Low blood pressure after a stroke: why and what to do, what it should be, high blood pressure, the indicator fluctuates

Stroke and blood pressure

For a number of reasons, human blood vessels can lose their elasticity and tone, and the walls become brittle and brittle. Particularly dangerous is a strong increase in blood pressure or jumps of 25-100 mm Hg. Art. This seriously increases the load on the vessels and increases the risk of stroke. Can you have a stroke with low blood pressure? What about high?

Compared to the usual level, blood pressure usually remains elevated during a stroke. The reason why an ischemic stroke occurred may be a surge in pressure. If blood pressure drops below 90/60 and remains low for a long time, brain cells suffer from a lack of oxygen in the blood. Because of this, the tissues swell and blood circulation is impaired. Thus, blood pressure during a stroke can be either high or low compared to normal. The doctor’s task is to restore blood circulation and normalize blood pressure.

Reasons for jumps

Blood pressure changes sharply after a stroke only if the patient’s internal organs fail to cope with their functions.
Most often, blood circulation in the brain is disrupted.

The main danger lies not even in the increase or decrease in blood pressure, but precisely in the fact that it is constantly changing.

In this case, cardiac and peripheral blood circulation becomes worse, the walls of blood vessels are destroyed throughout the body. Pressure surges lead to the development of an acute form of atherosclerosis, as well as repeated vascular pathologies.

The main reasons why blood pressure increases after a stroke are:

disruptions in the functioning of the central nervous system;
the vasomotor center is very inactive;
the amount of sugar in the blood is constantly changing;
the balance of hormones is disturbed;
the electrolyte composition of the blood undergoes changes.

To bring your blood pressure levels back to normal, you need to adhere to the following recommendations:

protect the patient from nervous tension;
reduce the patient's physical activity to zero;
Do not take diuretics under any circumstances;
start taking medications aimed at stabilizing blood pressure;
monitor your eating habits - eat small portions;
It is imperative to keep a blood pressure diary, the readings of which must be taken every 30 minutes.

REFERENCE! It is worth considering that with a hemorrhagic stroke there is a high risk of a recurrent attack. This usually happens 5-6 days after the first.

Signs of a stroke

Stroke can be ischemic or hemorrhagic . In the first option, blood circulation is disrupted due to cerebral edema or blockage of blood vessels, and there is no tendency for active development. In the case of hemorrhagic, the artery ruptures, causing hemorrhage, and the disease progresses quickly.

When medical care is provided within the first hours after the injury, the symptoms are reversible, and the likelihood of complications and dangerous consequences is reduced by 50-60%.

Common signs of hemorrhage in men and women are as follows:

Ringing and noise in the ears.
Dizziness.
Loss or confusion of consciousness.
Feeling of dry mouth.
Tachycardia.
Increased sweating.
Redness of the facial skin.

Other symptoms will be determined by the area of brain damage. There may be difficulty moving, problems with chewing, speaking, and loss of coordination. Paralysis of the facial muscles may occur, in which facial expressions occur only on one part of the face, while the second looks like a mask.

Hypertensive stroke

The condition of insufficient blood supply to the brain, which is provoked by a hypertensive crisis, is called a hypertensive stroke. Features of stroke of the hypertensive type are a sharp, significant increase in blood pressure and mild neurological deficit. According to the nature of the course and clinical picture, an episode of stroke resembles a hypertensive crisis. Symptoms accompanying an episode of stroke when blood pressure has increased significantly:

Pain in the head area. The pain is predominantly dull in nature, localized in the occipital and frontal region, aggravated by coughing and head movements.
Nausea accompanied by bouts of vomiting.
Dizziness, inability to maintain balance.
Impaired motor coordination.
Paresis (muscle weakness) of the limbs.
Paresthesia (sensitivity disorder).
Speech dysfunction.

The diagnosis of stroke is made on the basis of progressive neurological symptoms that occur against the background of increasing blood pressure values. During a hypertensive crisis, the patient's condition improves, signs of neurological disorders regress without a trace, when blood pressure levels decrease and return to normal.

