The information provided here is not a replacement for a doctor. You shouldn't use it for the purpose of self-diagnosing or self-medicating but rather so you can have a more informed discussion with a professional TCM practitioner.
Hypertension factsheet
Possible causes and remedies:
Spleen and Stomach Qi Deficiency
Symptoms: Deafness Tinnitus Dizziness and seven other symptoms
Recommended formula: Bu Zhong Yi Qi Tang
Symptoms: Aversion to cold Spontaneous sweating Thirst for warm drinks and one other symptom
Recommended formula: Bu Zhong Yi Qi Tang
In Chinese Medicine, hypertension can be associated with twenty so-called "patterns of disharmony". Chinese Medicine sees the body as a system, not a sum of isolated parts. A "pattern" is when the system's harmony is disrupted. It is not equivalent to the Western concept of "disease", as a matter of fact here hypertension can be caused by twenty different patterns.
To understand whether someone's hypertension might be caused by a given pattern, one needs to look for signs and symptoms associated with the pattern beyond what one might typically experience from hypertension alone. For instance when hypertension is caused by the pattern Spleen and Stomach Qi Deficiency, patients also experience symptoms such as dizziness, unsteadiness, blurred vision and deafness. Similarly, patients with Spleen and Stomach Qi Deficiency typically exhibit weak (Ruo) pulses as well as a pale tongue.
We've listed below a description of the twenty patterns associated with hypertension so that you can start to get an understanding of the various possibilities according to Chinese Medicine.
Once identified, patterns are often treated using herbal formulas. Drinking herbal infusions is the most common remedy in Chinese Medicine, together with acupuncture. Here we detail below fifteen formulas that can help treat the various patterns associated with hypertension, depending on which pattern fits your profile.
The twenty "patterns of disharmony" associated with hypertension
The Spleen is a so-called "Zang" Organ. Learn more about the Spleen in Chinese Medicine
Spleen and Stomach Qi Deficiency
Pulse type(s): Weak (Ruo)
Tongue color: Pale
Recommended herbal formula: Bu Zhong Yi Qi Tang
Symptoms: Deafness Tinnitus Dizziness Weak voice Unsteadiness Loose stools Poor appetite Blurred vision Pale complexion Shortness of breath
Hypertension might be due to Spleen and Stomach Qi Deficiency if the condition is paired with typical pattern symptoms such as dizziness, unsteadiness, blurred vision and deafness. Similarly, patients with Spleen and Stomach Qi Deficiency typically exhibit weak (Ruo) pulses as well as a pale tongue.
Milkvetch Roots (Huang Qi) is the key herb for Bu Zhong Yi Qi Tang, a formula used for Qi Deficiency Fever
Qi Deficiency Fever
Pulse type(s): Empty (Xu)
Tongue color: Pale
Tongue shape: Swollen
Recommended herbal formula: Bu Zhong Yi Qi Tang
Symptoms: Aversion to cold Spontaneous sweating Thirst for warm drinks Intermittent fever that worsens upon exertion
Hypertension might be due to Qi Deficiency Fever if the condition is paired with typical pattern symptoms such as intermittent fever that worsens upon exertion, spontaneous sweating, aversion to cold and thirst for warm drinks. Similarly, patients with Qi Deficiency Fever typically exhibit empty (Xu) pulses as well as a pale tongue.
The Triple Burner is a so-called "Fu" Organ. Learn more about the Triple Burner in Chinese Medicine
Heat and Blood Stagnation in the Lower Burner
Pulse type(s): Choppy (Se), Full (Shi)
Recommended herbal formula: Tao He Cheng Qi Tang
Symptoms: Thirst Amenorrhea Night fever Irritability Dysmenorrhea Restlnessness Delirious speech Lower abdominal pain
Hypertension might be due to Heat and Blood Stagnation in the Lower Burner if the condition is paired with typical pattern symptoms such as lower abdominal pain, night fever, delirious speech and irritability. Similarly, patients with Heat and Blood Stagnation in the Lower Burner typically exhibit choppy (Se) or full (Shi) pulses.
