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Hypertension and Afib, How They put you at Risk for Stroke

By Maris Lambie


stroke2In May 2016, two local hospitals took part in National Stroke Awareness Month. Both Unity Hospital and the University of Rochester Medical Center provided extra resources about stroke awareness, and took part in community talks to raise more awareness about the signs and symptoms of strokes.

Strokes are currently the third leading cause of death in the Western New York area, and the leading cause of adult disability in the nation.

“We wanted to focus on what were the risks, what they looked like, and what to do if someone is experiencing a stroke,” Dr. Chris Burke, director of the Stroke Center at Unity Hospital, stated, “We’re trying to make folks understand that a stroke is a medical emergency. You can’t just wake up one morning, and notice your face is drooping, or your left arm won’t move, and go back to bed. You have to call 911.”

The risks of stroke include diabetes, high cholesterol, smoking, a poor diet and little exercise, and hypertension, or high blood pressure.

According to the URMC, hypertension affects one in five Americans.

URMC officials describe a normal blood pressure as being below 120/80, with the top number measuring blood pressure when the heart is pumping, and the second number measuring blood pressure in between heartbeats.

A reading higher than 140/90 means that a patient has high blood pressure, which can lead to severe health problems.

“Hypertension weakens artery walls, leads to kidney disease, diabetes, heart failure, and is a big driver of stroke,” Dr. John Bisognano, director of UR Medicine’s Hypertension Clinic, stated.

Hypertension has also been nicknamed “the silent killer,” as most people do not know that they have it.

This can have fatal consequences, as medical experts claim 80 percent of stroke patients had hypertension.

In addition, according to the American Heart Association, African Americans are at a higher risk of hypertension.

The AHA has reported 40 percent of non-hispanic blacks have high blood pressure, and amongst non-hispanic blacks over the age of 20, “63 percent of men, and 77 percent of women, are overweight, or obese.”

The AHA has also reported cases of hypertension beginning earlier in life amongst African Americans.

“Generally, hypertension disorders are becoming more significant across the board, but there has especially been an increase in younger populations. Thirty percent of stroke patients from the past year were under the age of 65,” Burke stated.

Both Burke and Bisognano have listed diet choices, and weight, as key factors in hypertension.

Bisognano also claims these have led to an increase in hypertension in lower-income urban communities.

“It’s largely driven by weight, and sodium intake. People living in lower income areas a tend to have more processed foods, and use salt to make it taste better,” he stated. “While this does make maintaining a healthy diet more challenging, people can choose food with lower salt options.”

However, according to Bisognano, although it is hard to reverse the effects of hypertension, it can be manageable.

“Eat a balanced diet, exercise, and most people will require a medication to keep their blood pressure under control. Most of these medications are cheap and affordable,” he stated.

But, hypertension can also lead to other contributing factors of stroke such as atrial fibrillation, or afib.

The URMC describes afib as an irregular heartbeat rhythm, which can lead to weakened heart muscles that cannot pump blood regularly through the body.

In addition, the AHA has reported afib can be caused by many factors other than hypertension, such as sleep apnea, family histories, and other heart and chronic conditions such as smoking and heavy drinking.

However, it is typically seen as a medical issue that happens with age.

And, like hypertension, most people who have afib will not know that they have it.

“Seventy percent of patients won’t notice any symptoms,” Burke stated. “Some might notice heart palpitations, or shortness of breath, but most people won’t find out unless they go to the doctor, and the doctor listening to their heart notices strange sounds.”

Afib can also affect all race and ethnicities equally.

While there are also other factors affecting the risk of stroke, Burke said there is a four or five-fold risk of stroke in patients with afib, compared to those without.

But, while afib is hard to prevent, it can be easily treated with blood thinners, and medical procedures utilizing electricity, such as cardioversion, to help restore a regular heartbeat.

According to Burke, these treatments will not 100 percent prevent a stroke from occurring, but they can lead to a “sizeable decrease” of a patient’s risk of stroke.

While treating afib, and preventing hypertension are huge steps in preventing a stroke, medical experts agree that awareness of all signs and symptoms is key in reducing the number of deaths and disabilities amongst patients.

“Our awareness is the only way we can make sure folks get the appropriate treatment,” Burke stated.

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