Understanding Blood Pressure's Link To Strokes

High blood pressure, or hypertension, is the leading cause of strokes in the U.S. and is the biggest single risk factor for stroke worldwide. Blood pressure readings above 180/120 mmHg are considered stroke-level, dangerously high, and require immediate medical attention. High blood pressure damages arteries throughout the body, creating conditions that can make arteries burst or clog easily. Weakened or blocked arteries in the brain create a much higher risk for stroke. Strokes can happen in two main ways: something blocks the flow of blood, or something causes bleeding in the brain.

High blood pressure is the biggest single risk factor for stroke

High blood pressure, or hypertension, is when blood flows with too much force, putting more pressure on the arteries. This excess pressure stretches the arteries beyond their healthy limit and can cause small tears. The body then repairs these tears with scar tissue, which traps substances that form plaque and can lead to blockages, blood clots, and hardened, weakened arteries.

Over time, high blood pressure causes damage to the arteries, leading to blockages and blood clots that limit blood supply to vital organs. Without oxygen and nutrients from blood, the tissue in these organs dies. This is why high blood pressure can lead to stroke, as well as heart attack, kidney failure, and heart failure.

High blood pressure can lead to stroke in different ways. It can cause blood clots in the brain and damage the tiny blood vessels deep inside the brain. It can also make a stroke due to bleeding in the brain more likely.

There are two main types of stroke:

• Ischaemic stroke: This is when a blood vessel to the brain is blocked by a clot. High blood pressure damages blood vessels by making them narrower and stiffer, causing a build-up of fatty material (atherosclerosis). Clots can form on this fatty material, and if a clot travels to the brain, it causes an ischaemic stroke or transient ischaemic attack (TIA or mini-stroke).
• Haemorrhagic stroke: This is when a blood vessel in or near the brain bursts. High blood pressure can damage blood vessels inside the brain, causing bleeding in the brain.

Managing high blood pressure is critical to reducing the risk of stroke. This can be done through lifestyle changes such as eating a healthy diet, engaging in regular physical activity, maintaining a healthy weight, avoiding tobacco smoke, and limiting alcohol consumption. It is also important to take any prescribed medication and to monitor blood pressure regularly.

High blood pressure can cause blood clots in the brain

High blood pressure, or hypertension, is the biggest single risk factor for strokes, playing a part in about half of all cases. It can lead to blood clots in the brain and can damage the tiny blood vessels inside the brain.

In a healthy individual, arteries are strong and flexible with a smooth inner lining that allows blood to flow freely throughout the body. When an individual suffers from high blood pressure, the blood travels throughout the body at a higher speed and pressure than normal. This can cause damage to the walls and lining of the arteries. Once the arteries are damaged, there is a high risk that blood clots will form.

Blood clots can develop in damaged arteries because the lining becomes uneven. When fats, which come from the food we eat, enter the bloodstream, they can catch onto this uneven surface and accumulate, narrowing the arteries. Over time, the narrowing of arteries prevents or limits blood flow throughout the body, which can eventually lead to blood clots.

Certain signs of blood clots, like blood pressure changes, could signify something serious. If you or someone you know is experiencing problems speaking or understanding speech, an intense headache, paralysis, or dizziness, seek medical attention immediately as these may be signs of a blood clot in the brain that could be causing a stroke.

High blood pressure after an acute ischemic stroke is also associated with poor clinical outcomes. A study found that higher post-stroke blood pressure levels were significantly associated with a lower probability of good neurological recovery and elevated risks of neurological deterioration and poor functional outcomes.

Therefore, it is important to monitor and manage high blood pressure to reduce the risk of strokes and other serious health conditions.

High blood pressure can cause bleeding in or around the brain

High blood pressure, or hypertension, is a common condition that affects the body's arteries. It is caused by the tightening or stiffness of very small arteries called arterioles, which results in the heart having to work harder to pump blood. This can lead to a stroke in different ways, including blood clots in the brain and damage to the tiny blood vessels deep inside the brain.

One type of stroke caused by high blood pressure is a haemorrhagic stroke. This occurs when high blood pressure damages blood vessels inside the brain, causing bleeding in or around the brain. Haemorrhagic strokes are a medical emergency and require urgent medical attention.

