Brief Answer: Pre hypertension Detailed Answer: Dear Mr. XXXXXXX Thanks for reverting back with your follow up and following are the said clarifications 1. Since you were hypertensive earlier thus goal should be to have blood pressure less than 140/90 mm of Hg. 2. A new group called 'pre hypertension' with systolic BP of 120-139 mm of Hg and diastolic BP of 80-89 mm of Hg, needs lifestyle modifications to prevent cardiovascular disease. [since your readings suggests the same you should follow dietary regime and lifestyle management as stated earlier. PS. Physiologically blood pressure is usually lower in the morning and high in mid-afternoon. [ blood pressure can fluctuate 10 to 15 mm of mercury on the systolic value and 5 to 10 mm of mercury on the diastolic value due to this natural body rhythm], so your readings can be the effect of this natural rhythm or due to effect of medicines, so whatever may be the cause: go low go slow 3. Emotion [STRESS] is significant causative factor of VATA, since when one is upset or there is sense of grief/insecurity/fear, his/her VATA gets aggravated and resulting in Raktagat vaat [hypertension], but since stress is part and parcel of life make sure you are not deeply involved with it. Dr. Munish Sood Consultant & Physician Naimittika

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Brief Answer: Psycho-somatic treatment Detailed Answer: Dear Mr. XXXXXXX Thanks for reverting back with your concern(s) 1. Hridyamrit vati and arjunarishta are CARDIOTONIC [giving strength to the muscles of the heart and also boost the immune system], and is indicated in following conditions related with blood pressure: i. when due to excess VATA there is palpitation of the heart [present] ii. reduced sleep [present] iii. dry mouth, excess sweating iv. discomfort [mental] v. and because hypertension is one example of mind-body disease thus psychosomatic treatment is essential thus medhavati/ ashwagandha arishta is essential for that [which you are already taking] 2. Tribulus terrestris (gokshura) is a natural herb used for treating many diseases including high blood pressure. It has shown to be diuretic [water pill]. [talk with your health care provider for the same] 3. mix 4 spoons of onion juice in 2 spoons sugar and 2 spoons white butter. Eat for 1 month 4. add 1/2 spoon roasted turmeric powder to 1 coconut water, also add 1 spoon ghee and drink it daily for 1 month [heart ache due to blood pressure reduces] 5. add 1 spoon smashed fenugreek seeds and boil in 4 cups water, till 1 cup remains. filter it and add 4 spoons honey and drink daily for 1 month Dr. Munish Naimittika

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Brief Answer: Consultation Detailed Answer: Dear Mr. XXXXXXX Thanks for reverting back with your concern, and following points are worth mentioning: 1. since there is variation in readings of blood pressure and so you have to go for serial check up of blood pressure [10:00 AM in morning and 6:00 PM in evening] for 10 days continuously and thereby getting baseline measurements to decide whether blood pressure remains constant throughout the day or there is fluctuation from the normal and then your Physician will decide accordingly. PS. as stated earlier variation could be normal or medicine is still required for further work up. 2. since there are pressure symptoms which you are experiencing, thus make sure you do continue with the medicine, i.e. if you have taken them continuously for 4-6 months, shift tablets [vati] on alternate basis for 4-6 months. PS. since problem of hypertension is a psychosomatic problem [as stated earlier], thus ashwagandha will take care of mind and arjunarishta will take care of heart, take them regularly and not on alternate basis. Dr. Munish Naimittika

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