Ovbiagele said timing also appears to be important because the effects were most pronounced in the first six months after the primary stroke. This is just a theory, but there are a couple of other clinical studies that suggest early BP reduction after an acute stroke may be associated with some harm. This study and other recent data now suggest that there are several factors to take into consideration when lowering blood pressure to prevent stroke, including the age of the patient, level of blood pressure, any history of prior stroke, type of prior stroke and timing of prior stroke.
Media Contact: Scott LaFee, , slafee ucsd. You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Menu Search. Low systolic blood pressure may actually boost chances of recurrent stroke For patients who have suffered an ischemic stroke, traditional treatment prescribes keeping subsequent blood pressure levels as low as possible to reduce the risk of another stroke. This is because the drugs work in different ways, and rather than take more of one type, it can be more effective to take two or more different types.
You may need to try different combinations to find out which works best for you. If you need to take four or more different types of medication to control your blood pressure, you should be referred to see a specialist. How long will I be on medication? The aim of the medication is to keep your blood pressure low and stable over many years.
This helps to keep your blood vessels healthy and reduce the risk of a stroke. Some people may be advised to continue taking medication for high blood pressure for the rest of their lives. Talk to your doctor, pharmacist or stroke nurse to find out more about what is causing your blood pressure and the best treatment options for you.
Making changes to your lifestyle such as stopping smoking or losing weight can help to lower blood pressure. With support from your doctor or pharmacist, some people may eventually be able to reduce or stop the medication. If you stop taking your medication, your blood pressure will rise. This means your stroke risk will go up. If you're worried about side effects, ask for a medication review from your doctor or pharmacist.
You should have regular blood pressure checks, and a medication review every year. If you have high blood pressure during pregnancy, your blood pressure will be monitored during pregnancy, labour and after the birth. The most commonly used drug for high blood pressure in pregnancy is labetalol. These are not licensed for use in pregnancy, but they can be offered along with advice about the risks and the reasons for using it.
If you are on blood pressure medication before becoming pregnant, you might need to change to a different type as some types are not safe to use in pregnancy. You should speak to your doctor to discuss the best way to manage your blood pressure during pregnancy.
These are the most commonly used ones, but other types are also available, including beta-blockers. ACE inhibitors. These drugs are usually the first choice of treatment for people aged under 55 who are not of African-Caribbean origin.
Angiotensin II is a hormone which regulates blood pressure. ACE inhibitors stop the production of this hormone and relax your arteries, so your blood pressure falls.
ACE inhibitors seem to work better at lowering your blood pressure if you also reduce the amount of salt you eat. Possible side effects include dizziness, tiredness, weakness, rash, headaches and changes to your sense of taste.
The most common side effect is a persistent dry cough. If this is troublesome, you may be advised to try an angiotensin-2 receptor blocker medication instead see below which works in a similar way. You will have blood tests after starting or increasing your dose of ACE inhibitor to check your kidney function and the level of potassium in your blood. ACE inhibitors can cause unpredictable effects if they are taken with other types of medication including non-steroidal anti-inflammatory drugs like ibuprofen, as well as other drugs such as antacids and lithium.
Check with your GP or pharmacist before taking any other types of medication if you take an ACE inhibitor. Angiotensin-2 receptor blockers ARB.
Like ACE inhibitors, these work on the hormone angiotensin-2 by blocking its effects. They are usually used instead of an ACE inhibitor if you are not able to tolerate one. The two types of medication should not be used together. These drugs are usually recommended for people aged under 55 who are not of African-Caribbean origin.
They can be useful if you have diabetes or kidney disease as well as high blood pressure. This is because these types of drug can protect your kidneys. Possible side effects are usually mild and include dizziness, headache or cold or flu-like symptoms. Calcium channel blockers.
These drugs are particularly effective in controlling high blood pressure in people aged over 55 and in African-Caribbean people of any age.
They stop calcium from entering the muscle cells in your heart and blood vessels. This widens your arteries and lowers your blood pressure.
Examples of calcium channel blockers include amlodipine, felodipine and nifedipine. Diltiazem and verapamil may also be prescribed. Possible side effects include swollen ankles, ankle or foot pain, constipation, skin rashes, a flushed face, headaches, dizziness and tiredness. You should avoid drinking grapefruit juice while taking some types of calcium channel blockers as it can increase the amount of medication in your bloodstream.
This can make your blood pressure drop suddenly and increase your risk of side effects. Ask your doctor or pharmacist for advice. Thiazide-like diuretics are the diuretics most commonly used to treat high blood pressure. Diuretics are also known as water pills because they work by flushing out excess water and salt from the body through urine. This class of drug is often very successful in lowering blood pressure, especially in people over 55 and those of African-Caribbean origin.
You may need to have regular blood tests after you start treatment to check that the potassium levels in your blood have not dropped, and that your blood sugar level is maintained. Possible side effects include an increased need to go to the toilet, feeling thirsty, dizziness, weakness, feeling lethargic or sick, muscle cramps, skin rash, an increase in uric acid a chemical in the body that can cause kidney problems and gout , raised blood sugar levels and for men, problems with getting an erection.
Taking diuretics with beta-blockers can increase your long-term risk of diabetes. Check with your doctor whether this medicine combination is right for you. Other types of medication Beta-blockers. Beta-blockers work by making your heart beat more slowly and with less force, which reduces your blood pressure. It is important that you do not suddenly stop taking this type of medication without seeking medical advice first.
These drugs would need to be tailed off gradually. Stopping suddenly can lead to serious side effects such as a rise in blood pressure or an angina attack. Possible side effects include slowing of the heart rate, cold fingers and toes, nausea, diarrhoea, tiredness and disturbed sleep. If you are taking beta-blockers and experience difficulty breathing, or develop asthma, you should contact your doctor immediately.
Other drug groups. Talk to your doctor or a dietitian about how to lose weight safely, slowly, and permanently. Physical activity protects your heart, brain, and bones. It makes you stronger, gives you more energy, and helps you cope with daily stress. Aim for 30 minutes of moderate exercise on most days of the week. The 30 minutes could also be broken up throughout your day: take the stairs instead of an elevator, park at the end of parking lots, walk the dog, etc.
See your doctor regularly. Your doctor can check for "silent" stroke risk factors like high blood pressure and help you manage any chronic illnesses such as diabetes. The letters stand for: B: Balance - sudden dizziness or loss of balance or coordination E: Eyes - sudden trouble seeing in one or both eyes F: Face - sudden weakness of the face Does one side of your face droop?
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