Can Low Blood Pressure Cause A Stroke?

Overview

Having low blood pressure can cut off blood flow to the brain, which can lead to other serious health problems and, in some cases, stroke.

What Is A Stroke?

A stroke occurs when a portion of the brain loses its blood flow, destroying brain cells. Damage to the brain can change how the body works which can influence how you think and feel. The effects of a stroke depend on where it occurs in the brain and how big the affected region is.1

Causes/Risk Factors

Risk factors for stroke include 2:

  • High blood pressure (hypertension)
  • Obesity
  • Diabetes
  • Smoking
  • excessive alcohol intake
  • Lack of exercise
  • Stress
  • High cholesterol levels
  • Brain aneurysm
  • Atrial Fibrillation 

Types Of Stroke

Strokes can be either hemorrhagic or ischemic. They have different effects on the brain and can have many causes.2 

The majority of strokes occur as ischemic strokes.  This type of stroke takes place when a blood clot prevents the brain from receiving enough oxygen and blood. Most of the time, these blood clots form in places where fat deposits called plaques have narrowed or blocked the arteries over time. This process is referred to as atherosclerosis. Your arteries may naturally get narrower as you age, but there are some things that you can do to slow down this process. 2

Hemorrhagic strokes are not as common as Ischemic strokes. They take place when an artery ruptures, causing bleeding in the brain. High blood pressure, which can weaken the arteries in the brain and increase the risk of a split or rupture, is a primary cause of hemorrhagic stroke. 2

Symptoms

Although symptoms might differ from person to person, signs and symptoms of stroke typically start off unexpectedly. Your symptoms will depend on the area and severity of the brain that has been damaged since different regions of the brain regulate different parts of the body. Common symptoms include3:

  • Sudden weakness or numbness, especially on one side of the body, in the arm, face or leg 
  • Difficulty speaking, sudden confusion or understanding speech 
  • Unexpected vision problems in one or both eyes. 
  • Sudden lightheadedness,  poor coordination, difficulty walking or losing your balance. 
  • Sudden, severe headache

Low Blood Pressure And Stroke

How Low Blood Pressure Can Cause A Stroke?

Hypotension is a condition used to describe blood pressure that is excessively low. This can decrease blood flow to the brain. This often happens when an artery is damaged or narrowed. A heart attack, significant blood loss or a serious illness can all cause low blood pressure. Each of these disorders affects the ability of the heart and blood vessels to pump blood, which raises the chance of stroke.4

Comparison Of High And Low Blood Pressure In Causing A Stroke

A stroke can also result from persistently high blood pressure since it shows that there is a lot of blood pressing against the blood vessel walls. High blood pressure makes your heart work harder and gradually damages your organs and arteries. People with high blood pressure are more likely to suffer a stroke than those whose blood pressure is normal. The inner lining of the blood vessels becomes damaged due to high pressure which will make an artery narrow.5 

Diagnosis And Treatment

Physical examinations and brain scans are used to diagnose strokes. When you are at the hospital with a suspected stroke, the doctor will do a thorough examination of your symptoms. A variety of tests can be done to confirm the diagnosis and identify the cause of the stroke. This may include a blood test to determine your blood sugar and cholesterol levels, a pulse check to look for an irregular heartbeat and a blood pressure reading.6

Strokes are diagnosed by doing physical tests and looking at images of the brain made during a scan. When you initially arrive at the hospital with a suspected stroke, the doctor will want to learn as much about your symptoms as possible.6 

This might entail doing a blood test to determine your cholesterol and blood sugar levels, monitoring your pulse for an irregular heartbeat and measuring your blood pressure. Everyone suspected of a stroke should have a brain scan within 1 hour of arriving at the hospital.6 

The two main types of scans used to assess the brain in people who have had a suspected stroke are a CT scan and an MRI scan.

