The Silent Threat: How High Blood Pressure Increases the Risk of Stroke

Last reviewed:

14 Mar 2023,

Author:

Aktiia Team

Medically reviewed by:

Dr Jay Shah

How High Blood Pressure Increases the Risk of Stroke

If you’ve been diagnosed with high blood pressure, you may think of it as something that runs in the background. But, there are real concerns that come with high blood pressure, such as an increased risk of stroke.

High blood pressure is one of the leading causes of stroke. A stroke occurs when the blood supply to part of the brain is interrupted or reduced, causing brain cells to die. Depending on the severity and location, stroke can result in long-term disability, and sometimes can be fatal.

This article will explore the link between high blood pressure and stroke in more detail. We’ll look at how hypertension increases your risk of stroke, and steps you can take to prevent it. We’ll also discuss the symptoms of stroke and what to do if you suspect someone may be having one.

If you or a loved one has high blood pressure or are concerned about your risk for stroke, read on for valuable information and tips on how to protect yourself from this potentially devastating condition.

If you found this article because you are experiencing possible symptoms of a stroke, dial 999 immediately.

What is a stroke?

A stroke is a life-threatening condition where a person’s blood supply to a part of the brain is reduced to the point of damage to brain cells. There are two types of stroke: ischemic stroke and haemorrhagic stroke.

Ischemic stroke: the blood supply to an area of brain decreases, leading to dysfunction of that area. Around 85% of strokes are ischemic
Haemorrhagic stroke: bleeding inside the brain

Symptoms of a stroke

What happens when you have a stroke? Stroke symptoms can range from barely perceptible to debilitating. You may experience:

Inability to move a muscle group
Loss of feeling on one side of the body
Confusion
Speech difficulties
Dizziness
Vision loss or blurred vision on one side
Dysphagia (difficulty swallowing)
Sudden and severe headache

BE-FAST for Stroke

BE-FAST is a helpful way to remember what to look for if you suspect you or someone you know is having a stroke. The acronym stands for Balance, Eyes, Face, Arm, Speech, Time. Without immediate treatment, the effects of a stroke can be permanent or lead to death, so if you notice any of these symptoms, seek medical attention immediately. Mini stroke, or Transient Ischemic Attack (TIA)If stroke symptoms last less than 24 hours, the stroke is called a transient ischemic attack (TIA) or mini-stroke.

High blood pressure and stroke

The Stroke Association names hypertension as the single biggest risk factor for stroke. Research shows that over 50% of all stroke deaths can be attributed to high blood pressure. The good news is, blood pressure is a modifiable risk factor and with close monitoring and your doctor’s advice, you can manage the risk of high blood pressure.

How can high blood pressure cause strokes?

In cases of both ischemic or haemorrhagic stroke, high blood pressure (hypertension) puts a strain on blood vessels, including the ones leading to the brain. The blood vessels stiffen and the blood flow pathways narrow, which could cause a blockage or increased pressure.

The elevated pressure and narrowed blood vessels may be enough for ischemic stroke to occur. Increased pressure may impair blood flow enough that oxygen supply to the brain cells drops, which could cause brain cells to begin to die within minutes.

In haemorrhagic strokes, hypertensive strain can cause blood vessel walls to stretch and burst in the brain, leading to bleeding and damage to surrounding brain cells.

Stroke Prevention and Treatment

In addition to high blood pressure, there are many risk factors for strokes including:

Smoking
Excessive alcohol
Heart disease
Diabetes
High cholesterol
Recreational drug use
Use of certain prescription medications
Physical inactivity

Some risk factors cannot be controlled such as age, gender, and race. But remember, you can manage the most important risk factor – blood pressure – with a healthy diet, an active lifestyle, minimizing stress, and regular discussions with your doctor about blood pressure.

It’s best to focus on controlling what you can and try not to worry about factors you cannot control.

Continuous blood pressure monitoring and time in target range

Continuous blood pressure monitoring could help you understand your risk and have the right conversations with your doctor.

Measuring with traditional home BP cuffs or at the doctor’s office gives you a reading at one point in time. The problem with that is, you will have highs and lows throughout the day, and it’s hard to say whether you’re capturing your reading at a high point or a low point.

If you’re using a continuous monitor, you can track your time in target range, which is the amount of time your blood pressure stays in the safe zone.

An increase in time in target range means that your health habits are working, and a decrease or a minimal change indicates that you may need to reevaluate your diet and lifestyle. Either way, it’s valuable information that can help you and your doctor decide on next steps.

Time in target range could be valuable to track if you experience periods of stress throughout the day or if you experience white coat hypertension – a rise in blood pressure from being in a doctor’s office.

Stroke Prevention

You can make small changes to your lifestyle to drastically reduce hypertension and in turn reduce the risk of strokes, including:

Eating a balanced diet. Work with your doctor to find an eating pattern that incorporates protein, healthy fats, fiber, and nutrients, while keeping sodium low. Here’s an article on eating for high blood pressure to get you started.
Monitor your blood pressure regularly. You can get a home blood pressure cuff or schedule regular doctor visits to keep track of your blood pressure. Another option is wearable technology, which has made blood pressure monitoring so easy that you don’t have to think about it.
Exercise regularly. Some exercises are beneficial for high blood pressure, and others could be potentially harmful. This article explains more about exercising for high blood pressure.