Read more about Heat and Blood Stagnation in the Lower Burner here
Crow-Dipper Rhizomes (Ban Xia) is the key herb for Ban Xia Bai Zhu Tian Ma Tang, a formula used for Wind-Phlegm
Wind-Phlegm
Pulse type(s): Slippery (Hua), Wiry (Xian)
Tongue coating: Thick white coating
Recommended herbal formula: Ban Xia Bai Zhu Tian Ma Tang
Symptoms: Headaches Copious sputum Nausea or vomiting Dizziness or vertigo Stifling sensation in the chest
Hypertension might be due to Wind-Phlegm if the condition is paired with typical pattern symptoms such as dizziness or vertigo, headaches, stifling sensation in the chest and nausea or vomiting. Similarly, patients with Wind-Phlegm typically exhibit slippery (Hua) or wiry (Xian) pulses as well as a tongue with thick white coating.
The Bladder is a so-called "Fu" Organ. Learn more about the Bladder in Chinese Medicine
Qi Stagnation in Gallbladder and Stomach with Phlegm Heat
Pulse type(s): Slippery (Hua), Wiry (Xian)
Tongue coating: Yellow coating
Recommended herbal formula: Wen Dan Tang
Symptoms: Anxiety Palpitations Slight thirst Nausea or vomiting Dizziness or vertigo Bitter taste in the mouth Indeterminate gnawing hunger Focal distention of the chest Coughing of copious thick yellow sputum Dream disturbed sleep with strange or unusual dreams
Hypertension might be due to Qi Stagnation in Gallbladder and Stomach with Phlegm Heat if the condition is paired with typical pattern symptoms such as nausea or vomiting, dizziness or vertigo, dream disturbed sleep with strange or unusual dreams and palpitations. Similarly, patients with Qi Stagnation in Gallbladder and Stomach with Phlegm Heat typically exhibit slippery (Hua) or wiry (Xian) pulses as well as a tongue with yellow coating.
Read more about Qi Stagnation in Gallbladder and Stomach with Phlegm Heat here
The Bladder is a so-called "Fu" Organ. Learn more about the Bladder in Chinese Medicine
Heat in Gall Bladder
Pulse type(s): Rapid (Shu), Wiry (Xian)
Tongue coating: Thick coating, Yellow coating
Tongue color: Red
Recommended herbal formula: Hao Qin Qing Dan Tang
Symptoms: Thirst Nausea Epigastrium fullness Bitter taste in the mouth Stifling sensation in the chest Spitting up bitter or sour fluids Mild chills alternating with pronounced fever Distention and pain in the chest and hypochondria
Hypertension might be due to Heat in Gall Bladder if the condition is paired with typical pattern symptoms such as mild chills alternating with pronounced fever, bitter taste in the mouth, stifling sensation in the chest and spitting up bitter or sour fluids. Similarly, patients with Heat in Gall Bladder typically exhibit rapid (Shu) or wiry (Xian) pulses as well as a red tongue with thick coating, yellow coating.
Rhubarb (Da Huang) is the key herb for Da Cheng Qi Tang, a formula used for Heat in Yang brightness Organs
Heat in Yang brightness Organs
Pulse type(s): Full (Shi)
Tongue coating: Grey or black coating, Yellow coating
Recommended herbal formula: Da Cheng Qi Tang
Symptoms: Flatulence Focal distention Abdominal fullness Severe constipation Tense and firm abdomen Abdominal pain that increases upon pressure
Hypertension might be due to Heat in Yang brightness Organs if the condition is paired with typical pattern symptoms such as severe constipation, flatulence, focal distention and abdominal fullness. Similarly, patients with Heat in Yang brightness Organs typically exhibit full (Shi) pulses as well as a tongue with grey or black coating, yellow coating.
