STM Journals Peer-reviewed research from Consortium e-Learning Network

Research & Reviews : A Journal of Unani, Siddha and Homeopathy Review Article

Prevention of Primary Hypertension Through Asbab-e-Sitta Zaruriya: A Therapeutic Paradigm

  1. Musab Siddique Department of Moalejat, Ajmal Khan Tibbiya College and Hospital, Aligarh Muslim University, Aligarh
  2. Swaleha Akhtar Department of Moalejat, Ajmal Khan Tibbiya College and Hospital, Aligarh Muslim University, Aligarh
  3. Badrudduja Khan Department of Moalejat, Ajmal Khan Tibbiya College and Hospital, Aligarh Muslim University, Aligarh
  4. Tanzeel Ahmad Department of Moalejat, Ajmal Khan Tibbiya College and Hospital, Aligarh Muslim University, Aligarh
  5. Jamal Azmat Department of Moalejat, Ajmal Khan Tibbiya College and Hospital, Aligarh Muslim University, Aligarh

Abstract

Hypertension, defined as blood pressure elevation to a level that increases the risk of organ damage, Recent guidelines classify hypertension as systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg, distinguishing between primary (essential) and secondary forms. It affects over one billion individuals globally and contributes to approximately 9.4 million deaths annually. Nearly 63% of total deaths in India are due to non-communicable diseases, of which 27% are attributed to cardiovascular disease which affects 45% people in the 40–69 age group. Unani medicine refers to hypertension as “Zaghtuddam Qawi,” although classical texts discuss a condition known as “Imtila,” which exhibits clinical features akin to hypertension, such as headache and palpitation, heaviness in chest. Unani scholars categorize Imtila into two types: Imtila bi Hasbil Auiya, characterized by increased blood volume and vessel tension (akin to primary hypertension), and Imtila bi Hasbil Quwa, where blood quality is compromised. The prevention and management of hypertension in Unani medicine emphasizes the Asbab-e-Sitta Zaruriya (six essential factors), including atmospheric air, diet, physical activity, psychological well-being, sleep, and elimination/retention. Proper management of these factors can help to mitigate hypertension risks. This holistic approach recognizes the interplay of lifestyle and environmental factors in maintaining health, underscoring the importance of balanced nutrition, regular physical activity, and mental tranquility. Ultimately, the integration of Unani principles with modern understanding of hypertension offers a comprehensive framework for prevention and management.

Keywords

References (78)