At what pressure can a stroke occur?

Now let's figure out at what pressure a stroke occurs. All adults with vascular lesions or blood pressure disorders are susceptible to it. An ischemic stroke can appear at a reduced or normal level, when an embolus forms in the bloodstream of the brain, and a violation of fluid circulation occurs. With a strong jump or an increase of 20-30 mm Hg. Art. above the worker, the clot can break off and reach the brain along with the blood flow, blocking the lumen of the vessel.

And also read on our website: Hemorrhagic stroke - symptoms, signs, treatment and recovery

Can you have a stroke with normal blood pressure? With the ischemic type, everything is already clear. In the hemorrhagic form, since fragility and loss of elasticity of blood vessels are not always a consequence of hypertension, wall rupture is possible with any fluctuations in blood pressure.

However, since hypertensive patients are more susceptible to strokes, during an attack doctors record a level ranging from 200/120 to 280/140 mm Hg. Art. for hypotensive patients these numbers will be different – 130/90–180/110.

Pressure control in the acute period of stroke

There is no clear opinion regarding the nature of therapy aimed at reducing blood pressure in the acute stage. In 57% of cases, antihypertensive therapy is carried out upon admission to a medical facility. In 54% of cases, medications are used that the patient took before the stroke episode occurred; in 45%, doctors prescribe other antihypertensive medications.

If during a stroke in women and men, systolic pressure levels decrease by more than 20 mm Hg. Art. daily, this can be dangerous because it negatively affects the neurological status, which reflects the degree of damage to brain structures; the doctor must take into account the likelihood of an increase in the area of the infarction. The expansion of the diameter of the infarction is associated with damage to the vascular wall. Through the bursting of small vessels, blood seeps into the brain matter.

Multiple small foci of hemorrhage cause swelling of the brain tissue. When large foci of hemorrhage form, complications often arise - dislocation and compression of the brain matter, which often causes death. With a sharp decrease in blood pressure during the acute period of stroke, a repeated episode can occur within 3 months from the moment the stroke occurred. Clinical recommendations in the acute stage of stroke suggest the following tactics:

Prescription of antihypertensive drugs in the case of blood pressure values in the ischemic form above 200-220 mm Hg. Art. (systolic) or 120 mm Hg. Art. (diastolic). In the hemorrhagic form, indications for therapy are values above 180 mmHg. Art. (systolic) and 105 mm Hg. Art. (diastolic).
Lack of routine antihypertensive treatment at lower blood pressure levels.
Antihypertensive therapy of an emergency nature is carried out in patients with confirmed heart failure or myocardial infarction. Other indications: acute renal failure, aortic dissection (rupture of the intima and medial layer of the aortic wall), thrombolysis (thrombolytic therapy, destruction of blood clots due to the use of pharmaceuticals). During thrombolysis, systolic blood pressure is maintained below 180 mmHg. Art.

Recommended target values for systolic blood pressure are 100-180 mmHg. Art. (history of arterial hypertension), 160-180 mm Hg. Art. (no history of hypertension). The drug of first choice for correcting blood pressure values in the acute stage of stroke is Ebrantil (Urapidil). The drug acts as an alpha-blocker, gently, controllably reduces blood pressure.

The medicine is effective and has few side effects. A stroke without pressure is as dangerous as an episode of stroke against the background of a significantly increased blood pressure. In cases where there is low blood pressure after the onset of an ischemic stroke, the values need to be adjusted, which will improve the prognosis.

If the pressure after an ischemic stroke in the acute stage of its course decreases significantly, a search for causes is carried out. Among the possible causes, it is worth noting myocardial infarction, aortic dissection (dissecting aneurysm - rupture of the walls with blood leaking between the layers), thromboembolism of the pulmonary artery.

The pulse during a stroke against the background of myocardial infarction can drop to 50 beats/min. or increase to 90 beats/min., depending on the nature of the pathology. If it is not possible to establish the exact cause, infusion therapy with low molecular weight dextrans and crystalloid (saline) solutions - blood substitutes (Sodium chloride solution) is carried out.