Rhubarb (Da Huang) is the key herb for Da Cheng Qi Tang, a formula used for Yang Excess
Yang Excess
Pulse type(s): Rapid (Shu), Full (Shi)
Tongue coating: Sticky coating, Yellow coating
Tongue color: Red
Recommended herbal formula: Da Cheng Qi Tang
Symptoms: Fever Thirst Red face Irritability Restlnessness Scanty dark urination Yellow vaginal discharge
Yang Excess is a Full Yang state and its symptoms are similar to those are caused by the Heat Pernicious invasion. Yang is associated with Heat, activity and Dryness and these are the general symptoms when patients have Excess Yang. However, they become more specific depending on the Organ involved. For instance, Excess Liver Yang can cause migraines, or Excess Heart Yang can result in manic behavior and extreme restlessness. When there is Excess Yang, the body is in a hyperfunctional state. Over time, the Body Fluids can be "burned off" by the presence of Excessive Yang, resulting in a condition of Yin Deficiency.
Excess Yang is most likely caused by the Heat Pernicious Influence, either External or Internal. It can also be caused by internal damage from the Seven Emotions, the Stagnation of Qi or Blood, over-exposure to hot climates or environments, indigestion, and the over consumption of hot-natured and fried greasy foods, coffee, alcohol and red meat.
The Spleen is a so-called "Zang" Organ. Learn more about the Spleen in Chinese Medicine
Spleen or Kidney Yang Deficiency
Pulse type(s): Deep (Chen), Fine (Xi)
Tongue color: Pale
Tongue shape: Tooth-marked, Swollen
Recommended herbal formula: Zhen Wu Tang
Symptoms: Edema Coughing Vomiting Dizziness Loose stools Palpitations Urinary difficulty Heavy sensation in the head Abdominal pain that worsens with cold Deep aching and heaviness in the extremities
Hypertension might be due to Spleen or Kidney Yang Deficiency if the condition is paired with typical pattern symptoms such as abdominal pain that worsens with cold, urinary difficulty, deep aching and heaviness in the extremities and dizziness. Similarly, patients with Spleen or Kidney Yang Deficiency typically exhibit deep (Chen) or fine (Xi) pulses as well as a pale tongue.
Prepared Aconite (Zhi Fu Zi) is the key herb for Zhen Wu Tang, a formula used for Exterior Cold invading the Interior
Exterior Cold invading the Interior
Pulse type(s): Deep (Chen), Fine (Xi)
Tongue coating: Thin white coating
Recommended herbal formula: Zhen Wu Tang
Symptoms: Dizziness Unsteadiness Generalized twitching Palpitations in the epigastrium Sweating that doesnt reduce fever
Hypertension might be due to Exterior Cold invading the Interior if the condition is paired with typical pattern symptoms such as sweating that doesnt reduce fever, palpitations in the epigastrium, dizziness and generalized twitching. Similarly, patients with Exterior Cold invading the Interior typically exhibit deep (Chen) or fine (Xi) pulses as well as a tongue with thin white coating.
The Spleen is a so-called "Zang" Organ. Learn more about the Spleen in Chinese Medicine
Spleen Yang Deficiency
Pulse type(s): Deep (Chen), Slow (Chi), Weak (Ruo)
Tongue color: Pale
Recommended herbal formulas: Zhen Wu Tang, Bu Zhong Yi Qi Tang, Yi Huang Tang
Symptoms: Edema Fatigue Cold limbs Weak Limbs Loose stools Poor appetite Feeling of cold Vagina discharge
Generally speaking, Spleen Yang Deficiency often develops from Spleen Qi Deficiency, but it is more extensive and severe, with additional Cold symptoms, such as a cold feeling and cold limbs. It is because Spleen Yang fails to warm the body and Organs. Because of that, the body metabolism get slower and some food are not digested properly and passes directly into the stools. Since the Spleen fails to perform the function of transforming and transporting fluids, the circulation of Body Fluids is disturbed, causing symptoms such as Oedema, vaginal discharge and Lung mucus.
