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Health News for Seniors

Risk of bleeding stroke much greater if high blood pressure untreated

Important to be aware of having high blood pressure in the first place - more below story

senior man checking his blood pressure at homeFeb. 18, 2016 - Left untreated, high blood pressure may significantly increase your risk of developing a brain bleed, according to research presented at the American Stroke Association’s International Stroke Conference 2016. For senior citizens, women are more likely than men to have high blood pressure.

Intracerebral hemorrhage is a type of stroke caused by a weakened blood vessel that ruptures and bleeds into brain tissue.  High blood pressure is a powerful determinant of risk for intracerebral hemorrhage.

Researchers examined six-years of data from 4,646 patients who were white, black or Hispanic. Half of them had an intracerebral hemorrhage.

They found:

         Compared to people without high blood pressure, untreated high blood pressure increased the odds of a brain bleed by 9.5 times in whites, 9.7 times in Hispanics, and 11.1 times in blacks.

         For people with high blood pressure, untreated high blood pressure was linked to a 3.7 to 5.5 higher odds of brain bleed compared to when it’s treated.

         For patients with brain bleed and a previous diagnosis of high blood pressure, high blood pressure was more likely to not be treated in blacks (43.3 percent untreated) and Hispanics (48.3 percent) compared to whites (33.2 percent).

         Even when high blood pressure was treated, blacks still had a 75 percent higher odds and Hispanics had a 50 percent higher odds of brain bleed, compared to whites.

“The average age for a brain hemorrhage is much younger in minorities, especially in African-Americans, so they may suffer more disability earlier in life than others,” said Kyle Walsh, M.D., study author and an assistant professor of Emergency Medicine at the University of Cincinnati in Ohio.

Although it’s not completely clear why racial minorities have higher rates of untreated high blood pressure, a possible reason is access to medical care, Walsh said. 

The study analyzed data from the Ethnic/Racial Variations of ICH (ERICH) study, which followed people from 42 different sites. Each of the 2,323 people with bleeding stroke was matched with another person similar in age, gender, race/ethnicity, and geographic area, but who did not have a history of this type of stroke.

Researchers gathered blood pressure information based on participants’ medical history. They analyzed the number of cases with high blood pressure, including treated vs. untreated high blood pressure, and the associated risk of bleeding stroke.

The researchers also controlled for the effects of several factors including alcohol, cholesterol, education, insurance status, and blood thinning medications.

“It’s important to be aware of having high blood pressure in the first place, and once diagnosed, to have it treated appropriately,” Walsh said.

Co-authors are Daniel Woo, M.D., M.S.; Padmini Sekar, M.S.; Jennifer Osborne, R.N., B.S.N.; Charles Moomaw, Ph.D.; Carl Langefeld, Ph.D.; and Opeolu Adeoye, M.D., M.S. Author disclosures are on the abstract.

The ERICH study was funded by the National Institute of Neurological Disorders and Stroke.

 

Understanding Blood Pressure Readings

By American Heart Associaton

Blood pressure is typically recorded as two numbers, written as a ratio like this:

117 slash 76 mm Hg

Read as "117 over 76 millimeters of mercury"

Systolic

The top number, which is also the higher of the two numbers, measures the pressure in the arteries when the heart beats (when the heart muscle contracts).

Diastolic

The bottom number, which is also the lower of the two numbers, measures the pressure in the arteries between heartbeats (when the heart muscle is resting between beats and refilling with blood).
 


 

What is the American Heart Association (AHA) recommendation for healthy blood pressure?

This blood pressure chart reflects categories defined by the American Heart Association.

Blood Pressure
Category

Systolic
mm Hg (upper #)

 

Diastolic
mm Hg (lower #)

Normal

less than 120

and

less than 80

Prehypertension

120  139

or

80  89

High Blood Pressure
(Hypertension) Stage 1

140  159

or

90  99

High Blood Pressure
(Hypertension) Stage 2

160 or higher

or

100 or higher

Hypertensive Crisis
(Emergency care needed)

Higher than 180

or

Higher than 110

* Your doctor should evaluate unusually low blood pressure readings.

How is high blood pressure diagnosed?

Your healthcare providers will want to get an accurate picture of your blood pressure and chart what happens over time. Starting at age 20, the American Heart Association recommends a blood pressure screening at your regular healthcare visit or once every 2 years, if your blood pressure is less than 120/80 mm Hg.

Your blood pressure rises with each heartbeat and falls when your heart relaxes between beats. While BP can change from minute to minute with changes in posture, exercise, stress or sleep, it should normally be less than 120/80 mm Hg (less than 120 systolic AND less than 80 diastolic) for an adult age 20 or over. About one in three U.S. adults has high blood pressure.

If your blood pressure reading is higher than normalyour doctor may take several readings over time and/or have you monitor your blood pressure at home before diagnosing you with high blood pressure. 

Watch an animation of how a blood pressure test works.

A single high reading does not necessarily mean that you have high blood pressure. However, if readings stay at 140/90 mm Hg or above (systolic 140 or above OR diastolic 90 or above) over time, your doctor will likely want you to begin a treatment program. Such a program almost always includes lifestyle changes and often prescription medication for those with readings of 140/90 or higher.

If, while monitoring your blood pressure, you get a systolic reading of 180 mm Hg or higher OR a diastolic reading of 110 mm HG or higher, wait a couple of minutes and take it again. If the reading is still at or above that level, you should seek immediate emergency medical treatment for a hypertensive crisis. If you can't access the emergency medical services (EMS), have someone drive you to the hospital right away.

Even if your blood pressure is normal, you should consider making lifestyle modifications to prevent the development of HBP and improve your heart health.

Which number is more important, top (systolic) or bottom (diastolic)?

Typically, more attention is given to the top number (the systolic blood pressure) as a major risk factor for cardiovascular disease for people over 50 years old. In most people, systolic blood pressure rises steadily with age due to increasing stiffness of large arteries, long-term build-up of plaque, and increased incidence of cardiac and vascular disease.

>> Watch this video to learn more about your blood pressure numbers.  

>> More at American Heart Association

Other links

         High blood pressure risk calculator

         Comprehensive stroke centers may improve bleeding stroke survival.

         Costs to treat bleeding strokes increase 10 years later.

         Hispanics and heart disease, stroke

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Older, healthy adults with systolic BP below 140 have lower stroke risk

Feb. 8, 2016 — Raising the level for treatment for high blood pressure for seniors age 60 and older, who are free of chronic kidney disease or diabetes, from a systolic pressure of 140 up to 150 mmHg could put many older people at greater risk of stroke, says new research in the American Heart Association’s journal Hypertension. More...

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