Table 6 Complementary and alternative approaches to hypertension in Malaysia

Traditional shamanistic Malay healers (bomohs) view illness as produced either by physical factors, such as temperature, foods, small particles (“kuman”), or wind (“angin”), which may either act directly or under the influence of spirits, and by the spirits themselves, which may reside within individuals or may have rendered individuals or animals with whom they have contact toxic (“bias”) [57] . Individual bomohs are associated with particular conditions, causes and remedies, which can include incantations, trances, herbal remedies and many other modalities [58]. Other traditional Malay practitioners use herbal remedies, some of which are now manufactured commercially by producers adhering to principles of Good Manufacturing Practice. Yet others use physical therapies, such as massage, often accompanied by prayers.

Traditional Chinese Medicine is based on three concepts. These are vital forces, flowing through 12 channels in the body, Yin-Yang, where phenomena such as heat and cold are dependent but in opposition to one another, and Wu-Hsing, in which 5 elements are associated with body organs, such as fire and the heart. It views hypertension as being due to excessive blood in the body, with dizziness and headache caused by the blood rising to the head. This gives rise to treatment by bloodletting through small cuts at the back of the scalp. The excessive blood is attributed to excess body heat. This can be treated by avoidance of certain “hot” foods, such as red meat and durian, and consumption of “cold” ones, such as starfruit. It may also be treated by exercise regimes [59] or herbs [60].

Ayurvedic medicine recognises three forces, or “dasha”, each with characteristics derived from space, air, fire, water and earth. These are Vata, Pitta, and Kapha. Hypertension is due to a derangement of Vata and, in some cases, Pitta. Treatment is by herbs, including Rauwolfia, the source of the early anti-hypertensive reserpine, and others [61], as well as yoga and exercises.