Low Blood Pressure

What is low blood pressure?

Blood pressure is the force exerted by circulating blood on the walls of blood vessels. It constitutes one of the critically important signs of life or vital signs which include heart beat, breathing, and temperature. Blood pressure is generated by the heart pumping blood into the arteries modified by the response of the arteries to the flow of blood.

An individual's blood pressure is expressed as systolic/diastolic blood pressure, for example, 120/80.The systolic blood pressure (the top number) represents the pressure in the arteries as the muscle of the heart contracts and pumps blood into them. The diastolic blood pressure (the bottom number) represents the pressure in the arteries as the muscle of the heart relaxes following its contraction. Blood pressure always is higher when the heart is pumping (squeezing) than when it is relaxing.

The range of systolic blood pressure for most healthy adults falls between 90 and 120 millimeters of mercury (mm Hg). Normal diastolic blood pressure ranges between 60 and 80 mm Hg. Current guidelines define normal blood pressure range as lower than 120/80. Blood pressures over 130/80 are considered high. High blood pressure increases the risk of developing:

• heart disease,
• kidney disease,
• hardening of the arteries (atherosclerosis or arteriosclerosis),
• eye damage, and
• stroke.

Low blood pressure (hypotension) is pressure so low it causes symptoms or signs due to the low flow of blood through the arteries and veins. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidney, the organs do not function normally and may be temporarily or permanently damaged.

Unlike high blood pressure, low blood pressure is defined primarily by signs and symptoms of low blood flow and not by a specific blood pressure number. Some individuals routinely may have blood pressures of 90/50 with no symptoms and therefore do not have low blood pressure. However, others who normally have higher blood pressures may develop symptoms of low blood pressure if their blood pressure drops to 100/60.

How is blood pressure generated?

During relaxation of the heart (diastole) the left ventricle of the heart fills with blood returning from the lungs. The left ventricle then contracts and pumps blood into the arteries (systole). The blood pressure in the arteries during contraction of the ventricle (systolic pressure) is higher because blood is being actively ejected into the arteries. It is lower during relaxation of the ventricle (diastolic pressure) when no blood is being ejected into the arteries. The pulse that we can feel when we place our fingers over an artery is caused by the contraction of the left ventricle and the ejection of blood.

Blood pressure is determined by two factors: 1) The amount of blood pumped by the left ventricle of the heart into the arteries, and 2) the resistance to the flow of blood caused by the walls of the arterioles (smaller arteries).

Generally, blood pressure tends to be higher if more blood is pumped into the arteries or if the arterioles are narrow and/or stiff. (Narrow and/or stiff arterioles, by resisting the flow of blood, increase blood pressure.) Arterioles may become narrower when the muscles surrounding them contract. Arterioles may become stiff and narrow when older patients develop atherosclerosis.

Blood pressure tends to be lower if less blood is being pumped into the arteries or if the arterioles are larger and more flexible and, therefore, have less resistance to the flow of blood.

How does the body maintain normal blood pressure?

The body has mechanisms to alter or maintain blood pressure and blood flow. There are sensors that sense blood pressure in the walls of the arteries and send signals to the heart, the arterioles, the veins, and the kidneys that cause them to make changes that lower or increase blood pressure. There are several ways in which blood pressure can be adjusted - by adjusting the amount of blood pumped by the heart into the arteries (cardiac output), the amount of blood contained in the veins, the arteriolar resistance, and the volume of blood.

• The heart can speed up and contract more frequently and it can eject more blood with each contraction. Both of these responses increase the flow of blood into the arteries and increase blood pressure.

• The veins can expand and narrow. When veins expand, more blood can be stored in the veins and less blood returns to the heart for pumping into the arteries. As a result, the heart pumps less blood, and blood pressure is lower. On the other hand, when veins narrow, less blood is stored in the veins, more blood returns to the heart for pumping into the arteries, and blood pressure is higher.

• The arterioles can expand and narrow. Expanded arterioles create less resistance to the flow of blood and decrease blood pressure, while narrowed arterioles create more resistance and raise blood pressure.

• The kidney can respond to changes in blood pressure by increasing or decreasing the amount of urine that is produced. Urine is primarily water that is removed from the blood. When the kidney makes more urine, the amount (volume) of blood that fills the arteries and veins decreases, and this lowers blood pressure. If the kidneys make less urine, the amount of blood that fills the arteries and veins increases and this increases blood pressure. Compared with the other mechanisms for adjusting blood pressure, changes in the production of urine affect blood pressure slowly over hours and days. (The other mechanisms are effective in seconds.)

For example, low blood volume due to bleeding (such as a bleeding ulcer in the stomach or from a severe laceration from an injury) can cause low blood pressure. The body quickly responds to the low blood volume and pressure by the following adjustments which all increase blood pressure:

• The heart rate increases and the forcefulness of the heart's contractions increase thus pumping more blood through the heart.

• Veins narrow to return more blood to the heart for pumping.