In the post-stroke period after ischemic injury

When the artery responsible for feeding the brain is blocked, high pressure helps open reserve vessels and restore blood circulation. Due to this, the size of the ischemic zone is reduced. The transport of oxygen and saturation of tissues with it improves. In view of this, it is believed that an emergency decrease in pressure after an ischemic stroke can be dangerous. It is carried out only in emergency cases. On the first day, doctors can reduce blood pressure by no more than 15% of the original value. Its value is determined every half hour. The task of specialists is to eliminate factors that increase blood pressure.

Signs

It is easy to suspect a cerebral stroke based on the following clinical manifestations of a cardiovascular accident:

Pointed, intense headache in the area of development of the pathological process is a symptom that usually occurs with the development of a hemorrhagic stroke.
Impaired consciousness of varying severity - depending on the degree of brain damage, a stunned state or a complete lack of consciousness is possible (a person may suddenly fall), even to coma.
Severe nausea, which is accompanied by periodic vomiting that does not bring relief.
Change in skin color - in most cases, the facial area acquires a bluish tint (cyanosis); pallor is less common.
Development of tonic-clonic convulsions of striated skeletal muscles of varying severity. A person may fall unexpectedly (the fall is accompanied by involuntary muscle contraction).
Focal neurological symptoms - depending on the location of a sharp circulatory disorder in the brain tissue, there is a deviation (deviation to the side) of the tongue, a decrease or complete loss of all types of skin sensitivity in certain areas of the body, weakness in the muscles or a complete inability to move them, speech impairment, facial asymmetry, different pupil diameters. Focal symptoms usually appear on one side of the body. With a volumetric stroke of the brain, impaired muscle movements (paresis or paralysis) can be detected in both arms and legs.

The appearance of several signs of the development of a cerebral stroke requires immediate assistance with the initiation of adequate therapeutic measures.

Blood pressure pills after stroke

The drugs are mainly taken to lower blood pressure. This is due to the fact that it can be raised quite simply, and also because the likelihood of hemorrhage with low blood pressure is lower than with high blood pressure.

You can increase your blood pressure using natural methods: strong tea or coffee, physical activity, and so on.

The following drugs may be useful in the fight against hypertension:

Atenolol. Reduces blood pressure, normalizes pulse. The drug is quite strong, so it is important to choose the right dosage.
Clonidine. May be prescribed to dilate blood vessels.
Concor-cor. An analogue of atenolol also effectively combats elevated levels.
Diuretics may be indicated.

And also read on our website: Disability after a stroke - registration procedure

Causes of unstable blood pressure after stroke

Changes in blood pressure after hemorrhage are dangerous because they can cause the progression of atherosclerosis and new vascular lesions. The instability of this indicator after experiencing a problem may be a consequence of the following factors:

Disorders of the central nervous system.
Insufficient activation of the vasomotor center.
Fluctuations in glucose levels.
Endocrine disorders.
Autonomic dysfunctions.
Incorrect electrolyte composition of biological fluid.

After hemorrhage, it is necessary to monitor blood pressure more often than with heart pathologies. It is important to keep a measurement diary. However, if the patient is at home, these requirements are not always met, and it is difficult to assess the effectiveness of therapy. This poses a serious danger, since it will be difficult for a specialist to select the correct dosage of medications in the absence of knowledge about pressure indicators for a specific period.

Blood pressure during stroke – normal, increased, decreased

A stroke is diagnosed when there is a sudden disruption of blood flow in the vascular canals of the brain, which leads to tissue necrosis and ischemia. The main cause of blockade is increased blood pressure during a stroke.

During collapse, a certain area of the brain that is responsible for a specific function is damaged, as a result of which the victim loses one or another ability. The disease is dangerous due to its rapid development and unpredictable consequences.

Each person should monitor their blood pressure in order to begin treatment for the pathology on time.

Types and causes of brain catastrophe

Vascular channels lose elasticity due to an unhealthy lifestyle and unhealthy diet. The arteries become brittle and lose their tone.

