Hypertension: The No. 1 cause of stroke

When was the last time you checked your blood pressure?

You might think you don’t have to worry because you aren’t experiencing symptoms of elevated blood pressure such as severe headache or ringing in your ears.

But many people with high blood pressure, also called hypertension, don’t have symptoms until the damage has been done.

“When people experience a stroke, it’s often the result of years of high blood pressure,” says Dr. Wengui Yu, a neurologist at UCI Health, director of the UCI Health Comprehensive Stroke and Cerebrovascular Center.

“That’s why we call high blood pressure the ‘silent killer.’”

Stroke is the fifth-leading cause of death in the United States, and for most of the nearly 800,000 Americans who suffer a stroke each year, the culprit is hypertension. It is also a significant risk factor for heart disease.

Although nearly 120 million U.S. adults have high blood pressure, about 41% of them have no idea, according to the Centers for Disease Control and Prevention (CDC).

How hypertension raises risk

When someone has high blood pressure (HBP), the added force of blood pushing against his or her artery walls gradually weakens and damages the arteries.

“Over time, it creates sections that can bulge out, then rupture or become inflamed, narrow and clogged,” Yu says.

Blood carries oxygen and vital nutrients to your brain. If a narrowed or clogged artery cuts off blood flow to your brain, your brain cells begin to die. This is called an ischemic stroke.

If an artery in or near the brain ruptures, blood leaks into the surrounding tissue. This is called a hemorrhagic stroke.

Common misconceptions

Many people ignore their blood pressure because they believe symptoms will warn them before anything serious occurs, notes Yu.

Others do get diagnosed early and receive medication from their doctor to control their blood pressure.

“However, too many stop taking medicine once their blood pressure becomes normal because they think their hypertension has been ‘cured,’” he says. “But there is no cure. There are only ways to manage and control blood pressure.”

In time, Yu notes, one may be able reduce or eliminate hypertension medications, but most people need to take them for a lifetime.

Sometimes, a person’s blood pressure will remain elevated despite taking three or more drugs to lower it. Yu says this can cause patients to lose faith in prescription medications.

“The truth is that they may have an incorrect dose or the wrong combination of them. It may also be a condition called resistant hypertension, which increases the risk of stroke and cognitive decline.”

When that happens, he suggests seeing a cardiologist or nephrologist to identify blood pressure control strategies.

Reduce your risk

Yu recommends regular blood pressure checks for anyone who is overweight or has a family history of hypertension or diabetes.

This can be done at the doctor’s office during regular appointments, with a blood pressure kit at home or by using free machines located at many pharmacies.

Even people without risk factors should check their blood pressure regularly, using these guidelines:

• If it is normal (less than 120/80), continue to check it every few months.
• If elevated (120-139/80-89 or higher), see your doctor.
• Medication may be needed if the top number (systolic) is over 140 or your bottom number (diastolic) is over 90.

Manage or prevent hypertension

It’s possible to manage — or even prevent — high blood pressure and stroke by adopting a healthy lifestyle, says Yu. This includes:

• Eating a balanced diet rich in fruits, vegetables and low-fat dairy products.
• Avoiding high-fat foods such as red meat and reduce your sodium intake.
• Avoiding excessive salt in your food and soft drinks, which are high in sodium.
• Exercising regularly. “Just do what is comfortable for you,” Yu says. “If you’ve never exercised before, start slowly and build over time.”

Your doctor, as your healthcare partner, can guide you, he says.

“But it all starts with you.”