December 1, 2023 8:58 AM

Link Between High Blood Pressure And Stroke

A stroke occurs when a blood vessel in the brain is narrowed or blocked by a clot (ischemic stroke) or bursts (hemorrhagic stroke). A majority of strokes are caused by narrowed or clogged blood vessels in the brain that cut off the blood flow to brain cells, known as ischemic stroke. On the other hand, some strokes occur when a blood vessel ruptures in or near the brain, known as a hemorrhagic stroke. Hypertension has been reported in up to 60 % of patients with stroke and is the most important stroke risk factor. 

In this regard, Dr. Santhosh N S, who is a Consultant – Neurology, at Manipal Hospital, Whitefield, Bangalore said, “Hypertension or high blood pressure is the highest modifiable risk factor for stroke. The recommended universal blood pressure goal is 130/80 mm Hg, according to the ACC/AHA recommendations. A BP of more than 180/120 mm Hg causes hypertensive crisis and requires immediate medical attention.”

“High blood pressure damages the inner lining or the walls of our arteries. They develop plaque deposits in the blood vessel and cause narrowing of blood vessels. High blood pressure also leads to rupture of the blood vessel in or near the brain (hemorrhagic stroke). In case of a clogged artery or a burst vessel, brain cells start to die,” he added.

The Link Between Hypertension And Stroke:

Dr Arun B. Shah, who is the Director of Neurosciences, at Sir HN Reliance Foundation Hospital said, “Long standing high blood pressure causes changes of arteriolosclerosis in the arterial wall which leads to risk of ischemic stroke as well as brain haemorrhage as the arterial wall becomes weak and ruptures suddenly. In people with previous ischemic stroke or TIA, we suggest aiming for a blood pressure target of <130/80 mmHg to reduce the risk of recurrent stroke.”

Dr. Amit Kulkarni, who is a Senior Consultant & Lead – Neurology & Stroke, at SS SPARSH Hospital, Mysore Road, Bengaluru said, “Stroke is the second most important cause of mortality worldwide and the third most common cause of disability. In India the prevalence of hypertension in urban areas is 33.8% and the rural 27.6% with an overall prevalence of 29.8%. Proper control of BP is only 11% in the rural population and 20% in the urban population. Hence regular screening for BP and early treatment significantly reduces the incidence of stroke.”

“Up to 90% of all 1st strokes can be prevented with a risk factor modification. The other risk factors include diabetes mellitus, dyslipidemia, and obstructive sleep apnea. Hypertension can cause both ischemic strokes (due to damage to the vessel wall making it weaker) leading to an increased tendency for clot formation and hence blockage of blood vessels. It can also lead to rupture of blood vessels and leakage of blood in the brain,” he added. 

Additionally, he said, “As hypertension is largely asymptomatic, routine screening is necessary to identify patients with elevated BP. Prompt initiation of treatment cannot only effectively prevent both types of stroke, but it can also prevent many kidney, cardiovascular, and other end-organ complications. Control of blood sugar and cholesterol levels is equally important.”

Impact of Health Behaviours On Blood Pressure

Dr Arun B. Shah said the following:

  • Diet and weight control: 6 mm systolic BP
  • Reduce salt intake: 5 mm 
  • Reduce alcohol intake: 3 mm
  • DASH Diet: 11 mm
  • Physical activity: 3 mm
  • Relaxation therapies: 3
  • Multiple interventions: 5 
  • Hypertension, defined as >130/80 mm/Hg is the most important modifiable risk factor to reduce the risk of stroke
  • 30%-40% reduction of stroke with blood pressure management.
  • Risk reduction is greater with larger reductions in BP.
  • From available data, the use of diuretics and ACEI are an important treatment option.
  • Individualization of treatment is important depending on the overall clinical picture.
  • Control of HTN the most modifiable risk factor to prevent stroke.

How To Control Elevated Blood Pressure:

Proper blood pressure (BP) management is a cornerstone of stroke prevention and acute treatment. BP lowering also helps prevent cognitive decline and dementia. These pointers suggested by Dr. Santhosh N S will help you control elevated blood pressure:

  • Follow dietary approaches to stop hypertension (DASH). A typical DASH diet recommends:
  • Reduced salt intake
  • Eating a healthy diet that is high in fruits, vegetables, and whole grains, low-fat dairy products
  • Avoiding or limiting foods rich in saturated fats and trans-fats that cause cholesterol
  • Including foods rich in potassium
  • Avoiding processed food rich in salt
  • Exercise – Be physically active. Try to get in at least 150 minutes a week of moderate-to-intense exercise. Moderate exercise such as brisk walking for 30 minutes most days of the week can lower blood pressure
  • If you are overweight, try to lose weight and maintain a healthy BMI
  • Limit alcohol intake
  • Quit smoking. Avoid second-hand smoke
  • Monitoring your blood pressure at home
  • Regular medicines as prescribed to control your blood pressure
  • Frequent blood pressure monitoring and management of high blood pressure with pharmaceutical and lifestyle changes

[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]

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