During an acute ischemic stroke, blood pressure often rises due to various factors such as psychological stress, pain, elevated intracranial pressure, urinary retention, and hypoxemia. High blood pressure after an acute ischemic stroke is associated with poor clinical outcomes and can lead to neurological deterioration and poor functional outcomes.

It is important to monitor and control high blood pressure to reduce the risk of stroke and other serious health problems such as heart attack, aneurysm, heart failure, kidney problems, and eye problems. This can be done through healthy lifestyle habits, such as not smoking, exercising, and eating well, as well as medication if necessary.

Hypertensive crisis: when BP reaches 180/120 mmHg or higher

Hypertensive crisis is a condition where one's blood pressure reaches 180/120 mmHg or higher. It is a severe and abrupt elevation in blood pressure that can lead to life-threatening issues affecting the heart, lungs, or brain if left untreated.

Types of Hypertensive Crisis

There are two types of hypertensive crisis: hypertensive emergency and hypertensive urgency.

Hypertensive Emergency

Hypertensive emergency is characterised not only by extremely high blood pressure but also by damage to vital organs, including the brain, heart, kidneys, or blood vessels. This damage can manifest as conditions such as heart failure or loss of vision. It is crucial to seek immediate medical attention for hypertensive emergency, as it can be fatal if untreated.

Hypertensive Urgency

In hypertensive urgency, individuals experience very high blood pressure without any signs of organ damage. While this condition is not as critical as hypertensive emergency, it still requires prompt medical attention to prevent potential complications.

Causes of Hypertensive Crisis

Hypertensive crisis can be triggered by various factors, with the most common cause being non-compliance with prescribed blood pressure medications. Other causes include the abrupt discontinuation of blood pressure medications, medication interactions, and the use of recreational drugs. Additionally, certain health conditions, such as preeclampsia or eclampsia during pregnancy, can contribute to hypertensive crisis.

Symptoms and Complications

Hypertensive crisis may present with symptoms such as shortness of breath. If left untreated, it can lead to serious complications, including hypertensive encephalopathy (swelling in the brain) and bleeding around the brain.

Diagnosis and Treatment

To diagnose hypertensive crisis, healthcare providers will take blood pressure measurements in both arms and may perform additional tests, such as an electrocardiogram (EKG) or a computed tomography (CT) scan of the chest or head.

The treatment goal for hypertensive crisis is to safely lower blood pressure, and the approach may vary depending on the patient's medical condition. In some cases, providers may need to lower blood pressure immediately, while in others, a gradual reduction over several hours or days may be more appropriate. Hospitalisation may be necessary, particularly for hypertensive emergency cases, which often require intensive care and intravenous medications.

Prevention

The best way to prevent hypertensive crisis is to consistently take prescribed blood pressure medications and maintain a healthy lifestyle. This includes eating a low-salt diet, avoiding tobacco products, and regularly monitoring blood pressure at home.

Lowering high blood pressure: lifestyle changes and medication

High blood pressure, or hypertension, is often called a "silent killer" because it usually has no symptoms. It is the biggest single risk factor for strokes, playing a part in about half of all cases. It quietly damages blood vessels and can lead to blood clots in the brain, damage to the tiny blood vessels deep inside the brain, and bleeding in or around the brain.

There is no cure for high blood pressure, but there are ways to manage it and reduce your risk of a stroke. Medication and lifestyle changes can improve your quality of life, control your blood pressure, and reduce your risk of heart disease, stroke, kidney disease, and more.

Lifestyle changes

• Eat a well-balanced diet
• Get regular physical activity
• Reach and maintain a healthy weight
• Quit smoking
• Limit alcohol intake
• Improve your sleep
• Reduce your salt and refined sugar intake
• Eat more potassium-rich foods
• Follow a heart-healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet
• Limit processed food
• Manage stress
• Eat dark chocolate
• Try medicinal herbs
• Drink more water

Medication

If your blood pressure is very high or doesn't decrease with lifestyle changes, your doctor may recommend prescription drugs. Talk with your doctor about possible medications and what might work best for you.

Frequently asked questions