A CT scan is similar to an X-ray in that it takes many pictures of your brain to create a more accurate, three-dimensional image that can help your doctor pinpoint any problem regions. A CT scan can typically determine whether you've had an ischemic stroke or a hemorrhagic stroke. It can help you get the right treatment sooner because it is often faster than an MRI scan.6

An MRI scan can be used to diagnose a transient ischemic attack (TIA). This kind of scan reveals brain tissue in more detail, enabling the identification of smaller or more unusually located areas impacted by a stroke.6

A swallow test is required for everyone who has had a stroke since the ability to swallow is frequently compromised shortly after the stroke. The test is simple. The stroke patient will be given a couple of teaspoons of water to drink. If they can do it without coughing  or choking, they will be given half a glass of water. If they are having issues with swallowing the water, they'll be referred for a more detailed assessment.6 

Heart and blood vessel tests

Tests on blood vessels and the heart can be done to identify what caused your stroke. The most common tests for this are Carotid ultrasound and Echocardiography.6

Carotid ultrasound

A carotid ultrasound scan can determine whether the neck arteries going to your brain are narrowed or blocked. In an ultrasound scan, a small probe called a transducer is used to send high-frequency sound waves into your body. These sound waves can be used to produce an image of your body's insides. Carotid ultrasonography should be performed if necessary within 48 hours.6

Echocardiography

Echocardiography produces pictures of your heart in order to look for any issues that could be linked to your stroke. Usually, an ultrasound probe is moved across your chest to do this (transthoracic echocardiogram). Transoesophageal echocardiography (TOE) is a different type of echocardiogram that is sometimes used. An ultrasound probe is usually put down your gullet (esophagus) while you are sedated. It offers a clear picture of blood clots and other abnormalities that may not be noticed with a transthoracic echocardiogram because it enables the probe to be positioned directly behind the heart.

You could be given a thrombolytic (also known as a "clot-busting" treatment) to break blood clots if you visit the hospital within three hours of the onset of your ischemic stroke symptoms.  Doctors may also recommend surgery to remove the clot or prescribe other medications, such as blood thinners, to treat ischemic stroke.6

Prevention

The best way to keep from having a stroke is to eat well, exercise often and not smoke or drink too much. Your risk of issues like atherosclerosis, high blood pressure, and high cholesterol can be decreased by making certain lifestyle modifications. 

Making these changes after having a stroke will help lower your chance of experiencing another one in the future.7

When To See A Doctor

If a stroke is suspected, seek emergency medical attention right away. The more quickly you receive stroke treatment, the less damage is likely to occur.7

Summary

Low blood pressure might make you more susceptible to strokes and other conditions. Maintaining a healthy lifestyle to keep your blood pressure at a normal level and seeing your doctor often, especially if you think you have some of the symptoms, might avoid this.

References 

  1. Types of stroke [Internet]. Stroke Association. 2014 [cited 2022 Sep 28]. Available from: https://www.stroke.org.uk/what-is-stroke/types-of-stroke
  2. NHS. Causes - Stroke [Internet]. NHS. 2019 [cited 2022 Jul 28]. Available from: https://www.nhs.uk/conditions/stroke/causes/
  3. CDC. Stroke Signs and Symptoms | cdc.gov [Internet]. Centers for Disease Control and Prevention. 2022 [cited 2022 Sep 28]. Available from: https://www.cdc.gov/stroke/signs_symptoms.htm
  4. Articles [Internet]. Cedars-Sinai. [cited 2022 Sep 28]. Available from: https://www.cedars-sinai.org/health-library/articles.html
  5. American Stroke Association. High Blood Pressure and Stroke Am I at higher risk for HBP? [Internet]. [cited 2022 Jul 28]. Available from: https://www.stroke.org/-/media/stroke-files/lets-talk-about-stroke/risk-factors/stroke-and-high-blood-pressure-ucm_493407.pdf?la=en
  6. NHS Choices. Diagnosis - Stroke [Internet]. NHS. 2019 [cited 2022 Jul 28]. Available from: https://www.nhs.uk/conditions/stroke/diagnosis/
  7. CDC. Preventing Stroke: What You Can Do | cdc.gov [Internet]. www.cdc.gov. 2018 [cited 2022 Jul 28]. Available from: https://www.cdc.gov/stroke/prevention.htm

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