The causes are similar to these of Spleen Qi Deficiency, along with surplus consumption of cold, raw foods and drinks and overexposure to cold damp environments and climates.
The Kidneys is a so-called "Zang" Organ. Learn more about the Kidneys in Chinese Medicine
Kidney and Liver Yin Deficiency
Pulse type(s): Rapid (Shu), Fine (Xi)
Tongue coating: Partial absence of coating
Tongue color: Red
Recommended herbal formula: Liu Wei Di Huang Wan
Symptoms: Vertigo Tinnitus Night sweats Lightheadedness Diminished hearing Chronic sore throat Spontaneous and nocturnal emissions Soreness and weakness in the lower back
Hypertension might be due to Kidney and Liver Yin Deficiency if the condition is paired with typical pattern symptoms such as soreness and weakness in the lower back, lightheadedness, vertigo and tinnitus. Similarly, patients with Kidney and Liver Yin Deficiency typically exhibit rapid (Shu) or fine (Xi) pulses as well as a red tongue with partial absence of coating.
The Kidneys is a so-called "Zang" Organ. Learn more about the Kidneys in Chinese Medicine
Kidney Yang Deficiency
Recommended herbal formula: Ba Wei Di Huang Wan
Symptoms: Asthma Dysuria Coughing Impotence Spermatorrhea Frequent urination Persistent diarrhea Prostatic hypertrophy Spasms of the lower abdomen Cold in the lower extremities Soreness and weakness in the lower back
Hypertension might be due to Kidney Yang Deficiency if the condition is paired with typical pattern symptoms such as soreness and weakness in the lower back, cold in the lower extremities, impotence and spermatorrhea.
The Heart is a so-called "Zang" Organ. Learn more about the Heart in Chinese Medicine
Disharmony between Heart and Kidneys caused by Kidney Yang Deficiency
Pulse type(s): Rapid (Shu), Fine (Xi)
Tongue coating: Partial absence of coating
Tongue color: Red
Recommended herbal formula: Jiao Tai Wan
Symptoms: Anxiety Insomnia Irritability Restlnessness Coolness of the lower limbs Severe and continuous palpitations
Hypertension might be due to Disharmony between Heart and Kidneys caused by Kidney Yang Deficiency if the condition is paired with typical pattern symptoms such as irritability, restlnessness, severe and continuous palpitations and coolness of the lower limbs. Similarly, patients with Disharmony between Heart and Kidneys caused by Kidney Yang Deficiency typically exhibit rapid (Shu) or fine (Xi) pulses as well as a red tongue with partial absence of coating.
Read more about Disharmony between Heart and Kidneys caused by Kidney Yang Deficiency here
The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine
Liver Wind agitating Internally due to Liver Yang Rising
Pulse type(s): Rapid (Shu), Wiry (Xian)
Tongue color: Red
Recommended herbal formula: Tian Ma Gou Teng Yin
Symptoms: Vertigo Tinnitus Insomnia Headaches Dizziness Blurred vision Dream disturbed sleep Spasms in the extremities Numbness in the extremities Twitching in the extremities Feeling of heat rushing to the head
Hypertension might be due to Liver Wind agitating Internally due to Liver Yang Rising if the condition is paired with typical pattern symptoms such as headaches, dizziness, vertigo and tinnitus. Similarly, patients with Liver Wind agitating Internally due to Liver Yang Rising typically exhibit rapid (Shu) or wiry (Xian) pulses as well as a red tongue.
Read more about Liver Wind agitating Internally due to Liver Yang Rising here
The Lungs is a so-called "Zang" Organ. Learn more about the Lungs in Chinese Medicine
Lung Yin Deficiency
Pulse type(s): Rapid (Shu), Empty (Xu), Floating (Fu)
Tongue coating: Complete absence of coating
Tongue color: Red
Recommended herbal formulas: Yang Yin Qing Fei Tang, Mai Men Dong Tang
Symptoms: Insomnia Dry cough Dry mouth Tiredness Weak voice Dry throat Malar flush Night sweats Hot palms and soles Thin body lacking strength
Exterior Heat and Dryness can invade the Lungs and exhausts the Body Fluids. If it is not dealt with for a long time, it leads to Lung Yin Deficiency. Other factors can cause this pattern such as the Deficiency of Kidneys or Stomach Yin as well as prolonged Lung Qi Deficiency due to excessive smoking or use of voice. Emotional stress such as sadness and grief may also deplete Lung Qi and Yin.