• Blood flow to the kidneys decreases to reduce the formation of urine and thereby increases the volume of blood in the arteries and veins.

• Arterioles narrow to increase resistance to blood flow

These adaptive responses will keep the blood pressure in the normal range unless blood loss becomes so severe that the responses are overwhelmed.

Is low blood pressure bad for your health?

People who have lower blood pressures have a lower risk of stroke, kidney disease, and heart disease. Athletes, people who exercise regularly, people who maintain ideal body weight, and non-smokers tend to have lower blood pressures. Therefore, low blood pressure is desirable as long as it is not low enough to cause symptoms and damage to the organs in the body.

What are low blood pressure signs and symptoms?

When blood pressure is not sufficient to deliver enough blood to the organs of the body, the organs do not work properly and can be temporarily or permanently damaged. For example, if insufficient blood flows to the brain, brain cells do not receive enough oxygen and nutrients, and a person can feel lightheaded, dizzy, or even faint.

Going from a sitting or lying position to a standing position often brings out symptoms of low blood pressure. This occurs because standing causes blood to "settle" in the veins of the lower body, and this can lower the blood pressure. If the blood pressure is already low, standing can make the low pressure worse, to the point of causing symptoms. The development of lightheadedness, dizziness, or fainting upon standing caused by low blood pressure is called orthostatic hypotension. Normal individuals are able to compensate rapidly for the low pressure created by standing with the responses discussed previously and do not develop orthostatic hypotension.

When there is insufficient blood pressure to deliver blood to the coronary arteries (the arteries that supply blood to the heart's muscle), a person may develop chest pain (a symptom of angina) or even a heart attack.

When insufficient blood is delivered to the kidneys, the kidneys fail to eliminate wastes from the body, for example, urea (BUN) and creatinine, and increases in their levels in the blood occur.

Shock is a life-threatening condition where persistently low blood pressure causes organs such as kidney(s), liver, heart, lung, and brain to fail rapidly.

What are the causes of low blood pressure?

Conditions that reduce the volume of blood, reduce cardiac output (the amount of blood pumped by the heart), and medications are frequent reasons for low blood pressure.

• Dehydration is common among patients with prolonged nausea, vomiting, and diarrhea. Large amounts of water are lost when vomiting and with diarrhea, especially if the person does not drink adequate amounts of fluid to replace the depleted water.

Other causes of dehydration include exercise, sweating, fever, and heat exhaustion, or heat stroke. Individuals with mild dehydration may experience only thirst and dry mouth. Moderate to severe dehydration may cause orthostatic hypotension (manifested by lightheadedness, dizziness, or fainting upon standing). Prolonged and severe dehydration can lead to shock, kidney failure, confusion, acidosis (too much acid in the blood), coma, and even death.

• Moderate or severe bleeding can quickly deplete an individual's body of blood, leading to low blood pressure or orthostatic hypotension. Bleeding can result from trauma, surgical complications, or from gastrointestinal abnormalities such as ulcers, tumors, or diverticulosis. Occasionally, the bleeding may be so severe and rapid (for example, bleeding from a ruptured aortic aneurysm) that it causes shock and death rapidly.

• Severe inflammation of organs inside the body such as acute pancreatitis can cause low blood pressure. In acute pancreatitis, fluid leaves the blood vessels to enter the inflamed tissues around the pancreas as well as the abdominal cavity, concentrating blood and reducing its volume.

Causes of low blood pressure due to heart disease

• Weakened heart muscle can cause the heart to fail and reduce the amount of blood it pumps. One common cause of weakened heart muscle is the death of a large portion of the heart's muscle due to a single, large heart attack or repeated smaller heart attacks. Other examples of conditions that can weaken the ability of the heart to pump blood include medications that are toxic to the heart, infections of the muscle of the heart by viruses (myocarditis), and diseases of the heart's valves such as aortic stenosis.

• Pericarditis is an inflammation of the pericardium (the sac surrounding the heart). Pericarditis can cause fluid to accumulate within the pericardium and compress the heart, restricting the ability of the heart to fill and pump blood.

• Pulmonary embolism is a condition in which a blood clot in a vein (deep vein thrombosis) breaks off and travels to the heart and eventually the lung. A large blood clot can block the flow of blood into the left ventricle from the lungs and severely diminish the blood returning to the heart for pumping. Pulmonary embolism is a life-threatening emergency.

• A slow heart rate (bradycardia) can decrease the amount of blood pumped by the heart. The resting heart rate for a healthy adult is between 60 and 100 beats/minute. Bradycardia (resting heart rates slower than 60 beats/minute) does not always cause low blood pressure. In fact, some highly trained athletes can have resting heart rates in the 40s and 50s (beats per minute) without any symptoms. (The slow heart rates are offset by more forceful contractions of the heart that pump more blood than in non-athletes.) But in many patients bradycardia can lead to low blood pressure, lightheadedness, dizziness, and even fainting.

Several common reasons for bradycardia include: 1) sick sinus syndrome, 2) heart block, and 3) drug toxicity. Many of these conditions occur in the elderly.

