Healing Hypertension
by
Mitch Hall
Abstract
This essay defines hypertension and blood pressure; relates how blood pressure is measured and what level is considered normal; distinguishes two types of hypertension; refers to the insidiously asymptomatic character of most cases of hypertension; discusses the risk factors for hypertension; signals the dangers of the condition; cites the incidence of hypertension in the US and worldwide; presents recently developed, paradigm-shifting models of the heart, arteries, and veins; advocates natural approaches to regulating blood pressure, including nutrition, herbal therapeutics, exercise, lifestyle modifications, supportive social ties, cultural change, and raja yoga.
Defining Hypertension and Blood Pressure
Hypertension, also called high blood pressure, is “a condition in which the pressure in the arteries is too high” (Cowan, 2007, p. 157). “Blood pressure is a measure of the force of blood against the walls of your arteries” (Kaiser Permanente, 2006, p. 92), and this force is determined by the amount of blood flowing from the heart into the arteries in relation to the amount of resistance of the arteries (Mayo Clinic). The narrower the arteries and the more blood flowing from the heart, the higher the blood pressure is.
Blood pressure in the arteries is measured by two readings, systolic and diastolic. The former reveals the force of blood in the arteries while the heart is beating, and the latter indicates the force of blood in the arteries when the heart is resting between heartbeats. The numerical readings of these two pressures, measured with a pressure-sensitive device called a sphygmomanometer, are represented as a ratio, with the systolic on the top and the diastolic on the bottom, as in this example, 116/72. The systolic pressure, when the heart contracts, is understandably higher than the diastolic pressure, when the heart is at rest. Either or both of these measures can be elevated beyond safe limits (Achterberg, Dossey, & Kolkmeier, 1994). Hypertension can be situational or chronic. In the course of a given day, blood pressure will vary somewhat depending on time of day, activities, level of exertion, body position, mood, emotions, thoughts, and relationship factors. A temporary and minor rise in blood pressure is usual under stressful circumstances, and some people, called “hot reactors,” show disproportionate elevations of blood pressure when they perceive a situation as stressful (Achterberg, Dossey, & Kolkmeier, p. 186).
Shifting Standards of What is Considered Normal Blood Pressure
Over the years, the medical profession has been changing the standards for what level of blood pressure is considered normal. Just a few decades ago, normal pressure was considered to be “anything under 140/90 or 100 plus the person’s age over 90” (Cowan, 1997, p. 161). Today the standard of normalcy is considered lower. For adults, normal is considered 119/70 or below; borderline high is held to be 120-139/80-89; high is considered 140/90 or higher (Kaiser Permanente, 2006). As we see, what used to be considered normal is now generally viewed as hypertensive.
Types of Hypertension
The medical profession distinguishes between two types of hypertension, primary (essential) and secondary. The former accounts for 90 to 95 per cent of cases in adults, and its distinguishing characteristic is, according to most medical authorities, that “there’s no identifiable cause” (Mayo Clinic). It is believed to develop slowly over several years. Secondary hypertension tends to have sudden onset and to rise higher than does essential hypertension. It is caused either by other medical conditions (kidney abnormalities, adrenal gland tumors, some congenital heart defects) or by drugs, whether prescribed or bought over-the-counter (birth control pills, cold remedies, decongestants, analgesics, anti-inflammatory medications, and steroids), or illegal drugs (cocaine, amphetamines) (Mayo Clinic).
Symptoms of Hypertension
Most people with hypertension are asymptomatic (Mayo Clinic), making this an insidious condition. It has been “often called ‘the silent killer’” (Kaiser Permanente, 2006). When symptoms such as headaches, dizziness, and frequent nosebleeds occur due to hypertension, the condition may already be at dangerously high levels. Routine blood pressure monitoring at the time of a visit to a doctor’s office is a wise, non-invasive precautionary measure. Ironically, the very fact of having one’s blood pressure read is often itself worrisome enough to cause a temporary spike in blood pressure. Therefore, many doctors do a second reading after helping a patient relax.