The prerequisites for the formation of a blockade are surges in blood pressure (BP), since at these critical moments the load on the capillaries increases significantly. The period is accompanied by impaired blood circulation, hemorrhage, hematoma formation, and necrosis.

Among the reasons influencing the development of a cerebral stroke are:

arterial hypertension;
increased blood clotting;
diabetes;
arrhythmia;
atherosclerosis of cerebral arteries;
obesity;
elderly age;
psycho-emotional stress;
lack of physical activity.

Stroke is differentiated into hemorrhagic and ischemic. The latter type develops when a vascular canal is blocked and is detected most often. The hemorrhagic form is diagnosed when the arterial wall ruptures, causing bleeding. Blood clots put pressure on brain tissue, causing their death. This type is difficult to treat and usually leads to death.

Note! By providing first aid in the first hours after an impact, irreversible complications can be avoided.

In men and women, the attack is manifested by symptoms such as headache, confusion, blurred vision, numbness of the limbs, paralysis, and excessive sweating. A person’s speech becomes difficult, his smile becomes unsymmetrical, and his gait changes. The severity of symptoms depends on the health of the victim and the type of stroke.

The relationship between hypertension and blockade

For reference. Arterial hypertension several times increases the risk of hemorrhagic stroke, which is accompanied by rupture of the vascular wall and cerebral hemorrhage.

With chronic hypertension, arterial walls thicken and atherosclerotic deposits form. This leads to loss of elasticity and an increase in the diameter of the vascular channels. Aneurysms begin to appear and rupture during a hypertensive crisis—a hemorrhagic form of stroke is diagnosed.

Therefore, doctors say that an increase in arterial values increases the possibility of a brain catastrophe. Some doctors argue that high blood pressure readings after the blockade are normal, since there are no signs of heart failure.

But blood pressure after a stroke should return to normal values. If the values are not reduced, the risk of a repeat hemorrhagic attack, which usually leads to death, will increase.

In ischemic stroke , when a cerebral artery is blocked, high numbers contribute to the opening of reserve capillaries. Blood circulates through these channels, bypassing the blockade, which reduces ischemia parameters and improves oxygen supply. In the acute phase of an ischemic stroke, the medulla suffers due to a sharp decrease in blood pressure.

Normal blood pressure values

For reference. Blood pressure indicators are individual for each person, and the norm depends on many factors.

Absolutely healthy numbers range from 110-130 (systolic) and 60-90 (diastolic). Children have lower blood pressure levels than adults.

Is it possible to find out how long people are in the hospital with a stroke?

Many people are interested in what pressure can cause a stroke. Doctors say that a blow happens at any level. A jump in blood pressure is especially dangerous, since the increase is followed by a rapid decrease in values. Such changes disrupt the functioning of the cardiovascular system and provoke the development of serious complications.

Increased numbers

Increased pressure is the value of which exceeds 140-90. Detection of this indicator over a long period indicates hypertension.

Hypertensive stroke appears against the background of hypertension, if the values are not reduced.

The value depends on the volume of blood circulating through the vascular bed and on arterial resistance to blood flow.

The more blood enters the heart, the wider the diameter of the capillaries and the higher the pressure.

Note! An uncontrolled increase in values leads to the development of heart attacks and strokes.

If a person often registers figures of 150 mm when measuring pressure. Hg Art., and they do not decrease, then taking antihypertensive drugs is required. Because at such moments the functioning of the brain and heart muscle is disrupted.

Reduced values

Stroke with low blood pressure is diagnosed as often as with high blood pressure.

For reference. Often, a hemorrhagic form of collapse develops in hypertensive patients as a result of an emergency reduction in blood pressure with the help of antihypertensive drugs.

Therefore, treatment of hypertension should be carried out under the supervision of a doctor who constantly adjusts the dosage of medications.

Arterial values are reduced when readings are less than 100-60 mm. Hg Art. Despite this, many people do not feel weakness or discomfort with such numbers - this is their healthy blood pressure.

