Stroke & High Blood Pressure
February 2020 Issue
Many people think a stroke happens in the heart, but it happens in the brain, and it can be devastating. Stroke is a disease you must be educated about. When it happens, it is always sudden and never expected. Knowing the signs and symptoms, and acting FAST, can mean the difference between a stroke victim being permanently disabled, or being able to resume a normal, healthy life. It can also be the difference between life and death. Read on to educate yourself on the risk factors, signs and symptoms of stroke.
By Dr. Ravina Balchandani, Cardiologist — NuBodia
Q. What are TIAs and how do they affect my health?
Some consider a TIA a “mini-stroke”. However, the definition of a TIA (Transient Ischemic Attack) is a neurological deficit where the brain experiences a temporary lack of blood flow and reverses completely within 24-48 hours of the event and does not cause permanent damage or disability.
Healthwise, a TIA is a major warning sign for a larger stroke, heart attack or peripheral vascular disease. All four are in the same category and should be taken very seriously with regard to your health. One in three people who have a TIA go on to have a stroke often in the same year.
Q: What are ways to prevent stroke?
Stroke risk factors are similar to cardiovascular disease; they include preventable factors and non-preventable factors. The risk factor of a TIA doubles for both men and women with each decade after the age 55. Preventable factors are high cholesterol, hypertension, diabetes, smoking, obesity, obstructive sleep apnea and leading a sedentary lifestyle. Switching to a low-fat, low-salt, high fiber diet, along with maintaining a healthy weight, are ways to prevent another TIA, stroke, or heart attack. Non-preventable risk factors include gender and genetics. Men have a higher risk of a TIA, but woman have a higher lifetime risk of a stroke. The single most important risk factor for a TIA is sudden surges of hypertension.
Q: How detrimental is stress to high blood pressure and how can you handle it?
Long-term stress is usually not defined by high blood pressure. However, stress can cause transient high blood pressure due to surges in hormones, such as cortisol. Long-term effects of stress on high blood pressure is not well known. However, short-term, stress-related high blood pressure may not necessarily need to be acutely treated. Lifestyle changes such as exercising four to five times per week for 30 minutes, relaxation, proper sleep, breathing and meditation should be used to help alleviate stress. These steps should be employed first and are preferable, rather than starting with medication. Also, stress factors are different for each individual. Lifestyle changes should be considered first and then, if the stress continues, specific medication for that individual would be considered.
Be open-minded and willing to consider options when it comes to lifestyle changes to lower blood pressure.
Dr. Ravina Balchandani graduated from Gandhi Medical School and completed her medical residency, cardiology residency and interventional cardiology residency at Maimonides Medical Center in New York City.
Dr. Balchandani finds great enjoyment in the challenges of interventional practice, however, her primarily philosophy is that prevention is more important than the cure. She is a huge advocate for women and heart disease, and enjoys informing and empowering other women in the community through many talks and presentations about the dangers of heart disease. Dr. Balchandani has two offices, one on Hilton Head Island and another one in Bluffton. To contact her office, call 843-816-3733.
Stroke by Paul Mazzeo, M.D. - Neurologist
Q: Is there a specific window of time for someone who might be having a stroke?
A stroke usually occurs when there is a blockage of blood and oxygen to the brain, which can kill or damage brain cells, so receiving treatment quickly can mean the difference between life and death, or between disability and recovery. The time window for treatment of acute, non-bleeding stroke with a clot busting medication (like TPA) is 4.5 hours from the time someone was last seen without symptoms. For example, if someone goes to sleep at 10 p.m. and awakens the next morning showing signs of symptoms, that would be considered outside the time window to safely administer the TPA. However, if that person woke up to go to the bathroom in the middle of the night and was observed by their partner, the start time would reset. Brain MRI can sometimes be used to assist in determining this timing. Patients where a clot is seen in one of the major brain arteries may also be eligible for transfer to a comprehensive stroke center (like MUSC), often after intravenous TPA is administered, for removal of the clot via catheter retrieval.
Q: What is F.A.S.T. and how does it help identify stroke symptoms? Are there other symptoms?
F.A.S.T. stands for Face, Arms, Speech and Time. Facial drooping can be detected by asking the person to smile and looking for asymmetry. Arm weakness is determined by having the person hold out their arms and seeing if one arm drifts downward. Speech slurring, or an inability to speak or comprehend, can be determined by asking the person to repeat a sentence. Time reflects the need to call 911 to make sure the person with stroke receives evaluation and treatment as soon as possible. Other signs of stroke may be a slowness in tapping the thumb and index finger together on one side, or weakness in one leg. Many strokes manifest as asymmetries between one side of the body and the other.
Dr. Paul Mazzeo is a board-certified neurologist with Beaufort Memorial Hospital. Also certified in headache medicine, behavioral neurology and neuropsychiatry, Dr. Mazzeo practices with Coastal Neurology in Bluffton and Beaufort.