1.     Sick sinus syndrome: Sick sinus syndrome occurs when the diseased electrical system of the heart cannot generate signals fast enough to maintain a normal heart rate.

2.     Heart block: Heart block occurs when the specialized tissues that transmit electrical current in the heart are damaged by heart attacks, degeneration from atherosclerosis, and medications. Heart block prevents some or all of the electrical signals from reaching parts of the heart, and this prevents the heart from contracting as well as it otherwise would.

3.     Drug toxicity: Drugs such as digoxin (Lanoxin) or beta blockers for high blood pressure, can slow the transmission of electricity in the heart chemically and can cause bradycardia and hypotension (see section below "Medications that cause low blood pressure").

• An abnormally fast heart rate (tachycardia) also can cause low blood pressure. The most common example of tachycardia causing low blood pressure is atrial fibrillation. Atrial fibrillation is a disorder of the heart characterized by rapid and irregular electrical discharges from the muscle of the heart causing the ventricles to contract irregularly and (usually) rapidly. The rapidly contracting ventricles do not have enough time to fill maximally with blood before the each contraction, and the amount of blood that is pumped decreases in spite of the faster heart rate. Other abnormally rapid heart rhythms such as ventricular tachycardia also can produce low blood pressure, sometimes even life-threatening shock.

Medications that cause low blood pressure

• Medications such as calcium channel blockers, beta blockers, and digoxin (Lanoxin) can slow the rate at which the heart contracts. Some elderly people are extremely sensitive to these medications since they are more likely to have diseased hearts and electrical conduction tissues. In some individuals, the heart rate can become dangerously slow even with small doses of these medications.

• Medications used in treating high blood pressure (such as ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, and alpha-blockers) can excessively lower blood pressure and result in symptomatic low blood pressure especially among the elderly.

• Water pills (diuretics) such as hydrochlorothiazide furosemide (Lasix) can decrease blood volume by causing excessive urination.

• Medications used for treating depression, such as amitriptyline (Elavil), Parkinson's disease, such as levodopa-carbidopa (Sinemet), erectile dysfunction (impotence), such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) when used in combination with nitroglycerine, can cause low blood pressure.

• Alcohol and narcotics also can cause low blood pressure.

Other conditions that cause low blood pressure

• Vasovagal reaction is a common condition in which a healthy person temporarily develops low blood pressure, slow heart rate, and sometimes fainting. A vasovagal reaction typically is brought on by emotions of fear or pain such as having blood drawn, starting an intravenous infusion, or by gastrointestinal upset. Vasovagal reactions are caused by activity of the involuntary (autonomic) nervous system, especially the vagus nerve, which releases hormones that slow the heart and widen the blood vessels. The vagus nerve also controls digestive tract function and senses activity in the digestive system. Thus, some people can have a vasovagal reaction from straining at a bowel movement or vomiting.

• Postural (orthostatic) hypotension is a sudden drop in blood pressure when an individual stands up from a sitting, squatting, or supine (lying) position. When a person stands up, gravity causes blood to settle in the veins in the legs so that less blood returns to the heart for pumping, and, as a result, the blood pressure drops. The body normally responds automatically to the drop in blood pressure by increasing the rate at which the heart beats and by narrowing the veins to return more blood to the heart. In patients with postural hypotension, this compensating reflex fails to occur, resulting low blood pressure and its symptoms. Postural hypotension can occur in persons of all ages but is much more common among the elderly, especially in those on medications for high blood pressure and/or diuretics. Other causes of postural hypotension include dehydration, adrenal insufficiency (discussed later), prolonged bed rest, diabetes that has caused damage to the autonomic nerves, alcoholism with damage to the autonomic nerves, and certain rare neurological syndromes (for example, Shy-Drager syndrome) that damage the autonomic nerves.

• Another form of postural hypotension occurs typically in young healthy individuals. After prolonged standing, the individual's heart rate and blood pressure drop, causing dizziness, nausea, and often fainting. In these individuals, the autonomic nervous system wrongly responds to prolonged standing by directing the heart to slow down and the veins to dilate.

• Micturition syncope is a temporary drop in blood pressure and loss of consciousness brought about by urinating. This condition typically occurs in elderly patients and may be due to the release by the autonomic nerves of hormones that lower blood pressure.

• Adrenal insufficiency, for example, due to Addison's disease, can cause low blood pressure. Addison's disease is a disorder in which the adrenal glands (small glands next to the kidneys) are destroyed. The destroyed adrenal glands can no longer produce sufficient adrenal hormones (specifically cortisol) necessary to maintain normal bodily functions. Cortisol has many functions, one of which is to maintain blood pressure and the function of the heart. Addison's disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and, sometimes, darkening of the skin.

• Septicemia is a severe infection in which bacteria (or other infectious organisms such as fungi) enter the blood. The infection typically originates in the lungs (as pneumonia), bladder, or in the abdomen due to diverticulitis or gallstones. The bacteria then enter the blood where they release toxins and cause life-threatening and profound low blood pressure (septic shock), often with damage to several organs.

