High blood pressure, the silent stalker for stroke

Injil Abu Bakar, General practitioner, Boston, Massachusetts

"I felt fine. I looked fine. I was able to do what I wanted. I had no idea my blood pressure was rising until I had a stroke."

What is a stroke, or brain attack?

Stroke or brain attack occurs when a blood vessel in the brain bursts or get clogged. The affected part of the brain does not get the blood it needs and, in minutes, begins to die.

If you have a brain attack, you could die, suffer paralysis or have trouble talking or understanding speech. Your vision could be affected. You could also lose emotional control or become depressed. Every brain attack produces its own unique effects.

If you have the warning signs of brain attack, don't wait. Have someone drive you to the nearest hospital immediately. Every second counts!

What can you do?

Stroke is the number one cause of disability and the third leading cause of death in the United States. It is a devastating disease. That's why it's so important to minimize your risk.

Getting older, being male, being African-American, Hispanic or Asian, or having diabetes, a prior stroke or a family history of stroke all increase your risk of brain attack. You can't do anything about these risk factors.

But high blood pressure, heart disease, mini strokes (TIAs), cigarette smoking and a high red blood cell count are risk factors you can control. High blood pressure is especially significant among African-Americans. Blacks tend to develop high blood pressure earlier than whites and it's usually more severe. Blacks also have nearly double the rate of fatal strokes.

Regardless of your race, it's important that you get your blood pressure checked and treated, if it's too high.

What is high blood pressure?

Everybody has and needs blood pressure. Without some pressure in your vessels, your blood couldn't circulate through your body. And without circulating blood, your vital organs would not get the oxygen and food they need to keep working. Blood pressure is important.

Your blood pressure doesn't stay the same. It varies from moment to moment as your heartbeat adjusts to meet your body's needs. For example, your blood pressure rises when you're exercising or excited, and drops when you're resting or asleep. Changes are normal.

When your heart beats, it pump blood through large blood vessels called arteries. They conduct blood from your heart to other parts of your body. As your blood is pumped through your arteries, it pushes against the artery walls. This force against the artery walls is called blood pressure.

A healthy person's arteries are muscular and elastic. They stretch when the heart pumps blood through them; the amount they stretch depends on how much force the blood exerts.

Your heart beats about 60 to 80 times a minute under normal conditions. With each beat, it sends a surge of blood into your arteries. That makes the blood pressure in your arteries go up. Conversely, when your heart relaxes between beats, your blood pressure goes down.

This means you really have two levels of blood pressure. The higher level occurs when your heart is beating. The lower one occurs when your heart is resting. The higher reading is called the systolic pressure; the lower one, the diastolic pressure.

When a doctor takes your blood pressure, both levels are measured and recorded as numbers. For example, let's say your blood pressure reading is 124/80 (124 over 80). In this case, the systolic reading is 124; the diastolic, 80. The numbers are calculated in millimeters of mercury and are written as 124/80 mmHg.

These two numbers give important information about your health. The systolic pressure tells the maximum amount of pressure exerted on your arteries. The diastolic pressure tells the minimum pressure on your arteries. The harder it is for the blood to flow through your blood vessels, the higher both numbers will be -- and the more strain on your heart.

Normal blood pressure falls within a range; it's not one set of numbers. But it should be less than 140/90 if you're an adult. If your blood pressure goes above this threshold and stays there, you have high blood pressure.

What causes high blood pressure?

In 90 to 95 percent of high blood pressure cases, the cause is unknown. In fact, you can have it for years without knowing it. That's why it's the silent stalker -- it just creeps up on you. In the remaining cases, there is an underlying problem such as a kidney abnormality, tumor of the adrenal gland or congenital heart defect.

Why is high blood pressure bad?

It's dangerous -- by the time you know you have it, your body organs may already be damaged. Compared to people who control high blood pressure, you're seven times more likely to have brain attack; six times more likely to develop congestive heart failure; and three times more likely to develop coronary heart disease (which leads to a heart attack).

Advice you can live with:

There is only one safe way to find out if your blood pressure is high: Get id checked. If your blood pressure is normal, you should get it checked at least every two years. If your blood pressure is near the top of the normal range, or if you have a family history of high blood pressure, you're at a higher risk. Your doctor will tell you how often to have it checked.

What else can I do to reduce my brain attack risk? * If you smoke cigarettes, STOP NOW! Smoking cigarettes significantly increases your risk of brain attack. * Recognize and treat diabetes. If you have diabetes, never stop taking your medication without talking to your doctor first. * Don't drink too much alcohol. More than one drink a day may increase blood pressure. * Be physically active. Physical activity helps reduce the risk of heart disease, which is a risk factor for brain attack. Try to get 30 minutes of moderate to vigorous activity at least 3-4 times a week. * Eat a healthy diet. Enjoy foods that are low in fat, cholesterol, and sodium. * Have regular medical checkups. Good luck!