Hypertension in Unani Medicine: A Comprehensive Review of Ḍaghṭ Al Dam Qawī (Hypertension) and Its Therapeutic Approaches

Hypertension, a leading contributor to global mortality and morbidity, presents a significant public health challenge, particularly in low- and middle-income countries. While conventional medicine defines it by persistently elevated systolic and diastolic pressure, classical Unani texts correlate it with the concept of Imtila (congestion) and Sue-Mizaj Damvi (altered sanguineous temperament). Objective: To explore the etiopathogenesis, clinical manifestations, and management of hypertension (Ḍaghṭ al Dam Qawī) within the framework of Unani medicine, drawing parallels between traditional theories and contemporary biomedical understanding. Methods: This study conducted a critical review of classical Unani manuscripts alongside modern clinical literature. Comparative analysis was employed to align traditional etiological constructs like Muhtariq Sauda (Combusted Black Bile) and Salabat-e-Sharaayeen (Hardening of Arteries) with modern pathology of arteriosclerosis and vascular stiffness. Results: Hypertension in Unani medicine is primarily interpreted as an outcome of Imtila, resulting from poor lifestyle choices, improper digestion, and accumulation of morbid matter (fasid maddah). Management is stratified across four therapeutic modalities: Ilaj bil-Ghiza (dietotherapy) Ilaj-bit-Tadbeer (regimenal therapy) Ilaj-bil-Dawa (pharmacotherapy) Ilaj-bil-Yad (surgical methods) These encompass interventions such as Venesection (Fasd), Cupping (Hijamah), tailored diets, exercise (Riyazat), Massage (Dalak), and Steam Baths (Hammam), aligned with the principles of Asbab-E-Sitta Zarooriya (Six essential causes of health). Conclusion: Unani medicine offers a holistic and historically rooted approach to understanding and managing hypertension. Its conceptualization of vascular congestion and temperament imbalance complements modern views on blood pressure dysregulation. Thus, the review provides a deep understanding of the Unani Concept of the dreadful disease, Ḍaghṭ al Dam Qawī (Hypertension), and its effective management.