Peripheral Vascular Resistance in Hypertension: An Ayurvedic Interpretation through Sthaulya

Abstract

Ayurveda, with its holistic understanding of physiology and pathology, offers valuable insights into the etiopathogenesis of hypertension through the concepts of Dosha, Dhatu, and Srotas. Ayurveda recognises Sthaulaya (obesity) as a Santarpanjanya vyadhi that lead to systemic Srotorodha (obstruction in body channels) contributing to circulatory disturbances. Objective: The present review aims to explore the role of obesity (Sthaulya) in the pathogenesis of increased peripheral vascular resistance in hypertension from an Ayurvedic perspective and to correlate these classical concepts with contemporary biomedical understanding. Materials and Methods: A comprehensive review of classical Ayurvedic texts, including Charaka Samhita, Sushruta Samhita, was undertaken. Relevant contemporary medical literature, published research articles, and recent scientific updates from standard biomedical databases were also analyzed to elucidate the etiological factors and pathophysiological mechanisms of hypertension. Results: Obesity (Sthaulya), characterized by Medo Dhatu Vriddhi and Medo-Dhatvagni Dushti (disturbed fat metabolism), causes structural and functional alterations in blood vessels, leading to increased peripheral vascular resistance. Also, it plays a key role in vascular remodelling of the Sira (vessel), responsible for body circulatory mechanism. Conclusion: Hypertension can be comprehensively understood as a multifactorial disorder involving the interplay of Vata, Pitta, and Kapha through disturbances in Dosha, Dhatu, and Srotas. Obesity act as key modifiable etiological factors. Integrating Ayurvedic principles with modern scientific knowledge may provide a broader conceptual framework for understanding hypertension and may support the development of holistic preventive and therapeutic strategies.