Upashayatmaka effect of raktamokshana (siravyadha) in shonitadushti / essential hypertension: A clinical study

Background

Essential hypertension affects an estimated 188.3 million adults in India and is a leading non-communicable disease with significant cardiovascular morbidity. In Ayurveda, its clinical manifestations — Shiroruk, Klama, Bhrama, Tamodarshana, Krodhaprachurata, Akshiraga and Atidaurbalya — correspond closely to Shonitadushti, a Vata–Pitta pradhana Tridoshaja vikara with Rakta as the primary Dushya. Conventional pharmacotherapy carries well-known limitations, including side effects, polypharmacy, resistant hypertension and the need for lifelong medication. Acharya Charaka enumerates Raktamokshana as a principal line of treatment in Shonitadushti, warranting clinical evaluation of its antihypertensive efficacy. Aim and Hypothesis: To evaluate the Upashayatmaka (therapeutic-relief) effect of Siravyadha (therapeutic venesection) in patients presenting with Shonitadushti / Grade 1 essential hypertension. H₀: Raktamokshana has no statistically significant Upashayatmaka effect on blood pressure. H₁: Raktamokshana has a statistically significant Upashayatmaka effect on blood pressure.