Risk Factors for Hypertension
Whereas no medical consensus exists regarding the causes of primary hypertension, epidemiological studies have revealed several risk factors. These include smoking, being overweight or obese, being in a family where others have hypertension, being African-American, not getting regular exercise, drinking too much alcohol, eating a lot of salt (sodium chloride) and not getting enough potassium, calcium, or magnesium in the diet (Kaiser Permanente, 2006). Age is considered a risk factor for males over 55 and females over 65 (WHO/ISH, 2003). Also, high total cholesterol, high LDL-cholesterol, and low HDL-cholesterol are risk factors, as is diabetes (WHO/ISH). Elevated blood lead and cadmium levels, often found in people in areas with soft (acidic) water, are also associated with hypertension (Murray & Pizzorno, 1991). Significant atherosclerotic plaque is often found in the aorta, carotid, coronary, iliac, and femoral arteries of hypertensives (WHO/ISH). Regarding stress-related risk factors, “high blood pressure often occurs when the fight-or-flight response of the sympathetic nervous system becomes excessive in the arteries” (Cowan, 2007, p. 158). Similarly, “anger sharply increases blood pressure on a short-term basis, for instance, but it may well be the recurrent stewing over provocative events that causes sustained hypertension in touchy people like type A executives” (Lewis, Amini, & Lannon, 2000, p. 46). As we shall see below, another significant risk factor for hypertension is social isolation and a lack of supportive social ties.
Dangers of Hypertension
Hypertension is itself a risk factor for myocardial infarction (heart attack), heart disease, angina pectoris, coronary revascularization, congestive heart failure, ischemic stroke, cerebral hemorrhage, transient ischemic attack, kidney disease, excessive plasma creatinine levels, albuminaria, peripheral vascular disease, and eye damage (WHO/ISH, 2003; Kaiser Permanente, 2006). The higher the pressure, and the longer it stays high, the greater the risks of these conditions and of premature mortality.
Incidence of Hypertension
“Hypertension is the leading cause of cardiovascular disease worldwide” (Hajjar, Kotchen, &Kotchen, 2006). Whereas the condition appeared to be on the decline prior to 1990, it has subsequently been documented to be on the rise, with 28.6 per cent of the US population suffering from hypertension during the years 1999 to 2002 (Hajjar, Kotchen & Kotchen). Hypertension is “the most common reason for office visits to physicians for non-pregnant adults in the United States,” involving over 50 million Americans (Medical News Today, 2007). Worldwide, about 972 million people are hypertensive, and the prevalence of hypertension has been increasing. “Incidence rates of hypertension range between 3% and 18%, depending on the age, gender, ethnicity, and body size of the population studied” (Hajjar, Kotchen, & Kotchen).
The Heart of the Matter
Since hypertension is a disorder of the cardiovascular system, let’s take a fresh look at the amazing role of the heart and, in the next section, of the veins and arteries. The human heart is the first organ to begin forming as we develop in utero, followed by the brain, and then the rest of the body (Pearce, 2002, p. 67). When the heart ceases beating, without any possibility of being revived, we die. From the beginning to the end of life, the heart is central. When we speak idiomatically about the heart of the matter, we mean the essence of an issue. In traditional Chinese medicine, the inner spiritual core of the self—shen-- is deemed to reside, not in the head, but in the heart (Teeguarden, 1984, 1987, pp. 64-65). Likewise, in many indigenous cultures, the heart is held to be the organ of thought (Eden, 1998, p. 156).
Recent scientific research may lend credence to these multicultural perspectives on the heart because it has demonstrated that the heart is more than just a marvelous pump for the circulation of blood through the approximately 15 miles of vessels and thousands of miles of minuscule capillaries in the body (Pearce, 2002, pp. 56-57). Cowan (2007) analyzes and challenges the theoretical model that reduces the functioning of the heart to being a pump. He presents anatomical and physiological evidence to support his well-reasoned contention that “it is the gradient or difference of water pressure from the artery side to the vein side that provides the pump,” that the pump effect comes from the “generation of osmotic pressure” (Cowan, p. 145). Readers who wish to follow his elegant argument are referred to his book. In Cowan’s model, what then is the heart if not a pump? His view is close to that of traditional Chinese medicine:
The heart does not pump--what it does is listen. This amazing organ senses what is in the blood and then calls forth the necessary hormones so that homeostasis is maintained and the cells can function optimally. The heart serves the cells not by pushing blood towards them but by balancing and integrating the blood’s chemistry. In fact, Steiner suggested that the heart also senses and integrates our thoughts, our emotions, and our will to carry out tasks. The heart then is not a mechanical pump, but actually a sensitive integrator of all our experience (Cowan, 2007, p. 144).
