Hyper­ten­sion and stroke: Why drug ther­apy must never stop

Daily Trust - - DIGEST -

Hyper­ten­sion, which sim­ply means an ab­nor­mal blood pres­sure, is the big­gest sin­gle risk fac­tor for stroke ex­perts say.

“If un­con­trolled, hyper­ten­sion is im­pli­cated in about 50% of stroke cases,”said Ak­ing­bade B. Thomas, a phys­io­ther­a­pist at the Cen­tral Hos­pi­tal, Benin City.

“It in­vari­ably means that stroke in­ci­dence, can be re­duced by about 50% if hyper­ten­sion is ef­fec­tively con­trolled. The com­bi­na­tion of an­ti­hy­per­ten­sive drugs and life­style mod­i­fi­ca­tion like reg­u­lar ex­er­cise can ef­fec­tively con­trol hyper­ten­sion.”

He said a 2011 study by De­salu O.O and oth­ers re­ported that in south-west­ern Nige­ria, hyper­ten­sion has been shown to be present in up to 85% of stroke pa­tients in a ru­ral ter­tiary hos­pi­tal.

Thomas said that there was a habit among hy­per­ten­sive pa­tients which was in­im­i­cal to their health; that is stop­ping their drugs when their blood pres­sure reads nor­mal. He said it could make them de­velop stroke.

“They uni­lat­er­ally, with­out con­sult­ing their physi­cian, dis­con­tinue the an­ti­hy­per­ten­sive drugs, the mo­ment they know their ab­nor­mal blood pres­sure, is now within the nor­mal range. Un­for­tu­nately, most of them get to re­gret this ac­tion, when they sud­denly be­come stroke vic­tims,” he said.

The phys­io­ther­a­pist said till date, there was no med­i­cal cure for hyper­ten­sion but that it could be ef­fec­tively con­trolled with drugs and life­style mod­i­fi­ca­tions.

“Ef­fec­tive con­trol of hyper­ten­sion can be sus­tained, if the ad­vice of med­i­cal ex­perts is strictly ad­hered to,” he ad­vised.

Stroke

Stroke is a med­i­cal con­di­tion, in which the brain cells sud­denly die, as a re­sult of dis­rup­tion of blood sup­ply to the brain. This dis­rup­tion in blood sup­ply, re­sults from ei­ther block­age or rup­ture of the blood ves­sels in the brain. The death of cells in an area of the brain, can lead to dis­abil­ity or/and death.

Stroke is a non­com­mu­ni­ca­ble dis­ease with sig­nif­i­cant so­cio-eco­nomic con­se­quence world­wide. Ac­cord­ing to a pub­li­ca­tion by the world health or­ga­ni­za­tion (WHO), stroke ac­count for 10.8% mor­tal­ity and 3.1% of dis­ease bur­den world­wide.

In a study pub­lished by Em­manuel Sanya and oth­ers in 2015, the preva­lence of stroke in semi-ur­ban Nige­ria is 134 per 100,000.

Stroke re­lated cases, also ac­count for 24% of all ad­mis­sion in hospi­tals in Nige­ria, ac­cord­ing to Dr Em­manuel Effa, a con­sul­tant physi­cian at the Uni­ver­sity of Cal­abar Teach­ing Hos­pi­tal.

Thomas, the phys­io­ther­a­pist said it has been doc­u­mented that 90% of in­ci­dent stroke, is due to mod­i­fi­able risk fac­tors than risk fac­tors that you can do some­thing about. In ad­di­tion he said hyper­ten­sion, di­a­betes, smok­ing and obe­sity were some mod­i­fi­able risks fac­tors that pre­dis­poses peo­ple to stroke.

He said in the event that stroke oc­curs, the fol­low­ing symp­toms were the fea­tures that you would no­tice: trou­ble with speak­ing and un­der­stand­ing, paral­y­sis or numb­ness of the face, arm, or leg, trou­ble with see­ing in one or both eyes, headache, which is sud­den and se­vere, and trou­ble walk­ing.

The phys­io­ther­a­pist said the Stroke As­so­ci­a­tion rec­om­mended the acro­nym FAST, for easy and timely recog­ni­tion/help of some­one who was ex­pe­ri­enc­ing acute stroke in­ci­dence.

F-face (ask the per­son to smile, does one side of the face droop?)

A-arm (ask the per­son to raise both arm. Does one arm drift ran­domly? Or is one arm un­able to raise up?)

S- speech (ask the per­son to re­peat a sim­ple phrase. is the speech slurred or strange?) and

T-time (if you ob­served any of these signs, it is time to im­me­di­ately take the per­son to the near­est hos­pi­tal).

Ac­cord­ing to him, a stroke vic­tim can achieve a com­par­a­tive bet­ter treat­ment out­come, if such per­son is availed med­i­cal treat­ment, within the first few hours of on­set of the stroke.

“This is be­cause at the hos­pi­tal, med­i­cal pro­fes­sion­als like physi­cians, phys­io­ther­a­pists, nurses, psy­chol­o­gists, oc­cu­pa­tional ther­a­pist, among oth­ers are avail­able to pro­vide the needed man­age­ment that can help re­ha­bil­i­tate the stroke vic­tim, back to the op­ti­mal func­tional abil­ity achiev­able.

The level of op­ti­mal func­tional abil­ity, which can be achieved af­ter stroke, will de­pend on the sever­ity of the stroke, how soon med­i­cal treat­ment started and qual­ity of med­i­cal re­ha­bil­i­ta­tion,” he said.

The phys­io­ther­a­pist said stroke could be pre­vented, if the pre­dis­pos­ing fac­tor like hyper­ten­sion was first pre­vented. He added that if hyper­ten­sion was al­ready di­ag­nosed, ef­fec­tive con­trol of the hyper­ten­sion, via the com­bi­na­tion of an­ti­hy­per­ten­sive drugs and life­style mod­i­fi­ca­tion, could pre­vent stroke.

“Stroke is not a “spir­i­tual at­tack”, it is “brain at­tack” by pre­dis­pos­ing fac­tor like hyper­ten­sion. You can ef­fec­tively de­fend your­self from this at­tack, man­ag­ing your hyper­ten­sion ef­fec­tively,” he ad­vised.

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