Avoiding Second Stroke – Watch Your Blood Pressure

New research underlines the importance of taking your blood pressure medicine to avoid a second stroke. Stroke risk is one of the most pressing senior health issues.

HealthDay News reported on July 29, 2019, on a study that found the risk of having a second stroke was reduced by about 20% when blood pressure was carefully controlled. The conclusion: watch your blood pressure to avoid risk of having a second stroke.

In the study, some participants followed regular blood pressure control measures. The other group followed intensive blood pressure control measures.

Participants in the intensive group achieved a lower blood pressure level. Fewer people from the intensive group had a second stroke. The researchers then analyzed their results together with results from previous studies. The risk factor for second stroke for people had who intensively controlled their blood pressure was reduced by 22%.

Dr Kazuo Kitagawa, is a professor at the Tokyo Women’s Medical University. As the main study author, he suggests that stroke survivors should maintain a blood pressure of 130/80 mm HG or lower. To prevent stroke recurrence, that is the blood pressure level to aim for following stroke. If it is possible, survivors should aim for the lower figure of 120/80 mm HG.

The problem is, that to achieve that blood pressure level, the participants in the study had to take two or three different medications simultaneously. This was a challenging issue and it joins the other challenges stroke survivors face in lowering their blood pressure.


Difficulties in Achieving Lower Blood Pressure

  1. Patients forget to take their blood pressure medicine.
  2. Difficulties in making lifestyle changes, to improve health.
  3. Patients fear that the blood pressure will drop too low.
  4. Some doctors do not want to prescribe several medicines at the same time.

Each difficulty can be addressed separately.


Forgetting to Take Medication

Although there is a lot more to write upon this topic, we will briefly mention a few tips:

  • Use smartphone apps that can help you remember to take your medicine.
  • Sort the medications into daily/weekly/monthly medication compartments.
  • Put the medicine in a prominent place that you go to, to do an activity on a regular basis. For example, for medicine that you take three times a day, put it where you eat breakfast, lunch and dinner.
  • Ask a friend to call you to remind you. This is a bit of a wishy-washy idea in the long term, unless your friend is really dedicated. But support is very important and you can get a lot of support while the plan works.


Lifestyle Changes

These are clear cut and are really important for seniors to implement.

If you have to watch your blood pressure, no matter your age, pick up some lifestyle improvements here:

  • monitor and treat high blood pressure
  • check for an irregular heartbeat (atrial fibrillation)
  • watch your weight
  • stop smoking
  • alcohol – only as medically permitted
  • check and treat cholesterol problems
  • diabetes – keep it under control
  • frequent exercise
  • medical evaluation of any circulation problems
  • diet – low sodium, low fat, less processed foods; a lot of fruit and vegetable, whole grains and polyunsaturated fats such as olive oil.

This list is compiled from the National Stroke Association and John Hopkins Medicine . There are other similar lists, such as, from the American Stroke Association .

Low Blood Pressure

Patients and doctors are wary of side affects of lowered blood pressure.

  • dizziness
  • risk of falling
  • ankle swelling
  • fatigue
  • fainting
  • kidney issues

Close medical monitoring of the patient is required. The medications are increased and reduced to keep blood pressure within a safe range.


Doctors’ Reluctance

Doctors treating frail or elderly patients fear the above-mentioned side affects. That might be one of the factors explaining why doctors are reluctant to prescribe multiple medicines to treat blood pressure.

If an elderly patient falls, it could become a serious injury, maybe even life-threatening.

A doctor needs to take many factors into account in treating senior patients with risk of second stroke. Part of the equation might be:

  • How active the patient is in their own care and ability to manage their medications
  • How vulnerable they perceive themselves to be
  • Their ability to take part in preventative measures
  • An ability to interact with the doctor
  • The patient’s response to their health issues


Recap of Main Points

Even if the medical world doesn’t fully understand why lower blood pressure, lowers risk of stroke, the correlation is there.

Medical monitoring of a patient who is on blood pressure medicine and adjusting the dosage as necessary, is of primary importance.

It is worthwhile for all seniors to focus upon recommended points for lifestyle improvements.

Specifically for second-stroke risk, and generally for all senior health issues, medication management is crucial. Finding ways to remember to take your medicine is a project, but one that can be lifesaving.

It is worth all the required efforts to watch your blood pressure. This will help to avoid the risk of having a second stroke.


Watch your blood pressure - senior health issues - avoid a second stroke

Studies show that people who eat a Mediterranean diet are at lower risk for stroke. Doctors recommend: embrace a Mediterranean diet.


Photo by Ramiro Mendes on Unsplash

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