Other authors and studies lend further credence to Cowan’s inspiring model of the heart. Pearce (2002) refers to the “triune heart” (p. 55) because of its interrelated electromagnetic, neural, and hormonal functions. The beating heart generates two-and-a-half watts of electricity. The resulting electromagnetic wave is “at an amplitude from 40 to 60 times greater than that of brain waves” (Pearce, p.56), and the currents radiate from 12 to 15 feet beyond the body, while being strongest within a three-foot radius (Pearce). The strength of these cardiac waves is approximately a thousand times that of brain waves (Eden, 1998, p. 156). Because of its predominant power, “the heart tends to pull the brain and other organs into synchronization or ‘entrainment’ with its rhythm” (Eden, p. 156). The heart’s electromagnetic field is configured like a torus that arcs out from and back to its source in the protective thoracic cavity. This torus is organized around a roughly vertical axis that extends through the torso from the perineum to the crown of the cranium (Pearce, p. 57).
Furthermore, in fascinating research that is relevant to subsequent discussion in this paper about the effects of supportive ties on heart function and blood pressure, it has been found that the electromagnetic field generated by the heart of one person can even entrain the brain waves of another (Pearce, 2002). Linda Russek, a scientist at the University of Arizona, interviewed--as part of a study conducted with her colleague Gary Schwartz--individual men who had previously rated themselves as having been either well nurtured or not in childhood. Within a brief time, the brain waves, as measured by EEG, of the men who perceived their childhoods as positive became synchronized with Russek’s heart frequencies, as measured by ECG. “The EEG patterns of the subjects with negative childhoods showed a much slower-forming and weaker correspondence to the interviewer, if any at all” (Pearce, p. 246). These results may indicate, as has much other research (Bowlby, 1969; Lewis, Amini, & Lannon, 2000), that weak attachments in early childhood make it difficult to form supportive ties or establish interpersonal rapport in adulthood. As we shall see, the heart itself and our blood pressure are in turn affected by the quality of our sustained relationships with others.
In connection with the preceding discussion of the heart’s scientifically measurable electromagnetic field, it is significant that many healers have spoken of the energy of healing as radiating from the heart chakra (Motoyama, 1981, 1984; Green & Shellenberger, 1993). The Polish-born healer Mietek Wirkus stated, “Heart center vibrations relate to unconditional love, and to treating other beings with love, understanding, and respect.” (Green & Shellenberger, p. 51). He affirmed that healers “…must feel and be the heart chakra…” through “…the real sensation of pure love which brings warmth, delicate vibrations in your heart area” (Green & Shellenberger, p. 51). In these statements, Wirkus is giving phenomenological descriptions of his felt experience, which indicates that the heart can be a subtly tuned amplifier and transmitter of healing, altruistic intentions.
Far from being made up only of smooth muscle cells, the heart is also composed of neurons grouped in ganglia with the same sort of axon-dendrite connections found in the brain (Pearce, 2002, p. 64). These neural cells are estimated to comprise from 50 to 65 percent of all cardiac cells (Pearce, 2002). “Researchers at the University of Melbourne have shown that the heart has a nervous system and that it makes decisions independent of the brain, such as how fast to beat” (Eden, 1998, p. 156). The heart’s highly organized neural structures connect to nerves throughout the body and also have “unmediated neural connections with the emotional-cognitive, or limbic, brain” (Pearce, p. 64). There are receptors in the heart’s ganglia for “the same neurotransmitters that function in the brain” (Pearce, p. 64). Additionally, the atrium of the heart produces a hormone called ANF that influences the limbic brain, the balance between the sympathetic and parasympathetic nervous systems, the immune system, and virtually every other hormonal action of the body (Pearce).
In light of the foregoing discussion of recent scientific theories and discoveries about the complexity, power, and roles of the heart, we can perhaps better appreciate the fact that ancient cultures saw the heart as the seat of the soul. Metaphorically speaking, “A human being has dual hearts—the first a pulsating fist of muscle in the chest; the second, a precious cabal of communicating neurons that create feeling, longing, and love” (Lewis, Amini, & Lannon, 2000, p. 122). In English, as in other languages, many idioms attest to this “second” heart, the social-emotional heart. We speak of holding those we love in our hearts or close to our hearts. Anguish is referred to as heartache, whereas overwhelming sorrow or grief is called heartbreak. Sincere intentions and actions are heartfelt. To be generous and compassionate is to be openhearted or warmhearted, whereas being devoid of compassion is to be heartless. Open and possibly naive self-disclosure in romantic matters is called wearing one’s heart on one’s sleeve. Rejection involves closing one’s heart to another person. A heart-to-heart conversation is intimate and candid. To follow one’s heart means to act on the basis of an intuitive sense of one’s own most fulfilling option. Finally--and this listing of metaphorical heart expressions does not exhaust the possibilities--to hearten is to encourage, and our English word courage is itself derived from the French word, coeur, meaning heart.