• Anaphylaxis (anaphylactic shock) is a potentially fatal allergic reaction to medications such as penicillin, intravenous iodine used in some X-ray studies, foods such as peanuts, or bee stings (insect stings). In addition to a severe drop in blood pressure, individuals may also experience hives as well as wheezing due to constriction of the airways, and a swollen throat which cause difficulty breathing. The shock is caused by enlargement of blood-containing blood vessels and escape of water from the blood into the tissues.

Medical Author:

John P. Cunha, DO, FACOEP

Heart Disease and Abnormal Heart Rhythm (Arrhythmia)

Introduction to Arrhythmia

An irregular heartbeat is an arrhythmia (also called dysrhythmia). Heart rates can also be irregular. A normal heart rate is 50 to 100 beats per minute. Arrhythmias and abnormal heart rates don't necessarily occur together. Arrhythmias can occur with a normal heart rate, or with heart rates that are slow (called bradyarrhythmias -- less than 50 beats per minute). Arrhythmias can also occur with rapid heart rates (called tachyarrhythmias -- faster than 100 beats per minute). In the United States, more than 850,000 people are hospitalized for an arrhythmia each year.

What causes an arrhythmia?

Arrhythmias may be caused by many different factors, including:

• Coronary artery disease.
• Electrolyte imbalances in your blood (such as sodium or potassium).
• Changes in your heart muscle.
• Injury from a heart attack.
• Healing process after heart surgery.
• Irregular heart rhythms can also occur in "normal, healthy" hearts.

What Are the Types of Arrhythmias?

The types of arrhythmias include:

• Premature atrial contractions. These are early extra beats that originate in the atria (upper chambers of the heart). They are harmless and do not require treatment.
• Premature ventricular contractions(PVCs). These are among the most common arrhythmias and occur in people with and without heart disease. This is the skipped heartbeat we all occasionally experience. In some people, it can be related to stress, too much caffeine or nicotine, or too much exercise. But sometimes, PVCs can be caused by heart disease or electrolyte imbalance. People who have a lot of PVCs, and/or symptoms associated with them, should be evaluated by a heart doctor. However, in most people, PVCs are usually harmless and rarely need treatment.
• Atrial fibrillation. Atrial fibrillation is a very common irregular heart rhythm that causes the atria, the upper chambers of the heart, to contract abnormally.
• Atrial flutter. This is an arrhythmia caused by one or more rapid circuits in the atrium. Atrial flutter is usually more organized and regular than atrial fibrillation. This arrhythmia occurs most often in people with heart disease and in the first week after heart surgery. It often converts to atrial fibrillation.
• Paroxysmal supraventricular tachycardia (PSVT). A rapid heart rate, usually with a regular rhythm, originating from above the ventricles. PSVT begins and ends suddenly. There are two main types: accessory path tachycardias and AV nodal reentrant tachycardias (see below).
• Accessory pathway tachycardias. A rapid heart rate due to an extra abnormal pathway or connection between the atria and the ventricles. The impulses travel through the extra pathways as well as through the usual route. This allows the impulses to travel around the heart very quickly, causing the heart to beat unusually fast.
• AV nodal reentrant tachycardia. A rapid heart rate due to more than one pathway through the AV node. It can cause heart palpitations, fainting, or heart failure. In many cases, it can be terminated using a simple maneuvers, such as breathing in and bearing down, and others performed by a trained medical professional. Some drugs can also stop this heart rhythm.
• Ventricular tachycardia (V-tach). A rapid heart rhythm originating from the lower chambers (or ventricles) of the heart. The rapid rate prevents the heart from filling adequately with blood; therefore, less blood is able to pump through the body. This can be a serious arrhythmia, especially in people with heart disease, and may be associated with more symptoms. A heart doctor should evaluate this arrhythmia.
• Ventricular fibrillation. An erratic, disorganized firing of impulses from the ventricles. The ventricles quiver and are unable to contract or pump blood to the body. This is a medical emergency that must be treated with cardiopulmonary resuscitation (CPR) and defibrillation as soon as possible.
• Long QT syndrome. The QT interval is the area on the electrocardiogram that represents the time it takes for the heart muscle to contract and then recover, or for the electrical impulse to fire impulses and then recharge. When the QT interval is longer than normal, it increases the risk for "torsade de pointes," a life-threatening form of ventricular tachycardia. Long QT syndrome is an inherited condition that can cause sudden death in young people. It can be treated with antiarrhythmic drugs, pacemaker, electrical cardioversion, defibrillation, implanted cardioverter/defibrillator, or ablation therapy.
• Bradyarrhythmias. These are slow heart rhythms, which may arise from disease in the heart's electrical conduction system. Examples include sinus node dysfunction and heart block.
• Sinus node dysfunction. A slow heart rhythm due to an abnormal SA (sinus) node. Significant sinus node dysfunction that causes symptoms is treated with a pacemaker.
• Heart block. A delay or complete block of the electrical impulse as it travels from the sinus node to the ventricles. The level of the block or delay may occur in the AV node or HIS-Purkinje system. The heart may beat irregularly and, often, more slowly. If serious, heart block is treated with a pacemaker.

