Hypertension and stroke: Why drug therapy must never stop

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.