Empty Heat symptoms appear if the Lung Yin Deficiency condition is not treated for a while. Patients can feel malar flush, low-grade fever as well as Heat in the palms and chest, especially in the evenings.
The treatment principle is to tonify Lung Yin, nourish Body Fluids and clear Empty Heat if it is needed.
The Stomach is a so-called "Fu" Organ. Learn more about the Stomach in Chinese Medicine
Stomach Yin Deficiency
Pulse type(s): Empty (Xu), Floating (Fu)
Tongue coating: Partial absence of coating
Tongue color: Red
Recommended herbal formulas: Mai Men Dong Tang, Yi Wei Tang
Symptoms: Thirst Retching Dry mouth Hiccuping Dry throat Dry stools Constipation Poor appetite Slight thirst Bleeding gums Epigastic pain Epigastric pain Feeling of hunger Feeling of fullness Hot palms and soles Feeling of heat in the afternoon
The Stomach is responsible for receiving foods and drinks, ripening them and sending them to the Spleen for further digestion. Therefore, the Stomach is the origin of Body Fluids. It is also an Organ that likes Cold and Dampness which are both Yin characteristics. Stomach Yin Deficiency harms the Organ's functions and cause Dryness and Heat. As a result, symptoms such as thirst, dry stools, dry mouth and dry throat appear.
However, this is just Empty Heat due to lacking of Yin (and not the Excess of Yang), so the feeling of Heat often only happens in the afternoons or evenings. The patients experiences thirst or hunger but there is no desire to drink or eat, or they only drink in small sips. They also prefer warm liquids and their appetite is poor. Due to lack of Body Fluids, there is constipation with dry stools. Retching and hiccups may occur as Stomach's Qi downward function is impaired.
Unbalanced diet and bad eating habits are the major reasons for this pattern. The patients may often consume spicy and acrid foods, which deplete Stomach Fluids and Yin. Prolonged irregular eating habits also have similar negative impact, such as eating on the run, skipping meals, eating while working, having late meals or working right after eating. Finally chronic Stomach disease can also be a cause. In additional to above reasons, a high fever during an infectious disease or overconsumption of antibiotics can also lead to an acute Stomach Yin Deficiency.
The treatment principle is to nourish Stomach Yin and Body Fluids.
Poria-Cocos Mushrooms (Fu Ling) is the key herb for Ling Gui Zhu Gan Tang, a formula used for Phlegm-Fluids in the hypochondrium
Phlegm-Fluids in the hypochondrium
Pulse type(s): Slippery (Hua), Soggy (Ru), Wiry (Xian)
Tongue coating: Thick white coating
Tongue color: Pale
Tongue shape: Swollen
Recommended herbal formula: Ling Gui Zhu Gan Tang
Symptoms: Palpitations Dizziness or vertigo
Hypertension might be due to Phlegm-Fluids in the hypochondrium if the condition is paired with typical pattern symptoms such as palpitations and dizziness or vertigo. Similarly, patients with Phlegm-Fluids in the hypochondrium typically exhibit slippery (Hua), soggy (Ru) or wiry (Xian) pulses as well as a pale tongue with thick white coating.
The Pericardium is a so-called "Zang" Organ. Learn more about the Pericardium in Chinese Medicine
Pericardium Blood Stagnation
Pulse type(s): Knotted (Jie), Wiry (Xian)
Tongue color: Bluish-Purple
Recommended herbal formula: Xue Fu Zhu Yu Tang
Symptoms: Chest pain Purple lips Palpitations Purple nails Painful period Hypochondriac pain Shortness of breath Dark clots in menstrual blood Feeling of oppression of the chest
Hypertension might be due to Pericardium Blood Stagnation if the condition is paired with typical pattern symptoms such as chest pain, hypochondriac pain, palpitations and painful period. Similarly, patients with Pericardium Blood Stagnation typically exhibit knotted (Jie) or wiry (Xian) pulses as well as a bluish-purple tongue.