What are the symptoms of arrhythmias?

An arrhythmia can be silent and not cause any symptoms. A doctor can detect an irregular heartbeat during a physical exam by taking your pulse or through an electrocardiogram (ECG).

When symptoms of an arrhythmia occur, they may include:

• Palpitations (a feeling of skipped heart beats, fluttering or "flip-flops," or feeling that your heart is "running away").
• Pounding in your chest.
• Dizziness or feeling light-headed.
• Fainting.
• Shortness of breath.
• Chest discomfort.
• Weakness or fatigue (feeling very tired).

How are arrhythmias diagnosed?

Tests used to diagnose an arrhythmia or determine its cause include:

• Electrocardiogram
• Holter monitor
• Event monitor
• Stress test
• Echocardiogram
• Cardiac catheterization
• Electrophysiology study (EPS)
• Head-up tilt table test

How are arrhythmias treated?

Treatment depends on the type and seriousness of your arrhythmia. Some people with arrhythmias require no treatment. For others, treatments can include medication, making lifestyle changes, and undergoing surgical procedures.

What Drugs Are Used to Treat Arrhythmias?

A variety of drugs are available to treat arrhythmias. These include:

• Antiarrhythmic drugs. These drugs control heart rate and include beta-blockers.
• Anticoagulant or antiplatelet therapy. These drugs reduce the risk of blood clots and stroke. These include warfarin (a "blood thinner") or aspirin. Another blood thinner called Pradaxa (dabigatran) was approved in 2010 to prevent stroke in people with atrial fibrillation.

Because everyone is different, it may take trials of several medications and doses to find the one that works best for you.

