Systolic and Diastolic Blood Pressure
The single most important risk factor for stroke is hypertension, or high blood pressure. Your blood pressure consists of two numbers. The higher/first/top number is the systolic pressure. Your heart beats or contracts. The heart muscle squeezes together. This pumps blood out of the heart and into the arteries. These arteries are blood vessels that carry blood around the body and up to the brain. The pressure in the arteries when the heart beats is the systolic pressure. Between beats the heart relaxes and the pressure in the blood vessel drops. This lower pressure, the second/bottom number, is the diastolic pressure.
Normal Blood Pressure
We used to consider any pressure below 140/90 normal. We also used to accept as normal that a person’s blood pressure rose to this level and above as they aged. Now the range 121 to 139/81 to 89 is known as “prehypertension” no matter what your age. A normal blood pressure must now be 120/80 or lower.
Consequences of Hypertension
It is never all right to have high blood pressure. You probably will not be able to tell if or when your pressure is high. Hypertension is usually silent and can be deadly. It means there is increased pressure on the blood vessels. This makes the vessels more likely to rupture or break. If this happens in your brain you will have a hemorrhagic stroke. High blood pressure for a prolonged period of time damages the lining of the blood vessels. These damaged areas are places where fatty plaques can stick and grow. This narrows the blood vessels and less blood can flow through. Also, pieces of plaque can break off and drift along. These pieces can clog the vessels which become smaller as they travel through different body parts. The risk of ischemic stroke increases. This is the type of stroke you have if a portion of your brain dies because it does not get enough blood or oxygen.
High blood pressure also increases the risk of silent strokes. A silent stroke does not produce the sudden dramatic symptoms seen with the other strokes. No facial drooping, no drooling mouth, no weakness or paralysis of one side of your body, no headache, etc. You won’t feel anything but eventually changes may appear on an MRI scan. Over time these abnormal areas on your brain MRI may get larger. We often see these MRI changes in people who have developed dementia and cognitive deficits. So get your blood pressure checked regularly. If it is high, lowering it will decrease the risk of every type of stroke. It will also decrease your risk of developing dementia.
The changes in your blood vessels mean that your heart has to work harder to pump blood around your body. Your heart workload increases. Over time the heart muscle becomes thicker and stiff. That’s how hypertension contributes to heart disease. The risk of heart failure and heart attack increases, as does the incidence of aneurysms and kidney disease. So getting your blood pressure under control may benefit you in many ways.
Lifestyle Changes
Here are some lifestyle changes that may help. They may even make medicines unnecessary.
Lose weight if you are overweight
Cut your salt intake to one teaspoon or less a day
Increase your potassium intake to 3,500 mg a day
Eat more fruits and vegetables–they have less salt and more potassium
Take in at least 1,200 mg of calcium per day from low-fat dairy products
Increase your magnesium intake, 320 mg daily for women, 420 mg for men
Aim for at least 30 minutes of physical activity each day
Drink no more than one alcoholic beverage a day if you are a woman and no more than two if you are a man
If you smoke–QUIT !
Even though I am a neurosurgeon I am big on avoiding surgery and prescription medicines whenever possible. But, let’s be clear. The most important things are your health and safety. If your pressure is high and your doctor advises it, take the prescription. But start changing your lifestyle. The goal is to get your blood pressure down to a safe and normal level. That doesn’t mean you take your blood pressure pill, stop exercising and go back to pouring salt on your food. Lose a few pounds and your doctor might be able to take you off the medication. How would that make you feel? Healthy? Successful? Like you could achieve anything? Close your eyes and think about it. Visualize it. See yourself calmer, healthier, on a lower dose of blood pressure medicine, or on none. Make that great feeling your reality. That is your goal. Keep moving and keep your goal in mind!
Learn more about the things you can do to decrease your risk of stroke and dementia. Sign up to receive the Say No To Stroke! newsletter delivered straight to your inbox. You will also receive your copy of the 10 Steps — the ten things you can start doing today to help avoid stroke, Alzheimer’s disease, and other forms of dementia.
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