Stroke ranks among the top three causes of death among the elderly in China and is currently the leading cause of death from disease in the country. It carries high rates of mortality, disability, and recurrence. Hypertension is one of the most dangerous risk factors for strokes such as cerebral hemorrhage and cerebral infarction.
Dr. Wang Jingqing, Director of the Department of Cerebrovascular Diseases at Nanjing Municipal Hospital, explains that stroke corresponds to "wind-stroke" in traditional Chinese medicine. It is a disease caused by blockage or rupture of cerebral blood vessels, leading to damage in brain tissue function or structure. Its pathological basis is cerebral atherosclerosis, and hypertension is one of the key factors promoting the onset and progression of cerebral atherosclerosis.At atherosclerotic sites, arterial wall thickening, lumen narrowing, or plaque rupture can trigger thrombus formation. Additionally, embolism from certain large arterial thrombi can cause cerebral artery blockage, leading to insufficient cerebral blood supply or cerebral infarction. Hypertension is also a common cause of cerebral hemorrhage.Yangtze Evening News/Ziniu News reporter Cai Yunqi
Be Vigilant for Warning Signs to Avoid "Cerebrovascular Accidents"
Strokes onset abruptly, hence the term "cerebrovascular accident." However, most stroke patients experience some warning signs beforehand, often appearing minutes, hours, or days before the event.Director Wang explains: Cerebral hemorrhage is often triggered by activities such as emotional agitation, excessive alcohol consumption, or extreme fatigue. Some patients experience warning signs like dizziness, headaches, nosebleeds, or conjunctival hemorrhage before onset, accompanied by elevated blood pressure.In severe cases, patients may suddenly collapse, exhibiting neurological damage symptoms and signs like facial drooping, fixed gaze, limb paralysis, and incontinence. This may be accompanied by vomiting bloody stomach contents or life-threatening complications like gastrointestinal bleeding.In contrast, cerebral infarction typically occurs during rest, often presenting as sudden hemiplegia upon waking in the morning. Patients usually remain conscious, with noticeable changes in pulse and respiration, gradually progressing to hemiplegia, monoplegia, aphasia, or hemianopia.Prior to onset, some patients may experience transient ischemic attacks (TIAs) such as dizziness, headache, sudden speech difficulty, limb weakness, numbness, or heaviness, which resolve within minutes to an hour. Director Wang noted: "Some hypertensive patients exhibit no symptoms or only mild, overlooked signs until experiencing cerebral infarction or hemorrhage, serving as a cautionary reminder."
Preventing Cerebrovascular Accidents Starts with Proper Medication Use
Controlling blood pressure is paramount in preventing cerebrovascular accidents caused by hypertension. Director Wang Jingqing emphasized that rapid blood pressure reduction must be avoided when taking antihypertensive medications.Blood flow to brain tissue relies primarily on blood pressure. Since most hypertension stems from arteriosclerosis, abrupt blood pressure reduction diminishes cerebral blood flow, causing sudden insufficient perfusion and increasing stroke risk. Additionally, sudden drops in blood flow velocity raise blood viscosity, allowing platelet and fibrin deposition to form clots—further triggering cerebral infarction.Director Wang emphasized: Blood pressure regulation is a dynamic process. Patients without prior stroke should maintain stable blood pressure levels through long-acting medications or low-dose combination therapy to avoid fluctuations. During acute cerebral infarction, normalizing blood pressure is not recommended; adjustments must be tailored to the patient's specific condition.
If a family member shows signs of sudden stroke or rapidly rising blood pressure, relatives should not hastily attempt to lower it to normal levels with medication. Instead, promptly contact emergency services (120) for guidance and immediate cardiopulmonary resuscitation. Medical professionals will adjust treatment based on the patient's condition.Beyond hypertension patients who fail to receive timely treatment or discontinue medication, causing blood pressure fluctuations that increase stroke risk, experts also note that multiple risk factors combined significantly elevate stroke susceptibility. These include patients with diabetes and hypertension, those with hypertension showing left ventricular hypertrophy on electrocardiograms, and hypertensive patients over 50 years of age.Director Wang Jingqing recommends that hypertensive patients achieve blood pressure control through non-pharmacological approaches such as weight loss, dietary restrictions, sodium reduction, alcohol abstinence, and increased physical activity. These methods may be combined with Western medication to lower blood pressure. Additionally, actively managing metabolic syndrome conditions like dyslipidemia, diabetes, hyperuricemia, gout, and hyperhomocysteinemia can help prevent cerebrovascular diseases.