  1. Crees Z, et al. The Washington Manual of Medicine. 36th edition. New Delhi: Wolter Kulwer; 2022:73.
  2. loscalzo, et al. Harrison’s Principles of Internal Medicine. 21st edition. New York: MC Graw Hill; 2017. 2072.
  3. Abid M, Khan S, Khan N, Nazli T, Sajid M. Concept of Zaght al-Dam-Qawi (hypertension) and its management modalities in Unani system of medicine. J Integ Comm Health. 2021;10(1):11–15.
  4. Koya SF, Pilakkadavath Z, Chandran P, Wilson T, Kuriakose S, Akbar SK, et al. Hypertension control rate in India: systematic review and meta-analysis of population-level non-interventional studies, 2001–2022. The Lancet Regional Health - Southeast Asia. 2023;9:100113. doi:10.1016/j.lansea.2022.100113
  5. int. Hypertension [Online]. World Health Organization. 2019. Available from: https://www.who.int/health-topics/cardiovascular-diseases/hypertension#tab=tab_1
  6. Pescatello LS, Franklin BA, Fagard R, Farquhar WB, Kelley GA, Ray CA. Exercise and hypertension. Med Sci Sports Exerc. 2004;36(3):533–553. doi:10.1249/01.MSS.0000115224.88514.3
  7. Gupta R. Trends in hypertension epidemiology in India. Journal of Human Hypertension. 2004;18(2):73-78. doi:10.1038/sj.jhh.1001633
  8. Clark M, Kumar P. Medical Management and Therapeutics. New York: Elsevier; 2011.
  9. Ibn e sina. Kulliyat e qanoon. Fan-2. Translated by Hakeem Kabeeruddin. Lahore: Sheikh Mohammad Basheer and Sons; pp. 238–239, 156–157.
  10. Jurjani AH. Zakheera Khwarzam Shahi. New Delhi: Idara Kitab us Shifa; 2010. 24–25p.
  11. Majusi AA. Kamil us Sana. Translated by Ghulam Husain Kanturi. New Delhi: Idara Kitab al Shifa; 2010. 548–550p.
  12. Ashraf A, et al. Unani and conventional perspective of hypertension (Ḍaghṭ al-Dam Qawī). Res Rev J Herb Sci. 2023;12(1):26–30.
  13. Hamdani SK. Usoole Tib. Aligarh: Litho Colour Printer; 1980. 168, 202–203.
  14. Razi Z. Kitabul Mansuri. Urdu translation. 1st ed. New Delhi: CCRUM; 1991. 74–75p.
  15. Ahmer SM, Fahad A, Ali SJ. A comprehensive review on plethora: etiopathogenesis, signs, symptoms, and complications from the perspective of Unani medicine. J Nat Remedies. 2023;351–360.
  16. Iqbal N, et al. Concept of hypertension (Zaghtuddam Qawi) in Unani system of medicine. Int Pharm Sci. 2013;3:2.
  17. Kabeeruddin M. Ifada-e-Kabir Mujmal. Lahore: Sheikh Mohammad Basheer and Sons; 83, 144–146p.
  18. Kabiruddin, hakeem mohammad. Kulliyat e nafeesi. New delhi , idara kitab us shifa, 1954. pp. 188–201, 223–226, 226–33, 237–38.
  19. Prasad RR, Paudel S. Impacts of Air Pollution on Epidemiology and Cardiovascular Systems. Environmental Chemistry for a Sustainable World. 2020:179-207. doi:10.1007/978-981-15-3481-2_8
  20. An Z, Jin Y, Li J, Li W, Wu W. Impact of Particulate Air Pollution on Cardiovascular Health. Current Allergy and Asthma Reports. 2018;18(3). doi:10.1007/s11882-018-0768-8
  21. Colombini MP. Air pollution and its impact on the cardiovascular system. Einstein. 2008;6(2):221–226.
  22. Jurjani AH. Zakheera Khawarizm Shahi. Translated by Hkm Hadi Hasan Khan. Lucknow: Munshi Nawal Kishore; 37–38.
  23. Eilat-Adar S, Sinai T, Yosefy C, Henkin Y. Nutritional Recommendations for Cardiovascular Disease Prevention. Nutrients. 2013;5(9):3646-3683. doi:10.3390/nu5093646
  24. Gadiraju T, Patel Y, Gaziano J, Djoussé L. Fried Food Consumption and Cardiovascular Health: A Review of Current Evidence. Nutrients. 2015;7(10):8424-8430. doi:10.3390/nu7105404
  25. Helm L, Macdonald IA. Impact of beverage intake on metabolic and cardiovascular health. Nutrition Reviews. 2015;73(suppl2):120-129. doi:10.1093/nutrit/nuv049
  26. Rahman A, Ali SJ, Aslam M, Rashid B. Asbabe Sitta Zarooriya (Six Essentials of Life): A Review. Indo Am J Pharm Sci. 2014;1(6):402–506.
