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    Control Your Blood Pressure and Prevent a Stroke
    Richard C Senelick, MD posted:
    After being struck down by a stroke, it is not unusual to live in fear of having a second stroke. However, there are many things you can do to prevent having another stroke, but the single most important one is to control your blood pressure.

    Hypertension is the single most important cause of stroke and it is estimated that approximately 75 million or one-fourth the population of the United States have high blood pressure. The incidence of high blood pressure is even greater in African Americans (41%) whose risk of having a stroke is almost twice that of the white population. It should be obvious that we all need to know our blood pressure and work closely with our doctors to control it.

    When you control your blood pressure through the use of antihypertensive medication you reduce the risk of a first stroke by 32%. The odds are similar for preventing a second stroke. In patients who have had a TIA or a stroke, treatment of high blood pressure reduces the risk of a recurrent stroke by 30%. The exact blood pressure number you need to shoot for is a decision that is unique to each person and should be made in consultation with your physician.

    Medications alone are not enough and it is important to modify your lifestyle. It is easy to take a pill, but this is the hard part. This includes:

    • Restriction of salt intake

    • Weight loss

    • A diet rich in fruits and vegetables

    • Regular physical activity

    • Limited alcohol consumption


    Hypertension is defined as a systolic blood pressure of 140mmHg or more and a diastolic of 90mmHg or more (?140/90). We now have a new category of pre-hypertension which is defined as a systolic blood pressure of 120-139mmHg or a diastolic of 80-89mmHg. It turns out that pre-hypertension is quite common and occurs in up to 40% of the population. A recent study reported online in the Journal Stroke, found that in people who had never had a stroke, the treatment of pre-hypertension with medication lowered their risk of a stroke by 22%. However, because of the lack of large clinical studies, we do not have clear guidelines of how we should treat people with pre-hypertension, particularly those who have already had a stroke. Lowering the blood pressure in older individuals is not always advisable as they may need a little higher blood pressure to nourish their brain. This is definitely something to discuss with your physician.

    Twenty years ago there was such a thing as "a little bit of high blood pressure." Not anymore. Talk with your doctor and start making those lifestyle changes to prevent another stroke.
    After your stroke you may be experiencing a new normal, but remember what George Eliot said- It is never too late to be what you might have been. You still can achieve new goals.

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