Doubtful ‘Science of hypertension-according to Dr Hegde

By Dr Harold Gunatillake - Health Writer

Dr Hegde states that, as a researcher in the field for the past half a century, I fail to understand any scientific basis for blood pressure (BP) guidelines. But the drug companies keep coming out with expensive new BP-lowering drugs without any long-term experiential wisdom.

This is not true in everyday practice of doctors. Doctors do not prescribe any new drug that they are not familiar with. If medical reps do supply newer drugs, the practitioners will prescribe the drugs they are familiar with and has stood the test of time, experience, and wait until they hear or read about the efficacy and the compliance of the newer products through independent researchers. The doctors may change to newer products as alternatives, if the prescribed medication does not seem to be effective. Doctors do not act as drug pushers at the whimsy of the companies.

DR Hegde states-Fluids flow in nature by whirling and nothing flows laminarly (i.e., in parallel layers, with no disruption between the layers). In addition, we know little about fluid flow in a closed circuit. Hagioscopic studies of rat’s aorta did confirm that blood flows by whirling, unlike what is taught to us. If that were so, all our scientific assumptions lose their thrust in hypertension. Even if we were to assume that blood flows laminarly, many of the drugs that we use might do more harm than good! One example will suffice. 

 When you pump water through a rubber tube, the water does not whirl, but flows through uniformly to reach its destination. The words whirling, and laminal flow are imaginary. There is some whirling of the rapid blood flow at bifurcation of arteries, such as the lower end of the descending aorta where it bifurcates into two main branches supplying blood to the lower extremities and in the aortic arch regions. This whirling occurs due to the rapid thrust of the flow against the walls of the main artery at sites where branches give off. Such whirling does damage the inner lining of the arteries. That explains why atheromatous plaques are more frequent at such sites, on post-mortem specimens.

I don’t see the relevance between antihypertensive drugs and the way blood flows in closed circuit in the arteries.

The heart is a pump and its action distribute the fresh oxygenated blood to all organs and tissues of the body.

With age, thickening of arteries is a natural phenomenon as one could feel in your radial artery at the wrist on rolling your index and middle finger over the artery. The degree of this thickening varies from person to person due to various reasons. Thickening of the radial artery at the wrist reflects indirectly the assessment of the thickness of the coronary arteries supplying the heart muscles. Thickening of arteries is due to the hypertrophy of the smooth muscles layer.

 Leading a healthy life, with daily exercise, eating the right foods with emphasis on unprocessed grain foods such as brown rice and whole-meal bread, consuming high fiber veggies, keeping your weight within the normal BMI range, limiting your alcohol consumption to two drinks a day, controlling your blood sugar-all help to keep your arteries elastic for longer periods. Omega-3 fatty acids seem to relax such arteries to lower the blood pressure. Having high blood pressure alone can thicken your arteries and thickened arteries too lead to high blood pressure.

It makes no sense when Dr Hegde says,” Hagioscopic studies of rat’s aorta did confirm that blood flows by whirling, unlike what is taught to us. If that were so, all our scientific assumptions lose their thrust in hypertension

The standard teaching to control your blood pressure is through the conservative regime I have described earlier. Due to genetic and familial factors if you were to get high blood pressure, your doctor will consider prescribing, one, two or three kinds of drugs to bring down your BP to within the normal range.

Today, the normal range considered for males is a systolic pressure of 120-130 mmHg and diastolic below 80 mm Hg. For women, it should be lower.

Lowering high blood pressure helps prevent strokes, heart attacks, kidney problems and wellbeing. Doctors prescribe calcium channel blockers to relax the heart muscles and, relax blood vessels so blood can flow more easily.

If the heart rate is high your doctor will prescribe a ‘Beta-blocker’ to slow your heart rate.

To reduce the peripheral resistance of your arteries your doctor may prescribe a drug called ‘vaso-dilators’.

For older people to prevent kidney damage your doctor will prescribe drugs called Angiotensin inhibiting drugs.

The doctors will always prescribe medication they are familiar with and will not ever image giving medications to enrich the Pharma industry, as Dr Hegde is possessed with.

DR Hegde claims: In a laminar flow, the outermost layer of blood does not flow but only sticks to the vessel wall. When we use vasodilators (medicines that dilate blood vessels allowing blood to flow more easily), it is the flow speed in the centre that increases. This might bring some damage in the target organs like the kidney! Similarly, all other groups of chemicals try only to make man go away from the sympathetic mode to the parasympathetic mode. This could be done more effectively by yoga and praanaayama without the hazards of those reductionist chemicals called anti-hypertensives! 

 So, you can forget these imaginary theories of laminar flows and whirling when it comes to the treatment of hypertension. This learned doctor stating that all chemicals try only to make man go away from the sympathetic mode to the parasympathetic mode is meaningless.

High blood pressure is due to anatomical changes in the heart and arterial systems of your body, leading from a physiological mode to a pathological mode which in time, untreated leads to sudden heart attacks, angina attacks, strokes and damage to kidneys.

Through medication your doctor and your specialist will correct this damaging disease by giving you proper medication on the guidelines mentioned earlier.

If Dr Hegde a Western qualified physician advocates Yoga and Praanaayama without proper control with medication, the Indian medical council should investigate into such thinking.

Such information will mislead the people and may end up with complications and lead to death, bringing in suffering to the loved ones.

High blood pressure has no symptoms in the earlier stages. It is a physical finding by checking your pressure in your arteries with a sphygmomanometer or other device. The body gets ‘accommodated’ during the early stages until such time you end up with a stroke or heart attack.

Blood pressure needs to be controlled in the earlier stages with dietary regimes, exercise and medication, and not take Dr Hegde’s advice and avoid medication and go for yoga and other practices. It is a good habit to practice yoga, meditation and other practices whilst taking your conventional medicine, but check with your doctor first.

 (DrB. M. Hegde is a medical practitioner and has a M.B.B.S from Stanley Medical College (Madras), a M.D. from King George Medical College (Lucknow), FRCP from Royal College of Physicians, London, Glasgow, Edinburgh, and Dublin. He also has a FACC and FAMS. He also received training in cardiology from Harvard)

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