  27. Rushd I. Kitab ul Kulliyat. 2nd edition. New Delhi: CCRUM; 1987. 344–348.
  28. Ibn Hubl Baghdadi. Kitab ul Mukhtarat fit Tib, Part 1. Translated by CCRUM. New Delhi: CCRUM; 2005. 118–119.
  29. Nushrat J, Akhtar J, Khan AA. Prevention and management of lifestyle diseases through Unani system of medicine. Int J Unani Integr Med. 2020;4(2):01–04.
  30. Rahman MS, Salek AK. Role of exercise as a therapeutic intervention for hypertension. Univ Heart J. 2009;5(1):36–39.
  31. Wallace JP. Exercise in Hypertension. Sports Medicine. 2003;33(8):585-598. doi:10.2165/00007256-200333080-00004
  32. Ameen HKM, Malik W. Qadeem Ilmul Amraz. 7th edition. Delhi: NCUPL; 2017.
  33. Bacon SL, Campbell TS, Arsenault A, Lavoie KL. The Impact of Mood and Anxiety Disorders on Incident Hypertension at One Year. International Journal of Hypertension. 2014;2014(1). doi:10.1155/2014/953094
  34. Bener A, Kamal A, Al-Banna M, Al-Mulla A, Elbagi IA. Are symptoms of anxiety depression and stress risk factors for hypertension. Cardiol. 2006;2(2):45–51.
  35. Mucci N, Giorgi G, De Pasquale Ceratti S, Fiz-Pérez J, Mucci F, Arcangeli G. Anxiety, Stress-Related Factors, and Blood Pressure in Young Adults. Frontiers in Psychology. 2016;7. doi:10.3389/fpsyg.2016.01682
  36. Cameron GO. The Canon of Medicine of Avicenna. 1st edition. New York: AMS Press; 1973. 211–213.
  37. Calhoun DA, Harding SM. Sleep and Hypertension. Chest. 2010;138(2):434-443. doi:10.1378/chest.09-2954
  38. Li C, Shang S. Relationship between Sleep and Hypertension: Findings from the NHANES (2007–2014). International Journal of Environmental Research and Public Health. 2021;18(15):7867. doi:10.3390/ijerph18157867
  39. Makarem N, Alcántara C, Williams N, Bello NA, Abdalla M. Effect of Sleep Disturbances on Blood Pressure. Hypertension. 2021;77(4):1036-1046. doi:10.1161/hypertensionaha.120.14479
  40. Crees Z, et al. The Washington Manual of Medicine. 36th edition. New Delhi: Wolter Kulwer; 2022:73.
  41. loscalzo, et al. Harrison’s Principles of Internal Medicine. 21st edition. New York: MC Graw Hill; 2017. 2072.
  42. Abid M, Khan S, Khan N, Nazli T, Sajid M. Concept of Zaght al-Dam-Qawi (hypertension) and its management modalities in Unani system of medicine. J Integ Comm Health. 2021;10(1):11–15.
  43. Koya SF, Pilakkadavath Z, Chandran P, Wilson T, Kuriakose S, Akbar SK, et al. Hypertension control rate in India: systematic review and meta-analysis of population-level non-interventional studies, 2001–2022. The Lancet Regional Health - Southeast Asia. 2023;9:100113. doi:10.1016/j.lansea.2022.100113
  44. int. Hypertension [Online]. World Health Organization. 2019. Available from: https://www.who.int/health-topics/cardiovascular-diseases/hypertension#tab=tab_1
  45. Pescatello LS, Franklin BA, Fagard R, Farquhar WB, Kelley GA, Ray CA. Exercise and hypertension. Med Sci Sports Exerc. 2004;36(3):533–553. doi:10.1249/01.MSS.0000115224.88514.3
  46. Gupta R. Trends in hypertension epidemiology in India. Journal of Human Hypertension. 2004;18(2):73-78. doi:10.1038/sj.jhh.1001633
  47. Clark M, Kumar P. Medical Management and Therapeutics. New York: Elsevier; 2011.
  48. Ibn e sina. Kulliyat e qanoon. Fan-2. Translated by Hakeem Kabeeruddin. Lahore: Sheikh Mohammad Basheer and Sons; pp. 238–239, 156–157.
  49. Jurjani AH. Zakheera Khwarzam Shahi. New Delhi: Idara Kitab us Shifa; 2010. 24–25p.
  50. Majusi AA. Kamil us Sana. Translated by Ghulam Husain Kanturi. New Delhi: Idara Kitab al Shifa; 2010. 548–550p.
  51. Ashraf A, et al. Unani and conventional perspective of hypertension (Ḍaghṭ al-Dam Qawī). Res Rev J Herb Sci. 2023;12(1):26–30.
  52. Hamdani SK. Usoole Tib. Aligarh: Litho Colour Printer; 1980. 168, 202–203.
