Too many people die from it. Here's how to reduce the risk.
April 17, 2000 (Great Falls, Mont.) -- The numbers are startling: Every 53
seconds someone in the United States suffers a stroke, and someone dies from
one every 3.3 minutes. Strokes afflict a half million people each year, killing
about a third of them and disabling another 200,000, according to the American
Stroke Association, a division of the American Heart Association.
Right now, three million survivors are living with the life-altering
consequences of strokes, including Connie Bentley of Portland, Ore. A
cardiologist prescribed medication for her high blood pressure 10 years ago,
but because the pills made her sleepy, she stopped taking them. After all,
Bentley, now aged 49, was in peak shape at the time: She lifted weights three
days a week and ran four miles on alternate days.
Patients often have trouble talking to their doctors. It can be hard to get the words out when the topic is emotionally charged or one you’d never bring up in polite conversation.
And for various reasons, sometimes including their own embarrassment, doctors may find it hard to bring up certain topics -- and that can compromise the care their patients receive.
“Communication is an inexact science,” says Bob Arnold, MD, professor of medicine at the University of Pittsburgh School of Medicine and...
"I didn't think I needed medication because I was staying healthy by
exercising," says Bentley. So she told herself she could quit the medicine,
at least for now, and perhaps resume it in her 50s or 60s when she might not be
able to exercise as intensely. Then, two years ago, she suffered a stroke that
paralyzed her left arm and leg. Since then, she has learned to walk again, and
now lifts light weights.
The Costs of High Blood Pressure
Would Bentley have avoided a stroke if she'd stayed on her medication?
Perhaps. A study published in the February 2000 issue of the journal
Stroke reports that many strokes could be prevented if closer attention
were paid to those with hypertension (elevated blood pressure). Hypertension is
considered the most common and controllable of stroke risks, so when blood
pressure increases to a consistent reading of more than 140/90, doctors usually
begin to treat it with medication. For some people, however, the medications
don't always lower their pressure enough, and they need to be switched to other
medicines or a different dose. And some people, like Bentley, stop taking the
medication and don't bother to tell their doctors.
The price of uncontrolled blood pressure is great, according to internal
medicine physician Bruce Psaty, MD, PhD, and his colleagues at the University
of Washington in Seattle, who conducted the study. They monitored 555 patients
who had strokes despite taking blood pressure-lowering drugs. The researchers
also evaluated nearly 3,000 control patients who were also treated for high
blood pressure but did not have strokes. Their findings were striking. Blood
pressure was found to be inadequately controlled in 78% of those who had
ischemic strokes (in which a lack of oxygen damages brain tissue), in 85% of
those with hemorrhagic strokes (in which blood vessels in the brain burst), and
in 65% of the controls.
Psaty and his team concluded that uncontrolled high blood pressure raised
the odds for ischemic stroke 1.5 times and for hemorrhagic stroke 3.0 times,
compared to controls. And the higher the blood pressure, the greater the stroke
risk in both men and women, regardless of age. Overall, they estimate that a
third of strokes could have been avoided by better control of blood