At least one in three adults has high blood pressure and strokes are the 5th leading cause of death in the United States.
In May we raise awareness of both these conditions during American Stroke Monthand National High Blood Pressure Education Month.
Every 40 seconds, someone in the United States suffers a stroke. And high blood pressure puts one at risk of a stroke, as well as heart disease.
Here are your questions answered.
What do the blood pressure numbers mean?
The top number, or systolic pressure, is the pressure the heart exudes during a beat or pumping of the blood.
Diastolic pressure is the pressure in your arteries between beats while the heart is “filling.”
Both numbers are equally important as elevation of either can increase one’s risk of cardiovascular disease.
What blood pressure level is considered “normal” or “abnormal?”
High blood pressure has now been redefined as being greater than 130/80 mmHg, down from 140/90 mmHg. Last year it was guestimated that 42% of Americans would soon be considered “hypertensive.”
What can long-term high blood pressure cause?
Chronic high blood pressure can be dangerous. It may cause:
- Heart attacks
- Heart failure
- Kidney disease
- Eye damage – vision loss
- Erectile dysfunction…to name a few.
How do we treat high blood pressure?
The stages of blood pressure are defined in the chart above. At the elevated or early stages of high blood pressure the following lifestyle changes will be recommended:
- Weight loss
- Low salt diet
- Low fat diet
- Good sleep habits
- Regular exercise
- Avoiding tobacco products
- Limiting alcohol consumption
As a family physician I would also screen for diabetes, high cholesterol, low thyroid, kidney disease and sleep apnea.
If blood pressure cannot be controlled and continues to rise, medications may be prescribed to decrease blood volume, or lower the heart rate, or relax the blood vessels.
What is a stroke?
A stroke occurs when an area of the brain does not get the proper oxygen and blood flow it needs. There are two major types of stroke: ischemic and hemorrhagic.
Ischemic strokes are more common than the latter and occur when a clot prevents blood flow to part of the brain. 80% of all strokes fall under ischemic. It is a likened to a heart attack, except the brain tissue is being deprived of blood and nutrients. Plaques commonly arise from arteriosclerosis that break off travel to the smaller vessels of the brain.
Hemorrhagic strokes are less common and occur when there is a bleed of one of the brain vessels. The bleed prevents blood flow into the brain since it is seeping outside the brain tissue, causing damage to nearby cells. The bleeds could occur from high blood pressure or aneurysms that rupture.
What are the signs of a stroke?
Since a clot or bleed usually affect one area of the brain, we see symptoms on one side of the body, many times its contralateral (opposite) side. We can also see central effects. The symptoms of stroke include the following:
- Weakness of one side of the body
- Loss of balance
- Numbness on one side of the body
- Slurred speech
- Vision issues
- Facial droop
How are strokes treated?
If the stroke was caused by a clot (ischemic) immediate treatment includes dissolving/removing the clot. Aspirin is used initially and if within the proper time frame, tissue plasminogen activator (TPA). These clots can also be surgically removed and arteries widened to bring blood flow to the brain.
With a hemorrhagic stroke, we need to stop the bleed and improve flow to the brain. Controlling the bleed, bypassing the vessel, “clogging” the aneurysm with techniques such as “coiling” (endovascular embolization) are sometimes utilized.
Time is of the essence, so it's crucial to identify the warning signs and call 911 immediately. The American Stroke Association uses the acronym “FAST” (Facial drooping, Arm weakness, Speech difficulty, and Time to call 911). The sooner a stroke victim receives medical attention the better the prognosis.
COURTESY OF THE AMERICAN STROKE ASSOCIATION
What are the risk factors for stroke?
The following put us at risk of having a stroke.
- High blood pressure
- Family history of stroke
- Cardiovascular disease (artery clogging, such as the heart and carotid arteries)
- Abnormal heart rhythms, such as atrial fibrillation
- Clotting disorder
- Sleep apnea
- Being older (greater than 55)
- African-Americans appear to be more at risk than Caucasians and Hispanics
- Men seem to be more affected than women
How do we prevent strokes?
Avoid the following:
- Excessive drinking
- Drug use
- Tobacco products
- Control blood pressure, sugar and cholesterol
- Get evaluated by a medical provider if at risk for heart disease or stroke.