Duties of the Month of Muharram

Duties of the Month of Muharram- by Imam Ibn Rajab al-Hanbali (Allah have mercy on him)
1. It is the best of months for general voluntary fasts, after Ramadan.
2. It is especially recommended to fast the 10th of Muharram (known as the Day of `Ashura’), with a day before it or after it. [Ibn Abidin, Radd al-Muhtar, quoting Kasani’s al-Bada’i`]
3. It is also virtuous to give in charity on this day.
Extracts from Ibn Rajab’s Lata’if al-Ma`arif, regarding the month of Muharram:
The Virtues of Fasting in the Month of Muharram and Its First Ten Days
Muslim reported from Abu Hurayra (Allah be pleased with him), that the Prophet (Allah bless him and give him peace) said , “The best of fasts after the month of Ramadan are in the Month of Allah, which you call Muharram. And the best of prayer after the obligatory prayer is the night prayer.” [Muslim, 1163]
This refers to general voluntary fasts according to Imam Ibn Rajab (Allah have mercy on him): These are best in the month of Muharram, just as the best general voluntary prayer is night prayer.
The virtue and honor of this month can be attested to by the fact that the Prophet (Allah bless him and give him peace) called it, ‘the Month of Allah.’ (Shahr Allah) Such ascription is only made by Allah to the most special of His creation, such as the ascription of the Prophets Muhammad, Ibrahim, Ishaq, Ya`qub, and others to his slavehood (Allah’s peace and blessings be on them all), and His ascription of the House (Ka`ba) and the camel to himself.
Given that Allah ascribed fasting, between all spiritual works, to Himself [saying, “It is Mine,”] it was suitable that this month, which is also ascribed to Allah, be selected for this particular form of worship.
Fasting is a secret between the servant and his Lord. This is why Allah Mighty and Exalted says, [in the divine hadith (hadith qudsi)], “ Every action of the son of Adam is his, except for fasting. It is Mine, and it is I who reward it.” [Bukhari and Muslim, from Abu Hurayra]
The Prophet (Allah bless him and give him peace) also said, “The fasting person has two joys: one when he breaks his fast, and the other when he meets his Lord.”[Muslim]
Night Prayer
As for voluntary night prayer (qiyam al-layl), it is superior to voluntary prayer during the day because it is closer to secrecy, and nearer to sincerity (ikhlas).
Allah Most High said, “Lo! the vigil of the night is (a time) when impression is more keen and speech more certain.” [Qur’an, 73.9]
This is because the time of the night vigil (tahajjud) is the best of times for voluntary prayer, and the closest a servant gets to his Lord. It is a time when the doors of the skies are opened, supplications answered, and needs fulfilled.
Allah Most High has praised those who wake up at night in His remembrance, supplication, seeking forgiveness, and intimate entreating (munajat), saying, “Who forsake their beds to cry unto their Lord in fear and hope, and spend of that We have bestowed on them. No soul knows what is kept hid for them of joy, as a reward for what they used to do.”[Qur’an, 32.16-17]
And, “Or he who pays adoration in the watches of the night, prostrate and standing, bewaring of the Hereafter and hoping for the mercy of his Lord? Say: Are those who know equal with those who know not? But only those of understanding will pay heed.” [Qur’an, 39.9]
And He said to His Prophet (Allah bless him & give him peace), “And some part of the night awake for it, as voluntary worship for you. It may be that thy Lord will raise thee to a praised estate.” [Qur’an, 17.79]
It has been said that those who worship at night will enter Paradise without reckoning, and that standing in night prayer shortens the length of one’s Standing on the Day of Judgment.
This is why the Prophet (Allah bless him & give him peace) said, “Stick to night prayer, for it was the way of the righteous before you. Night prayer is a means of closeness to Allah Most High, of expiating for bad deeds, avoiding sins, and keeping away illness from one’s body.” [Tirmidhi (3543], Bayhaqi, and others; it is a sound (hasan) hadith]
Similarly, it has been related that fasting is a means for good health. The Prophet (Allah bless him & give him peace) is reported to have said, “Fast, and you shall have good health.” [Ahmad, from Abu Hurayra]
Lovers have no time more joyous than when they are alone in entreating their Beloved. This is the healing for their hearts, and the great thing that they could long for.
This is why Abu Sulayman al-Darani would say, “The people of the night find more joy than the people of distraction (lahw) in their distractions. Were it not for the night, I would not like to remain living.”
The Day of `Ashura’: The Tenth of Muharram
It is mentioned in Bukhari and Muslim from Ibn Abbas (Allah be pleased with him and his father) that he was asked about fasting the Day of `Ashura’ [10th of Muharram]. He said, “I did not see the Messenger of Allah (blessings and peace be upon him) fast a day while more avid to seek its virtue than this day,” meaning the Day of `Ashura’.” [Bukhari (2006), and Muslim (1132)].
The Day of `Ashura’ has great virtue, and tremendous sanctity (hurma). The virtue of fasting it was known among the Prophets (peace be upon them all). Both Prophet Nuh and Prophet Musa (peace be upon them both) fasted it.
The Prophet (Allah bless him & give him peace) used to fast this day even in Mecca, though he had not yet ordered others to do so, as mentioned in both Bukhari and Muslim. [Bukhari (2002), Muslim (1125)]
When he migrated to Medina, and found the People of the Book fasting this day and venerating it, he ordered the Muslims to fast it, and encouraged it so much that even the children would fast it.
It has been reported in both Bukhari and Muslim from Ibn Abbas (Allah be pleased with him), that, “When the Messenger of Allah (blessings and peace be upon him) reached Medina, he found the Jews fasting the Day of `Ashura’, so he asked them, ‘What is this day you are fasting?’ They said, ‘This is a tremendous day. Allah saved Musa and his people on this day and drowned Pharaoh and his people. Musa fasted it out of thanks, so we fast it too.’ The Messenger of Allah (blessings and peace be upon him) said, ‘And we are more deserving of Musa than you are.’ So he fasted this day, and ordered that it be fasted.” [Bukhari (2004) and Muslim (1130)]
At the end of his life, the Messenger of Allah (blessings and peace be upon him) made the determination not to fast this day alone, but with another day [f: either before or after it], in order to be different from the People of the Book.
It has been reported in the Sahih of Imam Muslim (Allah have mercy on him), also from Ibn Abbas (Allah be pleased with him) that, “When the Messenger of Allah (blessings and peace be upon him) fasted the Day of `Ashura’ and ordered his companions to fast it, they said, ‘O Messenger of Allah! This is a day that the Jews and Christians venerate.’ So the Messenger of Allah (blessings and peace be upon him) said, ‘When next year comes – if Allah wills – we will fast the Ninth [of Muharram with it].’ But the next year did not come before the Messenger of Allah (blessings and peace be upon him) passed away.” [Muslim (1134), Abu Dawud (2445)]
And it is reported in the Musnad of Imam Ahmad (Allah have mercy on him), from Ibn Abbas (Allah be pleased with him) that the Prophet (Allah bless him and give him peace) said, “Fast the Day of `Ashura’ and be different from the Jews by fasting a day before it or a day after it.” [Ahmad]
Giving in Charity on the Day of `Ashura’
It has been reported from Abd Allah ibn `Amr ibn al-`As (Allah be pleased with him), that “Whoever fasts `Ashura’ it is as if he has fasted the entire year. And whoever gives charity this day it is like the charity of an entire year.”
Mourning on the 10th of Muharram is an Innovation
As for the mourning and grieving of the Shiah on this day because of the martyrdom of Sayyiduna Husayn ibn Ali (Allah be pleased with him and his father), this is of the actions of those whose actions in this life are misguided while they think that they are doing well. Neither Allah Most High nor His Messenger (Allah bless him & give him peace) commanded us to mourn on the days of the tribulations of the Prophets, or their deaths, let alone anyone else.
The fuqaha have mentioned that it is an innovation to consider Muharram a month of mourning. It is not disliked to marry in this month. It is a highly reprehensible innovation to participate in the rituals of the Shiah in mourning the death of Husayn (Allah be pleased with him).
Some of the Virtues of the Day of `Ashura’
It is a day in which Allah forgave an entire people. Tirmidhi relates that the Prophet (Allah bless him and give him peace) said to a man, “If you want to fast a month after Ramadan, then fast Muharram, for it has a day in which Allah forgave an entire people, and He turns to others in repentance in.” [Tirmidhi (841)]