Having looked at some major aspects of what is known about the heart--literally and figuratively--we will review below the evidence for how supportive ties affect the health of the heart and of the overall cardiovascular system, in general, and hypertension, in particular. Before doing so, however, let’s first look at the remarkable complementarity of the veins and arteries, respectively the yin and yang of the circulatory system.
Veins and Arteries: Yin and Yang of Circulation
Etymologically the English words “vein” and “artery” have astrological and mythological roots that metaphorically reveal the essentially spiritual imbalance manifested somatically by hypertension (Cowan, 2007). “Vein” is derived from Venus (Aphrodite), the archetypal goddess of nurturing, the harvest, and feminine energy. “Artery” is derived from Ares (Mars), the archetypal god of aggression, action, war, and male energy. The veins are receptive. They carry toward the heart the blood whose volume, in comparison to arterial blood, has been increased due to the added carbon dioxide and water released from the capillaries to the venules (small veins) and then to the veins as a result of cellular metabolism (Cowan). The arteries move oxygenated, nutrient-enriched blood in the waves of their own heart-generated contractions towards the capillaries that nourish the cells throughout the body. On the basis of the different energetic functions of veins and arteries, the symbolism of their etymologies makes sense and points to the significance of hypertension as an imbalance of yang and yin, a domination of forceful male energy over nurturing female energy.
This model shows us the interconnection of the heart and circulation with the whole male-female polarity in particular, and with the reconciliation of opposites in general. The circulation is really the biological field where the soul lives out its life (Cowan, p. 158).
In this light, hypertension may be viewed as an individual disorder that microcosmically mirrors the macrocosmic, male-dominated, planet-plundering, competitive, societal, cultural, and economic systems that prevail. It is, in fact, more of a health problem in the so-called developed world, with the US having the highest incidence, and it is related to the lifestyles, diet, relationship patterns, and cultural ideals of capitalism.
What Helps Regulate Blood Pressure
Because hypertension manifests in the individual human body, how can an individual regulate blood pressure and bring it back to normal? Allopathic medicine offers an array of drugs to this end. While they can be effective in the short run, they all have harmful side effects, and depression may unfortunately be one of these (Cowan, 2007). Therefore, it makes sense to approach the down-regulation of hypertension through bringing more balance into one’s nutrition, lifestyle, relationships, and spiritual outlook. Raja yoga, because it is a holistic spiritual path that embraces the wellness of the human body, can also be a valuable therapeutic modality in the treatment of hypertension, and empirical research, to be discussed below, has found evidence that yoga can brilliantly reduce hypertension. Let’s look in turn at some of the practical ways to bring blood pressure into a healthy balance.
Nutrition and Herbal Therapeutics
Because being overweight is a risk factor for hypertension, it is important that one’s food consumption be commensurate with one’s physical activity level. Cowan (2007) has given the following dietary recommendations. One should avoid refined carbohydrates, processed foods, especially those with trans-fatty acids, refined salt, and excessive liquid consumption that could drive blood pressure higher. Too much water can “increase blood volume and edema (water retention)” (Cowan, p. 162). Whole grain carbohydrates may be eaten in moderation and should constitute no more than one-quarter of any given meal. Celtic sea salt, which is rich in magnesium, a trace mineral that helps lower blood pressure, should be used instead of refined salt. Healthy fats provide the nutrients needed for the body’s production of hormones and neurotransmitters, and these fats are encouraged. They include coconut oil and raw, grass-fed butter and cream. Bone broths, liver, shell fish, eggs, and lacto-fermented vegetables, such as raw sauerkraut, and lacto-fermented vegetables, such as kombucha, are also to be emphasized. Herbal therapeutics include chamomile extract, rauwolfia extract, hawthorn tablets, and horsetail extract. Chamomile contains copper, which helps regulate blood pressure. “Hawthorn helps relax the walls of the arterial blood vessels and is a cardiotonic” (Cowan, p. 162). Castor oil packs can be placed over the kidneys and adrenals for an hour at a time on three or four days because “castor oil relaxes the overaggressive sympathetic nervous system” (Cowan, p. 163).