  53. Razi Z. Kitabul Mansuri. Urdu translation. 1st ed. New Delhi: CCRUM; 1991. 74–75p.
  54. Ahmer SM, Fahad A, Ali SJ. A comprehensive review on plethora: etiopathogenesis, signs, symptoms, and complications from the perspective of Unani medicine. J Nat Remedies. 2023;351–360.
  55. Iqbal N, et al. Concept of hypertension (Zaghtuddam Qawi) in Unani system of medicine. Int Pharm Sci. 2013;3:2.
  56. Kabeeruddin M. Ifada-e-Kabir Mujmal. Lahore: Sheikh Mohammad Basheer and Sons; 83, 144–146p.
  57. Kabiruddin, hakeem mohammad. Kulliyat e nafeesi. New delhi , idara kitab us shifa, 1954. pp. 188–201, 223–226, 226–33, 237–38.
  58. Prasad RR, Paudel S. Impacts of Air Pollution on Epidemiology and Cardiovascular Systems. Environmental Chemistry for a Sustainable World. 2020:179-207. doi:10.1007/978-981-15-3481-2_8
  59. An Z, Jin Y, Li J, Li W, Wu W. Impact of Particulate Air Pollution on Cardiovascular Health. Current Allergy and Asthma Reports. 2018;18(3). doi:10.1007/s11882-018-0768-8
  60. Colombini MP. Air pollution and its impact on the cardiovascular system. Einstein. 2008;6(2):221–226.
  61. Jurjani AH. Zakheera Khawarizm Shahi. Translated by Hkm Hadi Hasan Khan. Lucknow: Munshi Nawal Kishore; 37–38.
  62. Eilat-Adar S, Sinai T, Yosefy C, Henkin Y. Nutritional Recommendations for Cardiovascular Disease Prevention. Nutrients. 2013;5(9):3646-3683. doi:10.3390/nu5093646
  63. Gadiraju T, Patel Y, Gaziano J, Djoussé L. Fried Food Consumption and Cardiovascular Health: A Review of Current Evidence. Nutrients. 2015;7(10):8424-8430. doi:10.3390/nu7105404
  64. Helm L, Macdonald IA. Impact of beverage intake on metabolic and cardiovascular health. Nutrition Reviews. 2015;73(suppl2):120-129. doi:10.1093/nutrit/nuv049
  65. Rahman A, Ali SJ, Aslam M, Rashid B. Asbabe Sitta Zarooriya (Six Essentials of Life): A Review. Indo Am J Pharm Sci. 2014;1(6):402–506.
  66. Rushd I. Kitab ul Kulliyat. 2nd edition. New Delhi: CCRUM; 1987. 344–348.
  67. Ibn Hubl Baghdadi. Kitab ul Mukhtarat fit Tib, Part 1. Translated by CCRUM. New Delhi: CCRUM; 2005. 118–119.
  68. Nushrat J, Akhtar J, Khan AA. Prevention and management of lifestyle diseases through Unani system of medicine. Int J Unani Integr Med. 2020;4(2):01–04.
  69. Rahman MS, Salek AK. Role of exercise as a therapeutic intervention for hypertension. Univ Heart J. 2009;5(1):36–39.
  70. Wallace JP. Exercise in Hypertension. Sports Medicine. 2003;33(8):585-598. doi:10.2165/00007256-200333080-00004
  71. Ameen HKM, Malik W. Qadeem Ilmul Amraz. 7th edition. Delhi: NCUPL; 2017.
  72. Bacon SL, Campbell TS, Arsenault A, Lavoie KL. The Impact of Mood and Anxiety Disorders on Incident Hypertension at One Year. International Journal of Hypertension. 2014;2014(1). doi:10.1155/2014/953094
  73. Bener A, Kamal A, Al-Banna M, Al-Mulla A, Elbagi IA. Are symptoms of anxiety depression and stress risk factors for hypertension. Cardiol. 2006;2(2):45–51.
  74. Mucci N, Giorgi G, De Pasquale Ceratti S, Fiz-Pérez J, Mucci F, Arcangeli G. Anxiety, Stress-Related Factors, and Blood Pressure in Young Adults. Frontiers in Psychology. 2016;7. doi:10.3389/fpsyg.2016.01682
  75. Cameron GO. The Canon of Medicine of Avicenna. 1st edition. New York: AMS Press; 1973. 211–213.
  76. Calhoun DA, Harding SM. Sleep and Hypertension. Chest. 2010;138(2):434-443. doi:10.1378/chest.09-2954
  77. Li C, Shang S. Relationship between Sleep and Hypertension: Findings from the NHANES (2007–2014). International Journal of Environmental Research and Public Health. 2021;18(15):7867. doi:10.3390/ijerph18157867
  78. Makarem N, Alcántara C, Williams N, Bello NA, Abdalla M. Effect of Sleep Disturbances on Blood Pressure. Hypertension. 2021;77(4):1036-1046. doi:10.1161/hypertensionaha.120.14479
Support