Blood: The Incomparable Liquid Of Life

LOOK at yourself in the mirror.  Can you feel the presence of a network of crimson red fluid pumping at high speed and pressure just 2 millimeters under the skin of your face?  Are you aware of a magnificent  network of veins, altogether thousands of kilometers in length, and a pumping heart capable of squirting blood meters high in to the air?

NO! There is no sign of this impressive movement in your reflection in the mirror.  Yet this activity continues ceaselessly while you get on with your heart pumps blood with great power and audible sound known as your heartbeat, and the blood flows at great speed, again with a sound known as your pulse.  The chief reason why you are unaware of all this is your delicate skin, created specially for you.  This gives you an attractive, ordered and calm appearance while concealing and protecting all this activity beneath.  This circulatory system is formed collectively by your blood, heart and net work of blood vessels, and functions without pause throughout your life.  The flowing of the blood, with all its countless features, is one of the matchless proofs of creation.

The blood acts both as a carrier and as a regulator within the body.  It flows constantly and has tasks that it will not fail to perform at every moment throughout that journey:

• The blood is responsible for nearly all the communication inside the body.
• Raw materials  necessary for the cells, and the therefore for the body to obtain energy, are transported in the blood.
• The blood adjusts the body’s temperature just like an air conditioning unit.
• Thanks to its circulation, our body temperature always remains the same.
• As the blood flows, the defensive antibodies and white cells in it are on constant duty.  They are always on guard against germs that might enter the body.
• The blood is also responsible for providing the body’s nutrition. Foodstuffs are distributed to every cell by means of the blood.
• The veins and arteries also act as a sewage system in which waste products and toxins are carried away.

The blood also contains a kind of repair unit, which immediately identifies any tears or damage occurring in the veins and repairs them.  But how does this mechanism that manages such different and necessary tasks, function?  What elements comprise it?  What makes all these elements compatible with the circulatory network?  Which molecules in the blood are responsible for which tasks?  How do they perform their duties and how do they move?  Where do they receive their instructions from and how are they organized?

All these are important questions, of course, whose answers shall be examined.  Those answers also lead to a very important truth, of interest to our entire lives:  Our bodies did not emerge haphazardly.  The bodies that we possess have been shaped down  to the finest detail.  The origin of this body cannot be coincidences as the Darwinists have claimed for more than 150 years.  Our origins lie in creation, in which every detail has been specially created, not in a so-called evolutionary process based on chance.

The Lord of that creation is Almighty Allah, Who has created not just human beings but all living things, the entire universe, and everything that exists.  The miracle  in the circulation of the blood is just one of the matchless examples of Allah’s creation.  The superior nature of His creation is revealed in the Quran, sent down to us as a guide:  “Don’t they see that Allah, Who created the heavens and Earth, has the power to create the like of them, and has appointed fixed  terms for them of which there is no doubt?  But the wrongdoers still spurn anything but disbelief” (17:99).

For a long time now, scientists have been trying to produce a substance resembling blood, but they have not been successful.  The most important reason for this is that the secret of the very special molecules carried in the blood, and the functions these perform, have not yet been fully unraveled. In fact, however, even if the properties of blood were to be fully understood, how to reproduce molecules possessing those features and making them fully functional would still represent a total impasse for scientists.

When we examine the individual elements that make up the blood, this statement will become clearer.  Every single molecule has been charged with and shaped for a special purpose.  To put it another way, the presence of a special creation in the bloodstream is manifest.  Rather than being simply a fluid, blood is actually a tissue like the bones and muscles in our bodies.

However, it is very different from these, because the cells that comprise bone or muscle tissues are tightly bound to one another.  Despite being a tissue, the cells in the blood move freely, independently of one another.  Red blood cells (erythrocytes), white blood cells (leukocytes) and thrombocytes float in the blood plasma.

The human body contains between 5 an d 6 liters (1.3 and 1.5 gallons) of blood, which represents between 7 and 8% of the average body weight.  Half of the blood consists of the fluid or “watery” part known as plasma.  The other half is made up of cells and molecules with various functions.  A drop of blood that leaks  from your finger because of a tiny cut contains some five million red blood cells, 10,000 white blood cells and 250,000 thrombocytes.  In addition, each member of this enormous community has very important duties.

Furthermore, these cells are constantly being renewed.  Every day, 260 to 400 billion new blood cells are produced in the body.  This truly astonishing production, which takes place at the bone marrow, the main center, depends on various dividing abilities of special cells known as stem cells.  The stem cell is charged with producing the blood cells needed in the body; and the production and work performed by this cell is literally amazing.