The Stomach is a so-called "Fu" Organ. Learn more about the Stomach in Chinese Medicine
Stomach Blood Stagnation
Pulse type(s): Wiry (Xian)
Tongue color: Bluish-Purple
Recommended herbal formula: Xue Fu Zhu Yu Tang
Symptoms: Nausea Vomiting Epigastric pain Vomiting of blood
Hypertension might be due to Stomach Blood Stagnation if the condition is paired with typical pattern symptoms such as epigastric pain, nausea, vomiting and vomiting of blood. Similarly, patients with Stomach Blood Stagnation typically exhibit wiry (Xian) pulses as well as a bluish-purple tongue.
The fifteen herbal formulas that might help with hypertension
Zhen Wu Tang
Source date: 220 AD
Number of ingredients: 5 herbs
Key actions: Warms and tonifies the Yang and Qi of the Spleen and Kidneys. Eliminates Dampness.
Why might Zhen Wu Tang help with hypertension?
Because it is a formula often recommended to help with the patterns Spleen or Kidney Yang Deficiency, Exterior Cold invading the Interior and Spleen Yang Deficiency which are sometimes associated with hypertension. If any of these patterns look like something you might suffer from, this formula might help (although please seek confirmation with a professional practitioner beforehand).
Bu Zhong Yi Qi Tang
Source date: 1247
Number of ingredients: 10 herbs
Key actions: Tonifies Qi of the Spleen and Stomach (Middle Burner). Raises the Yang. Detoxifies. Lifts what has sunken.
Why might Bu Zhong Yi Qi Tang help with hypertension?
Because it is a formula often recommended to help with the patterns Spleen and Stomach Qi Deficiency and Qi Deficiency Fever which are sometimes associated with hypertension. If any of these patterns look like something you might suffer from, this formula might help (although please seek confirmation with a professional practitioner beforehand).
Da Cheng Qi Tang
Source date: 220 AD
Number of ingredients: 4 herbs
Key actions: Purges Heat from the Stomach and Intestines. Relieves constipation.
Why might Da Cheng Qi Tang help with hypertension?
Because it is a formula often recommended to help with the patterns Heat in Yang brightness Organs and Yang Excess which are sometimes associated with hypertension. If any of these patterns look like something you might suffer from, this formula might help (although please seek confirmation with a professional practitioner beforehand).
Mai Men Dong Tang
Source date: 220 AD
Number of ingredients: 6 herbs
Key actions: Nourishes the Stomach. Generates Body Fluids. Directs Rebellious Qi downward.
Why might Mai Men Dong Tang help with hypertension?
Because it is a formula often recommended to help with the patterns Lung Yin Deficiency and Stomach Yin Deficiency which are sometimes associated with hypertension. If any of these patterns look like something you might suffer from, this formula might help (although please seek confirmation with a professional practitioner beforehand).
Xue Fu Zhu Yu Tang
Source date: 1830 AD
Number of ingredients: 11 herbs
Key actions: Invigorates the Blood. Dispels blood Stagnation. Spreads the Liver Qi. Unblocks the channels.
Why might Xue Fu Zhu Yu Tang help with hypertension?
Because it is a formula often recommended to help with the patterns Pericardium Blood Stagnation and Stomach Blood Stagnation which are sometimes associated with hypertension. If any of these patterns look like something you might suffer from, this formula might help (although please seek confirmation with a professional practitioner beforehand).
Symptoms related to hypertension
Dizziness Thirst Palpitations Tinnitus Poor appetite Loose stools Irritability Restlnessness Dizziness or vertigo Insomnia
