Medical experts discuss link between ‘silent killer’ high blood pressure and stroke
Naylon Bird talks about strokes a lot. As a registered nurse in the neurology department at Harris Health System Ben Taub Hospital, she encounters stroke victims every day.
“A stroke is a brain attack,” says Bird, RNBC, SCRN, who worries people don’t give strokes the serious consideration this medical emergency requires. According to the American Heart Association, someone dies of stroke every 3 minutes and 33 seconds in the US, yet still, there remains a gap between public perception of stroke and the medical reality. This might be because stroke doesn’t carry with it the same obvious warning signs as a heart attack.
One of the leading causes of stroke— chronic high blood pressure—is often asymptomatic (without symptoms) until it becomes very serious. Dubbed the “silent killer,” chronic high blood pressure leads to hypertension and causes a grab-bag of the worst medical events a person can experience, from stroke to cardiovascular disease, which kills Americans at a higher rate than all cancers combined. “High blood pressure and hypertension are prevalent and under-diagnosed,” says Dr. Nasser Lakkis, chief of Cardiology at Ben Taub Hospital and professor at Baylor College of Medicine. “You can have hypertension and not know it until you have a heart attack or stroke.”
This unsettling reality has increased the urgency in both Lakkis and Bird to better educate the public on recognizing and treating high blood pressure, and the early warning signs of stroke and how teating a stroke within 4.5 hours of the victim’s last known moment of normalcy greatly increases the individual’s chances of a full recovery.
Understanding the ABCs of Blood Pressure
According to the American Heart Association, blood pressure (BP) is a measure of two numbers:
• Systolic blood pressure (the first number) – indicates how much pressure your blood is exerting against your artery walls when the heart beats.
• Diastolic blood pressure (the second number) – indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.
This measurement is represented by two numbers grouped together like this: 120 (systolic)/75 (diastolic). As these numbers increase, so does your risk of hypertension, which can lead to stroke and cardiovascular disease. Here’s a chart to know what your blood pressure reading means:
• Normal Blood Pressure = below 130 / below 80
• High Blood Pressure (Hypertension) Stage 1 = 130-139 / 80-89
• High Blood Pressure (Hypertension) Stage 2 = 140 or higher / 90 or higher
• Hypertension Crisis (seek care IMMEDIATELY) = higher than 180 / higher than 120
It’s important to note, Lakkis says, that one high blood pressure reading doesn’t automatically mean you have high blood pressure. You should check your blood pressure a couple times a year as long as it remains in the normal range. But if you notice a high reading multiple times in a row, separated by a few weeks, it’s imperative to see your doctor, Lakkis says. The good news is that hypertension is quite treatable through preventive measures. Simply limiting your consumption of high salt-added foods—canned soups, fast food, pizza, deli meats and cheese—can lower your blood pressure. Conversely, eating foods rich in potassium (tofu fruits, whole grains, beats, leafy veggies, nuts, avocados and seeds) helps your body handle sodium correctly. “Stress-reduction is also key in reducing blood pressure,” Lakkis says. Activities like mindfulness, regular moderate exercise, and yoga are all great ways to lower your blood pressure.
If you have a family history of hypertension, or if you have co-morbidities like diabetes, coronary artery disease or advanced kidney failure, you may need to monitor your blood pressure closely.
Why Does High Blood Pressure Cause Stroke?
A stroke occurs when there’s a disruption in the blood flow to the brain. Chronic high blood pressure often causes this disruption.
“High blood pressure adds to your heart’s workload and damages your arteries and organs over time. It causes damage to the inner lining of the blood vessels, narrows arteries and can cause an ischemic stroke,” Bird says. “About 13% of strokes occur when a blood vessel ruptures in or near the brain. Chronic high blood pressure or aging blood vessels are the main causes of this type of stroke.”
How Do I Know if I’m Having a Stroke?
“When the symptoms of stroke occur— numbness, weakness, dizziness, difficulty speaking—there’s a tendency to attribute these symptoms to other factors,” says Bird.
Rather than ignore these symptoms, we need to overreact, especially if you have a history of high blood pressure or have co-morbidities like diabetes or kidney problems. “Don’t ignore symptoms of stroke,” she warns. “The faster you seek care, the better chance you have at not experiencing lasting effects.”
What to Do if You or a Loved One Is Having a Stroke
Stroke experts created an acronym to help us recognize and respond to stroke: BE FAST. Any one of these symptoms can be a sign of stroke:
B alance: watch for sudden loss of balance E yes: check for vision loss
F ace: look for an uneven smile
A rm: check to see if one arm is weak
S peech: listen for slurred speech
T ime: call 911 right away.
Dealing with a stroke quickly can save the victim’s life and limit the damage caused by the disruption of blood flow to the brain.
How to Prevent a Stroke
Controlling risk factors like high blood pressure and bad habits can greatly decrease your risk of stroke. First, don’t smoke. Smokers are 30% more likely to die from stroke than non-smokers. Second, eat healthy and consume less alcohol. Third, be more physically active. Regular exercise greatly reduces your chance of a stroke.
These lessons couldn’t be timelier. With increasing access to healthy foods through programs like Harris Health’s Food Farmacies, new treatments and the continued educational efforts of medical experts like Bird and Lakkis, we can hope to see a reduction in stroke deaths in the future. But for now, we can only do our part.