The determination of the stem cells in the bone marrow is quite astonishing.  Only one out of every 10,000 cells produced in the bone marrow has the properties of a stem cell—a ration that sometimes falls to as low as one in 100,000.  In appearance, a stem cell has no difference from the other cells.  Yet it is actually pretty special. It has highly sensitive and vital properties that enable us to survive.  This special cell determines the requirements inside the body and then, thanks to its unique dividing ability, sometimes forms red blood cells and sometimes white blood cells—the main elements of the immune system.

Allah has created the stem cell especially to be able to fulfill these important tasks. For example, the stem cell acts according to the various chemical and electrical signals it receives chemical and electrical signals it receives from its surroundings .  Thanks to the signals that they send to the stem cell, damaged cells report the need for cell production in the body.  The new cells produced by the stem cell set out for the site of the damage to replace the damaged cells. In this way, one single stem cell can produce all the different types of blood cells for weeks on end.  Red blood cells lost due to bleeding, or white blood cells that die in their battles against infection are renewed and replaced exactly in the right amounts, neither too many nor too few, and exactly at the right time.

Our 21st century biologist are still trying to decode the chemical language by which stem cells establish dialogue with other cells.  This process, performed many times at every moment by individual stem cells in the human body, still represents a puzzle for scientists.

KHASIAT COKLAT

Coklat adalah kaya dengan antioxidant seperti catechins an phenols. Ia membantu dalam pencegahan sakit jantung dan kanser. Kandungannya sama seperti dalam teh hijau, jus oren, bayam, bawang, jagung dan pisang.

Coklat hitam dikatakan mempunyai empat kali kadar catechins dan phenols berbanding teh. Untuk makluman, satu kajian menyatakan, minumlah teh tanpa susu untuk mendapat khasiat antioxidant teh.

Phenols dikatakan dapat melindungi daripada serangan sakit jantung. Antioxidant yang wujud bukan setakat melindungi sel-sel dan DNA daripada radikal bebas malah ia menghalang pembentukan bahan lemak yang boleh menyebabkan salur darah jantung tersumbat.

Coklat tidak mengemukkan. Tidak ada satu jenis makanan akan menyebabkan gemuk. Pengambilan berlebihan sesuatu jenis makanan meningkatkan kalori. Jika kalori ini tidak dibakar sebanyak ia diambil, ini yang menyebabkan kegemukan. Makanlah coklat dalam kadar yang sederhana, bukan sekadar coklat malah semua jenis makanan.

Satu kajian yang dijalankan di Universiti Pittsburgh mendapati coklat tidak menyebabkan migrain seperti yang disangkakan sebelum ini. Mereka yang sering mengalami migrain atau sakit kepala boleh memakannya tanpa perlu risau ia akan menyebabkan sakit kepala.

Malah coklat mengandungi bahan seperti ubat penenang, yang menjadi penahan sakit dan meningkat tahap rasa sihat. Coklat keluarkan endorphins yang membuat kita rasa gembira.

Makan seberapa banyak dan kerap, coklat bukanlah bahan ketagihan. Permakanannya boleh dihentikan bila-bila masa.

Makan coklat dikatakan boleh menguatkan sistem pertahanan badan. Ini boleh mengurangkan risiko jangkitan selsema dan flu.

Coklat bukanlah penyebabkan jerawat. Jerawat disebabkan oleh perubahan hormon dan genetik. Jangan streskan diri, makanlah coklat. Ia boleh tenangkan anda sewaktu stres.

Coklat mengandungi phenylethylamine dan tyramine, bahan kimia yang menyebabkan rasa sayang dan berahi. Coklat adalah salah satu makanan aphrodisiac. Phenylethylamine adalah kimia yang berkait dengan amphetamines. Ia meningkatkan aliran darah, kadar glukos dalam darah, jadikan kita lebih waspada atau sedar dan rasa puas. Coklat boleh dikatakan makanan untuk **** selain tiram.

Coklat berwarna hitam merupakan sumber tembaga (copper) dan dalam kadar sedikit adalah perlu untuk kesihatan metbolisma dan membantu menghalang penyakit Alzhemier's dan osteoporosis.

Bagi wanita yang menghadapi PMS, makan coklat dapat membekalkan magnesium yang diperlukan oleh badan. Datang bulan mengurangkan kadar magnesium dalam badan dan ini meningkatkan masalah kesakitan waktu haid (PMS).

Selain coklat, mengambil soya 40mg ke 80mg sehari boleh melegakan masalah yang timbul akibat datang haid kerana soya mengandungi phytoestrogens, struktur kimia yang hampir sama dengan estrogen. Mampu menolong mengurangkan ketegangan.

Bagi wanita, coklat menggalakkan pengeluaran kimia endorphins bagi otak wanita, yang menggalakkan rasa gembira dan mengurangkan stres.

Makan coklat adalah baik untuk kita, namun seperti mana-mana makanan janganlah ambil berlebihan