Lifestyle
It is clearly important for a person with hypertension to eliminate known risk factors for the condition. These include smoking, excessive alcohol consumption, amphetamines, and cocaine. Also, if a person tends to be a ‘hot reactor,’ getting easily angered, some form of psychotherapy, spiritual counseling, or meditation would help reduce the levels of anger that, if chronic, put one at greater risk for hypertension. Healthy exercise at least five or six days per week is also recommended for its stress-relieving and metabolism-enhancing effects. Because a hypertensive individual tends to be “uptight,” relaxation practices and movements that help the person to be grounded, that is, to be mindfully in touch with the supporting ground and to let go of excess muscular tension are recommended. Some forms of dancing, taiji, qigong, and yoga are very helpful. The last of these will be discussed in a separate section below.
Supportive Social Ties
In the section on the heart above, we have seen how the heart and entire cardiovascular system are central and exquisitely responsive to our social interactions. Research has shown direct effects of supportive social ties on heart rate and blood pressure regulation. Because most people find public speaking stressful, researchers have looked into how the presence or absence of social support affects a person asked to speak in public. In one experiment conducted by Kamarck and associates, “People without support had higher systolic and diastolic pressure both before the actual challenge as well as during the challenge. Thus, support availability protects against increased blood pressure response associated with stressful situations (Berkman & Glass, 2000, p. 154). In another study using the public speaking context,
Lepore et al. (1993) had participants perform a speech, while in one condition a confederate made comments designed to reflect emotional support. In contrast, the confederate in the low emotional support condition was reserved and inattentive. Results indicated that the social support speech condition was associated with lower SBP and DBP reactivity than the no support speech condition (Uchino, Cacciopo, & Kiecolt-Glaser, 1996, p. 511)
In a review of 28 studies, Uchino, Cacciopo, and Kiecolt-Glaser (1996) found that in 23 of them, “the results of the correlational studies are consistent with the notion that higher social support is associated with better cardiovascular regulation (e.g., lower blood pressure)” (p. 490). An apparent gender difference emerged from the studies regarding the kind of social support that helps regulate blood pressure: “social resources were a stronger predictor of blood pressure in men, whereas instrumental support was a stronger predictor of blood pressure in women” (Uchino, Cacciopo, & Kiecolt-Glaser, p. 491). A few studies compared the differential effects on blood pressure of the presence of a family member, a friend, or a stranger. Spitzer et al. found that “being around a family member was associated with lower ambulatory SBP and DBP compared with being around a friend or stranger” (Uchino, Cacciopo, & Kiecolt-Glaser, p. 505). For many people, siblings are among the closest and longest lasting of supportive ties. In view of this fact it is not surprising that, “individuals high in number of siblings and low in life stress were characterized by the lowest blood pressure” (Uchino, Cacciopo, & Kiecolt-Glaser, p. 505).
In one experiment, Gerin et al. contrived a conflict situation. They engaged participants in discussions either with or without social support. In both conditions, two confederates attacked the participant’s views. In the support condition, a third confederate defended the participant, whereas in the condition without any social support, the third confederate sat in silence. “Results of the study revealed that social support during the conflict discussion was uniformly associated with lower increases in heart rate, SBP and DBP” (Uchino, Cacciopo, & Kiecolt-Glaser, 1996, p. 510)
Achterberg (1998, p. 6) reports on a review in Science by James House et al. of over 60 studies that showed those who felt included in supportive social networks are at less risk for, among other things, blood pressure disorders and cardiovascular disease. On the other hand, the effects of a lack of supportive ties appear to be cumulative: “The laboratory studies suggest that the higher cardiovascular reactivity seen in situations involving low social support may translate to gradual elevations in tonic blood pressure across the lifespan” (Uchino, Cacciopo, & Kiecolt-Glaser, 1996, p. 510). As has been repeatedly demonstrated, isolation and lack of reliable social ties are highly stressful and harmful to cardiovascular health. Graphic representations of the heart’s electrical activity show that, “In response to a negative signal, the frequency realm of the heart drops from coherent to incoherent” (Pearce, 2002, p. 71), and such incoherent patterns can likely be observed in people who chronically lack supportive ties. Schore (2002) reports on studies that demonstrate that, “strategies of the right hemisphere are underutilized by coronary heart disease patients” (Schore, 2002, p. 228). Since the right hemisphere is strongly connected with the limbic brain, and since these are the primary regions of the brain involved in social-emotional functioning, the correlation noted by Schore is consonant with what we know about the effects of supportive ties on the health of the heart.
