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Keep BP under control

(Reporting by C. Maya)
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Hypertension is the primary risk factor for stroke

Approximately 12 per cent of all strokes in the population occur in those who are less than 40 years of age, according to the Stroke Surveillance in India report by the WHO in 2006.

And the no. 1 cause for a significant number of these strokes in the younger population is uncontrolled hypertension.

High blood pressure or hypertension is well known to be the primary modifiable risk factor for strokes, especially the haemorrhagic strokes, when a blood vessel in the brain ruptures or leaks due to uncontrolled blood pressure. Yet not even half of those diagnosed with hypertension have their blood pressure levels under control.

Stroke, particularly haemorrhagic stroke, can be a devastating and disabling event because there is very little that medical intervention can do to help improve the outcome of an acute intracerebral haemorrhage (ICH).

In the event of an ICH, a blood vessel bursts and bleeds into the brain tissues, rapidly damaging the brain cells

An ICH is considered to be the least treatable form of stroke, even though only about 20 per cent of all stroke incidence are the haemorrhagic or bleeding brain strokes. The mortality and morbidity burden of this type of stroke is double that of the ischaemic stroke (stroke caused when a blood clot in the blood vessels to the brain prevents the flow of blood to brain, causing brain cells to die).

Haemorrhagic stroke also manifests as weakness on a side, dizziness or slurred speech, but the symptoms are often severe, with patients going comatose and it is important that they are rushed to a hospital with CT scan facilities.

“We can administer thrombolysis to save a patient who is brought into the hospital with an ischaemic stroke, within the crucial window of three-and-a-half hours. But in the case of a haemorrhagic stroke, there is a limit to what we can do. Intensive lowering of blood pressure and preventing the expansion of haematoma in the brain, within the first six hours can reduce mortality and morbidity,” points out P.N. Sylaja, Additional Professor of Neurology and the head of the Stroke Unit at the Sree Chitra Tirunal Institute for Medical Sciences and Technology.

Though aneurysms (weakened spots in blood vessels which balloon up and may burst) and vascular malformations can also cause haemorrhagic strokes, these are less common causes

“A significant number of hemorrhagic stroke patients we see are less than 45 years of age and uncontrolled blood pressure is the primary cause of the event. Despite our advice, people seldom understand how important it is to keep blood pressure levels under control.

“Even those diagnosed with hypertension are erratic with their prescribed medication,” she says.

(Reporting by C. Maya)

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