Always speak to a qualified medical professional before making any significant changes to your diet or physical exercise.

Ischemic stroke Treatment

Medical professionals may be able to treat ischemic and haemorrhagic strokes if they take quick action.

Thrombolysis

Medical doctors can treat ischemic stroke with a medication called alteplase, which is known as “clot buster” medication or thrombolysis. Thrombolysis dissolves blood clots and is most effective if it is used within 4.5 hours of symptom onset.

Thrombectomy

Severe ischemic strokes may be treated with an emergency procedure called thrombectomy, which involves surgically removing blood clots from large arteries in the brain. To do this, a surgeon inserts a catheter into an artery elsewhere in the body, usually through the groin area, and a device is guided through the catheter to the clot to remove it.

Thrombectomy is effective if it is started soon after symptom onset.

Medications

Medications are often administered to stroke patients to manage the current stroke, and to help prevent complications and subsequent strokes:

Statins to prevent thromboembolism to the brain
Antiplatelets to prevent subsequent strokes
Anticoagulants to decrease the amount of brain cells affected by the stroke
ACE inhibitors are often coupled with a diuretic to prevent secondary strokes

Your doctor will determine what medication combination will manage your current condition as well as prevent future complications.

Haemorrhagic stroke treatment

Haemorrhagic stroke is a serious medical emergency and your doctor may apply a combination of treatments:

Medication. If you have been taking blood thinning medication for high blood pressure, your doctor may administer medicine to slow the bleeding along with medicine to reduce pressure in the brain. You may also receive medication to prevent seizures and blood vessel spasms.
Surgery. Your doctor may perform surgery to drain some of the blood and fluid from the brain, and address blood vessel problems that may be present. Your surgeon may also clamp the blood vessel at the source of the haemorrhage to keep it from bleeding more. Another option is to insert a coil which causes blood to clot.
Stereotactic radiosurgery. A doctor may choose to use minimally invasive radiation to repair blood vessels.

FAQs about Strokes and High Blood Pressure

Is eye twitching a sign of a stroke?

Eye twitching is not usually a symptom of a stroke. However, if it is accompanied by other more serious symptoms such as slurred speech, facial drooping, balance issues, numbness, tingling, or confusion, then it could be an indication of a stroke and should be treated as a medical emergency.

Call 999 immediately, even if you’re not sure.

Are numb lips a sign of a stroke?

Numbness or tingling in the lips can be a sign of a stroke, especially if it is accompanied by other symptoms of stroke such as blurred vision, difficulty speaking, facial drooping, weakness or numbness on one side of the body. If you experience any of these symptoms along with numb lips, seek medical attention immediately.

Call 999 immediately, even if you’re not sure.

Can stress cause a stroke?

Stress itself does not cause a stroke, but it can be a contributing factor. People who experience chronic stress and anxiety are at an increased risk of stroke due to the effects it has on the body’s cardiovascular health. Stress can also lead to lifestyle habits that increase your risk, such as smoking or poor diet choices.

Are strokes hereditary?

Having close relatives who have experienced a stroke greatly increases your risk of having one yourself. Other risk factors, such as high blood pressure, obesity, and diabetes can also be hereditary. It’s important to talk to your doctor about your family history to better understand your risk.

Conclusion

As hypertension is the most common cause of a stroke, it’s crucial to keep blood pressure levels as close to normal range as possible. We recommend regular blood pressure monitoring as a simple but effective way to help and Aktiia makes this a breeze. Aktiia’s BP monitor is easy to wear, gives important insights into your heart health 24/7, and provides a summary you can share with your doctor.

Disclaimer: This article is for informational purposes only and does not contain medical advice and is not a replacement for medical advice. The information in this article is not intended to diagnose, treat, cure, or prevent any disease. Talk to a qualified medical professional before making any changes to your health regimen.

Sources:

NHS Inform: Stroke, Accessed February 21, 2023 – https://www.nhsinform.scot/illnesses-and-conditions-stroke

The Stroke Association: High Blood Pressure, Accessed February 21, 2023 – https://www.stroke.org.uk/what-is-stroke-are-you-at-risk-of-stroke

Blood Pressure Control and Primary Prevention of Stroke: Summary of the Recent Clinical Trial Data and Meta-Analyses, October 25, 2013 – https://www.ncbi.nlm.nih.gov/articles-PMC3838588

Risk Factors, British Heart Foundation, Accessed February 21, 2023 – https://www.bhf.org.uk/informationsupport-risk-factors

NHS, Stroke – Treatment, September 13, 2022 – https://www.nhs.uk/conditions-stroke

BE-FAST (Balance, Eyes, Face, Arm, Speech, Time): Reducing the Proportion of Strokes Missed Using the FAST Mnemonic, Jan 12, 2017 – https://www.ahajournals.org/stroke

Angiotensin-Converting Enzyme Inhibitors for Stroke Prevention, Feb 1, 2003 – https://www.ahajournals.org/doi-10.1161