Why High Blood Pressure and Cholesterol Increase Stroke Risk

A stroke occurs when the brain doesn’t get the blood that it needs. This happens when there’s a rupture or blockage in a blood vessel, or if the blood vessel becomes too narrow for blood to efficiently pass through it.

But why do these things happen to blood vessels in the first place, and how can you reduce the odds of them happening to you?

Let’s explore two conditions that cause injury to your blood vessels and put you at a higher risk of having a stroke: high blood pressure and high cholesterol.

High Blood Pressure

High blood pressure, or hypertension, occurs when the force of the blood traveling through your arteries is too high.

“As a result of excessive pressure acting on the walls of your arteries on a consistent basis, the internal lining of your arteries gets injured and leads to arterial narrowing (arteriosclerosis) and fatty deposits (atherosclerosis),” shares Ehad Afreen, MD, a vascular neurologist with ProMedica Stroke Network.

High blood pressure is the primary risk factor for both ischemic and hemorrhagic strokes. Ischemic strokes occur when blood flow to the brain is compromised. This can occur due to narrowing or blockage of the arteries. Hemorrhagic stroke occurs when a blood vessel ruptures due to an abrupt rise in the pressure on the vessel walls which causes bleeding in the brain.

Who is at risk?

Your lifestyle, any existing health conditions and family history may raise your risk for developing high blood pressure.

Lifestyle choices that may increase your risk of developing high blood pressure include eating a diet with too much salt, living a sedentary lifestyle, smoking or drinking too much alcohol.

“If you have diabetes, chronic kidney disease, sleep apnea or a family history of high blood pressure, you are at a greater risk of developing high blood pressure,” Dr. Afreen shares.

High Cholesterol

High cholesterol, or hypercholesterolemia, is a well known risk factor for atherosclerosis. Atherosclerosis occurs when there is a buildup of fatty deposits in the inner layer of the larger arteries. The deposits  combine into a plaque, called an atheroma. The fatty plaques cause large arteries, like the coronary and carotid arteries, to become narrow, leading to heart attacks and strokes.

“When the narrowing occurs in cerebral or precerebral arteries, the brain is put at risk for decreased blood flow which can then lead to an ischemic stroke, ” Dr. Afreen explains.

Who is at risk?

Again, your family history, lifestyle and existing medical conditions can put you at a higher risk of developing high cholesterol.

Living a sedentary lifestyle, eating a diet high in saturated fats, smoking, obesity and chronic steroid use are conditions that can put you at a greater risk of developing high cholesterol. Having diabetes or other endocrinological diseases can also put you at a higher risk for the condition.

However, Dr. Afreen assures that while high cholesterol is serious, it is a controllable problem.

How can you reduce your risk of high blood pressure and cholesterol?

Reduce your risk of stroke from high blood pressure and high cholesterol by visiting your primary care provider for regular well visits.

Patients above the age of 18 should be screened for high blood pressure at every visit. It is recommended that adults above the age of 35 have their lipid profile checked every two to three years. Existing conditions or a family history may prompt your provider to check for these conditions more often.

If you are diagnosed with high blood pressure or high cholesterol, it is important to actively manage the condition with medication and lifestyle modifications, such as:

• Getting regular exercise.
• Managing your stress.
• Eating a healthy diet with limited saturated fats, trans fats and salt.
• Learning to be mindful of your body and how you feel.
• Quitting smoking and reducing or eliminating excessive alcohol intake.
• Losing weight.

“Existing data demonstrates that mild to moderate reductions in weight can have a clinically significant impact on blood pressure control,” Dr. Afreen shares.

Losing weight can also help manage your cholesterol levels by reducing fatty deposits and plaque formation. This makes weight loss an integral part of any high blood pressure or cholesterol management plan.

“High blood pressure and high cholesterol work synergistically toward causing strokes,” Dr. Afreen shares. “If you have both, the negative effects are magnified and you’re at an even higher risk for stroke.”

Active, aggressive management of these conditions is integral – especially if you have both of them.

Strokes on the Rise Among Young Adults

“High blood pressure and high cholesterol are no longer conditions that are mostly seen in older individuals. We’re seeing them in younger and younger patients each year,” Dr. Afreen explains. “This is causing the number of strokes among younger people to rise.”

According to a study observing the trends of stroke in young adults, the incidence of stroke for adults in the United States aged 20 to 44 increased from 17 per 100,000 in 1993 to 28 per 100,000 in 2015.

So whether you’re 25 or 52, staying up to date on your wellness checks and actively managing any health conditions is just as important for your overall health and well-being.

Warning Signs of a Stroke

“Any abrupt loss of neurological function may be a sign of a stroke,” Dr. Afreen shares. Getting the person to a hospital as soon as possible is imperative.

BE FAST is a helpful acronym to remember when someone is having a suspected stroke. It stands for:

• Balance or coordination difficulties and dizziness.
• Eyesight changes (blurry or double vision).
• Face drooping or numbness (the smile may look uneven).
• Arm weakness (when a person lifts both arms at once, one of them may drift downward).
• Speech difficulty or trouble repeating a sentence.
• Time to call 911. Call 911 immediately and make note of when the symptoms first appeared.

If someone shows signs of having a stroke, call 911 immediately and let the dispatcher know the person has stroke-like symptoms. Stay calm and give CPR if the person does not have a pulse or stops breathing.

Ehad Afreen, MD
Dr. Afreen is a vascular neurologist with ProMedica Stroke Network. View his profile.