope that the use of African herbal remedies should be considered for the treatment and control of blood pressure alongside lifestyle changes. Many of the herbal remedies are cheap or free and widely available. There are many herbs or plants that can assist with the control of blood pressure or are antihypertensive, namely Garlic, Ginger, Coriander, Neem, Bitter Melon, Noni, Soursop, Moringa and Bissap.
Moringa known commonly as Nebedie (wollof) or Nebedieyo (Mandinka). The plant material of interest is the whole plant, and is used as food and medicine. The leaves are used in a preparation which is cooked and taken for the treatment of high blood pressure.
The seeds of the moringa plant exert its protective effect by decreasing liverlipid peroxides, antihypertensive compounds thiocarbamate and isothiocyanate glycosids have been isolated from the acetate phase of the ethanolic extract of Moringa pods (Farooq Anwar, Said Latif, Muhammed Ashraf and Anwarul Hassan Gilani). The seeds of Moringa are considered to be anti-pyretic, acrid, bitter (Oliveira et al., 1999) and reported to show antimicrobial activity (The Wealth of India, 1962).
The seed can be consumed fresh as peas; or pounded, roasted, or pressed into sweet, non-desiccating oil. The unique property is the ability of its dry, crushed seed and seedpress cake, which contain polypeptides, to serve as natural coagulants for water treatment (Ndabigengesere and Narasiah, 1998).
The widespread combination of diuretic along with lipid and blood pressure lowering constituents make this plant highly useful in cardiovascular disorders. Moringa leaf juice is known to have a stabilizing effect on blood pressure (The Wealth of India, 1962; Dahot, 1988). Nitrile, Mustard oil glycosides and thiocarbamate glycosides have been isolated from Moringa leaves, which were found to be responsible for the blood pressure lowering effect (Faizi et al., 1994a;1994b; 1995)
Bissap or Sorrel, known scientifically as Hibiscus sabdariffa. The plant material of interest is the flower which is dried and used to make drinks, tea, and powder. The dry calyx of this plant possesses great commercial value because of its use as a plant colorant for food and drugs, but principally due to its use as beverage and, recently, for its antihypertensive properties (Haji-Faradi and HajiTarkhani, 1999). The plant is a tropical beverage used commonly in folk medicines to treat hypertension, pyrexia, inflammation, liver disorders, kidney and urinary bladder stones, and obesity (Liu et al., 2006). Its leaves are commonly used as a diuretic, sedative and refrigerant, and its fruits are considered to be an anti-scorbutic. The calyces are commonly prepared as a drink and used as a mild diuretic, a colorectal, an intestinal anti-septic, a mild laxative, and as an aid in heart and nerve conditions, to lower blood pressure and to treat calcified arteries (Ajay et al., 2007; Onyenekwe et al., 1999).
Even though, the uses of different parts of Bissap are many and varied both in food and in traditional medicine, all parts of Bissap including seeds, leaves, fruits and roots are used as a food in different parts of the world. The fleshy red calyxes of Bissap are commonly used for the production of soft drinks and tonic without alcohol like wine, juice, jam, jelly, syrup and also dried and brewed into tea and spice. The calyxes are rich in carotene, riboflavin, anthocyanins, ascorbic acid, niacin, calcium, iron and vitamin C.
The young leaves and tender stems of Bissap are consumed raw as green vegetable. The Bissap seeds are good source of protein, tlat, total sugars and are widely used in the diet in many African Countries. Bissap is also used in many folk medicines.
The effectiveness of an aqueous extract of Bissap on mild to moderate hypertension has been investigated in many researches. Aqueous extract of Bissap was as effective as a branded Ace inhibitor in treating mild to moderate hypertension and there was no adverse effect with the treatment, confirming the effectiveness and safety of the extract. Even though the possible mechanism(s) of action of Bissap extract has not been fully investigated, daily consumption of an aqueous Bissap extract resulted in decrease in systolic and diastolic blood pressure.
Azadirachta indica commonly known as neem is another antihypertensive tree. Various parts of the Neem tree, including the leaves, bark, fruit, flowers, oil, and gum are associated with the medical folklore in the treatment of certain medical conditions such as cancer, hypertension, heart diseases, and diabetes. Multiple studies have confirmed the anti-diabetic and anti-hypertension, anti-hyperlipidemia, and anti-obesity effects of neem. The mechanisms underlying the protective effect of neem against high blood pressure have been shown to include the blocking of calcium channels.
Another less known antihypertensive is the fruit of the Noni tree, its scientific name is Morinda citrifolia from the Rubiaceae family. Traditional healers have used different parts of the Noni tree to treat pain, inflammation, diabetes, gout, wounds, cancer, high blood pressure, and numerous other ailments for many years. The preliminary results of a study in 2008 by Afa Kehaati Palu et al, suggest that concentrated noni juice is able to lower high blood pressure by inhibiting ACE enzymes and AT receptors.
Another study carried out in 2019 in Poland by D. Nowak et al, where subjects who consumed 30ml hourly of noni juice showed a significant decrease in systolic and diastolic blood pressure of 5% and 7.5% respectively.
As is usual further research needs to be undertaken to establish the scientific properties and efficacy of the plant.
As mentioned previously some commonly used household spices are also effective in controlling high blood pressure, Ginger (Zingiber officinale), garlic (Allium sativum) and coriander (Coriandrum sativum).
All parts of the Coriander plant are edible, but the fresh leaves and the dried seeds are the parts most traditionally used in cooking. Coriander seeds contains chemicals that lower blood pressure by causing blood vessels to dilate and work as a diuretic;
Garlic (Allium sativum) isn’t just used to flavour a meal. Adding it to the diet can help treat many chronic diseases. Its potential benefits include lowering cholesterol, preventing cancer, and acting as a blood thinner. Recent clinical trials have demonstrated that garlic supplements are effective in reducing blood pressure in patients with uncontrolled hypertension, similar to first-line standard anti-hypertensive medications. A 2019 review (Toshiaki Matsutomo, Central Research Institute) notes that allicin in garlic may limit the production of angiotensin II, a hormone that increases blood pressure. It may also relax blood vessels, allowing blood to flow more easily;
Ginger (Zingiber officinale) has also been found to be beneficial for reducing blood pressure and improving circulation. One study has found that taking a ginger supplement daily for eight weeks significantly reduced systolic and diastolic blood pressure in people with hypertension Ginger is commonly consumed in foods and as a flavoring in drinks. As medicine, ginger is available in many forms, including teas, syrups, capsules, and liquid extracts.
Ginger has most often been used by adults in doses of 0.5-3 grams by mouth daily for up to 12 weeks. Taking ginger along with medications that lower blood pressure might cause blood pressure to go too low. Monitoring blood pressure closely is necessary.
Conclusion
It must not be understated that it is not herbal plants alone that can effect change in someone suffering from hypertension. Lifestyle changes such as a review and change in diet e.g an alkaline diet, an increase in regular exercise if lacking, loss of body weight, a regular sleep pattern and less exposure to stress are all necessary to impact the changes desired.
In conclusion it can be recognised that the use of herbal plants along side lifestyle changes can be highly effective in the management of hypertension resulting in relief without additional side effects, lower cost and a more holistic outcome.
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