In closing this section about the beneficial effects of supportive social ties on cardiovascular health and blood pressure regulation, it is heartening to note that at any age and in virtually any condition, we respond positively to others who reach out to us in a heartfelt manner: “In a remarkable series of studies of people in coma by James Lynch, when a compassionate nurse or doctor stopped at the bedside and spoke to the patient or touched with a comforting hand, their electrocardiograms showed a slower rate” (Achterberg, 1998, p. 4).
Cultural Change
I believe that a more humane, cooperative, egalitarian, cooperative, and nonviolent cultural, social, and economic context could bring great benefits to cardiovascular health and contribute greatly to reducing the incidence of hypertension. As we have seen, hypertension indicates an overly activated stress response with the sympathetic nervous system hyperalert for flight or fight reactions. Many factors in US and global culture are producing highly stressful conditions that are contributing to high stress and potentially to hypertension. These factors include the following. The gap between rich and poor keeps widening to an egregious degree. More and more people are hard-pressed to provide for their families‘ basic needs. Cultural pressures are intense to measure “success” in life by material wealth. Unemployment rates are high, with six people in the US seeking work currently for each job opening. Social services are dwindling. Precious resources are squandered on exploitative wars in a permanent war economy that benefits only the super-rich. Violence is rife in the cities. People who are not “successful” in the narrow, materialistic sense of the term, are stigmatized as failures. Disadvantaged minorities are at higher risk for hypertension, and this has much to do with the history of racism, negative stereotypes, discrimination, and socioeconomic distress. As can be seen, if we wish to reduce hypertension as a society, it is inimical to this goal if the cultural values and social and economic structures do not change in a direction that allows for more people to eat healthy food, get good exercise, relax, feel good about themselves, and relate to one another in humane, supportive, sustained circles of families and friends.
Raja Yoga
Empirical evidence supports the benefits of yoga in the treatment of hypertension. In a review of 12 published, randomized and quasi-randomized research studies, yoga was considered one among a range of mind-body therapies, also including meditation and guided imagery (Medical News Today, 2007). Yoga was defined as comprising “a series of body positions and movements developed in order to help relax the body and calm the mind. It involves breath control, physical exercises and meditation.” The results of the literature review were highly promising, especially with respect to yoga as a mind-body intervention for hypertension.
Mind-Body Therapies (MBT) significantly reduced systolic blood pressure (SBP) by a mean 11.52 mm Hg and diastolic blood pressure (DBP) by 6.83 mm Hg. Of the three MBT analyzed, yoga therapies demonstrated results of the greatest magnitude, with mean SBP reductions of 19.07 mm Hg and DBP by 13.13 mm Hg. Significant results were seen in SBP reductions by yoga and meditation therapy, while only yoga therapies demonstrated significant reductions in DBP (Medical News Today).
This research review provides scientific support for the practice yoga as a healthy, natural way to reduce hypertension. The benefits of yoga practice were found to be “comparable to pharmacologic monotherapy in both effect size and temporality” (Medical News Today). Since allopathic medications all have deleterious side effects (Cowan, 2007), yoga practice is a safer, more beneficial way to reduce hypertension, and it can bring many other benefits as well. “Additionally, reductions in systolic and diastolic blood pressure to the degree found in yoga interventions were associated with reductions in vascular death rates as well as decreased overall cardiac risk” (Medical News Today). In other words, yoga can save lives. Parallel research findings apply for qi gong, tai chi, and some forms of meditation.
Concluding Remarks
As the foregoing exposition has shown, hypertension is an insidious, common, potentially life-threatening disorder that can be prevented and safely, successfully treated through a combination of good nutrition, supportive social ties, healthy lifestyle choices, and mind-body practices that reduce the effects of stress and promote mindful relaxation. Empirical research to date has found raja yoga to be the most effective mind-body practice for the purpose of reducing hypertension. Maintaining health and wellness is the responsibility of each one of us. At the same time, we are living with many cultural, social, and economic conditions that cause high stress, and it is also our responsibility to contribute to salutary, systemic transformations to whatever extent possible, beginning, but hopefully not ending, with ourselves.
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