Comparative Study of Ayurvedic and Conventional Hypertension Management

Abstract

Hypertension is the single most prevalent modifiable cardiovascular risk factor in adult European populations, and while conventional pharmacotherapy is effective for most patients, a meaningful share either cannot tolerate standard agents at effective doses or remain inadequately controlled on monotherapy. Ayurvedic medicine has engaged with hypertension-like clinical pictures for centuries under the classical categories of Rakta-gata-vata and Dhamani-pratichaya, with a repertoire that notably includes Sarpagandha (Rauwolfia serpentina), the historical source of reserpine. This was a 24-week, multicentre, randomised, open-label, controlled comparative effectiveness trial in 280 adults with grade 1-2 essential hypertension (office SBP 140-169 mmHg and/or DBP 90-109 mmHg) at four European integrative-medicine centres. Participants were randomised 1:1:1:1 to Arm A (conventional ACE inhibitor or ARB monotherapy), Arm B (Sarpagandha-based Ayurvedic monotherapy with lifestyle support), Arm C (Mukta Vati classical polyherbal with lifestyle support), or Arm D (integrated protocol combining conventional antihypertensive therapy with Ayurvedic polyherbal adjuncts, localised Panchakarma and structured yoga therapy). Primary outcome was change in office systolic blood pressure at 24 weeks. Secondary outcomes included 24-hour ambulatory blood pressure, metabolic and lipid markers, medication dose adjustments, quality of life, and adverse events. Office SBP reductions were -14.8 mmHg (Arm A), -11.2 mmHg (Arm B), -13.6 mmHg (Arm C), and -18.4 mmHg (Arm D). The composite Hypertension Clinical Effectiveness Index (HCEI) placed Arm D at 0.908, Arm A at 0.824, Arm C at 0.782, and Arm B at 0.712. Adverse events were mild and comparable, with no serious AEs attributed to study interventions.