Stroke due to high blood pressure

Test results at People’s Hospital 115 showed that the patient was obese with a weight of 100 kg and a blood pressure of 182 mmHg. According to Associate Professor, Dr. Nguyen Huy Thang, Head of the Department of Cerebrovascular Diseases, Vice President of the Vietnam Stroke Association, high blood pressure is the culprit behind the risk of stroke, not night bathing as people mistakenly believe.

According to Associate Professor Thang, many people are subjective with blood pressure readings, even in the medical profession. An 80-year-old woman, mother of a cardiologist, is controlling a stable blood pressure of 130 mmHg. A few weeks ago, she often felt dizzy. This doctor was worried that her blood pressure might be too low compared to the need for blood flow to the brain and was the cause of dizziness, so she decided to reduce the dose of medicine. As a result, he was hospitalized for a cerebral hemorrhagic stroke with a blood pressure of 180 mmHg, and was fortunately out of danger after a month of treatment.

Two cases show that a “permissive” view of blood pressure is still common. In fact, hypertension is a “silent killer”, involved in more than 90% of brain hemorrhage cases. The control target is usually below 140/90 mmHg, ideally below 130/80 mmHg, but even in the US only about 50% reach the basic level and 20.7% reach the more stringent level.

Recently, the international TRIDENT trial on 1,670 patients with cerebral hemorrhage showed that strict blood pressure control <130 mmHg brought clear benefits. After 6 months, nearly half of the three-drug combination group reached the goal, much higher than 26.4% in the conventional treatment group; Average blood pressure was 127 mmHg and 138 mmHg, respectively. After 2.5 years of follow-up, the rate of recurrent stroke in the intensive treatment group clearly decreased, and major cardiovascular events were also lower.

Meanwhile, stroke in Vietnam is trending younger, with an average age of about 62, nearly 10 years younger than in the world. Many people of working age survive but cannot return to work, becoming a burden to their families and society. Most patients after a stroke face serious sequelae such as paralysis, limb weakness, language and emotional disorders and vision impairment.

It is estimated that one in four adults over the age of 25 is at risk of having a stroke in their lifetime. About 90% of patients have risk factors such as hypertension, diabetes, dyslipidemia, atrial fibrillation, obesity, smoking, and drinking alcohol.

Treatment compliance in Vietnam is still very limited. Many people, even if they have underlying diseases, are still subjective because they do not see clear symptoms.

According to Associate Professor Nguyen Huy Thang, many young people have persistent high blood pressure but still ignore it because they think they are “healthy”. In fact, hypertension hardly causes symptoms, even when the reading exceeds 200 mmHg. This is the leading cause of cerebral hemorrhage – a form of stroke with a high mortality rate.

Doctors recommend that when you have underlying diseases such as hypertension, diabetes, dyslipidemia, you need to focus on optimal control instead of worrying about “marginal” factors such as bathing at night, bending over to tie shoelaces… More than 70% of stroke patients can be avoided if they comply with treatment. Especially in young people like the 21-year-old patient above, good blood pressure control can provide more pronounced and long-term stroke prevention benefits.