A stroke with low blood pressure can be caused by the following factors:

genetic predisposition;
physical inactivity;
diseases of the cardiovascular system;
physical and emotional stress;
diseases of the adrenal glands, respiratory tract, thyroid gland.

Low blood pressure after a stroke, accompanied by an infrequent pulse, indicates the development of heart failure. This condition is characterized by an unfavorable prognosis, since the slightest pressure difference can provoke a disaster.

Sudden changes in values

For reference. The most dangerous condition when the blood supply to the brain is disrupted is sudden fluctuations in pressure. Such changes increase the scale of brain damage and worsen the condition of arterial walls and blood circulation.

Jumps in blood levels during the rehabilitation period contribute to the development of atherosclerosis and repeated cerebral collapse. Factors influencing the instability of blood pressure include dysfunction of the regulatory system, low activity of the vasomotor region, and disorders of autonomic functioning.

Such patients are difficult to treat because it is impossible to choose the correct dosage of drugs.

Arterial parameters during an attack

In case of ischemic or hemorrhagic cerebrovascular accident, values less than 40 units between the upper and lower marks are critical.

The patient may not experience discomfort with increased blood pressure during a stroke; sometimes the state of health does not change, but destruction of brain tissue occurs. And low blood pressure may not cause painful symptoms.

Cerebellar stroke and its place among strokes

During the first hours after the impact, pressure surges are observed and arterial hypertension is recorded. If the values do not exceed 180 mm. Hg Art., then the indicators do not decrease. The situation indicates a compensatory self-defense of the body aimed at restoring brain perfusion.

For reference. High blood pressure after a stroke also indicates processes that preserve brain tissue.

A hemorrhagic attack is the most dangerous because it is accompanied by hemorrhage into the brain structures. This leads to the progression of necrotic phenomena.

The extent of damage to the brain substance will increase until excess fluid is removed from the brain tissue.

It is possible to restore blood supply to brain tissue only after reducing arterial parameters. If the numbers are high, an emergency injection of magnesium sulfate is required; if it is impossible to use an injection, adrenaline is administered in the clinic.

Elimination of post-stroke hypertension

To combat arterial hypertension, it is necessary to adjust lifestyle and diet, as well as take hypertensive drugs as a preventive measure.

Note! After a stroke, it is necessary to measure blood pressure for more than 100 days in a row.

For extremely high readings, Captopril is prescribed, which quickly reduces the readings. If the pressure has increased slightly, it is recommended to use Enalapril, Renitec. Inhibitors have a gentle effect on the body, preventing a dangerous decrease in numbers.

During the rehabilitation period, a person must donate blood to determine the concentration of glucose and cholesterol. It is necessary to regularly monitor the condition of the vascular channels using ultrasound scanning. These preventive measures help avoid recurrent circulatory disorders.

Combating post-stroke hypotension

Often the period after a stroke is accompanied by low values, which are also dangerous. But therapy that increases blood pressure is rarely practiced. When the marks on the tonometer drop to critical numbers, the patient should take Dopamine, Gutron or Dopmin.

Along with taking medications, a special diet and exercise are required. The patient should not make sudden movements or take hot baths. To prevent a lack of oxygen, it is recommended to take frequent walks and not get overtired.

To normalize nutrition, you need to exclude sugar, caffeine, carbohydrates, and fats from the menu.

For reference. The drinking regime is especially important for hypotensive patients after a stroke: you need to drink more than 1.5 liters of water daily.

How to maintain normal blood pressure after a stroke?

After suffering a blow, the patient requires control for a long time. This will not only allow you to choose the right treatment, but also prevent the recurrence of threatening conditions.

To prevent a recurrent stroke and control blood pressure, you must adhere to the following rules:

Take medications prescribed by your doctor exactly according to the schedule.
Undergo the necessary studies that will give doctors the opportunity to objectively assess the patient’s condition.
To refuse from bad habits.
Follow all the specialist’s recommendations (daily routine, exercise therapy, etc.).

Therapy is often complemented by psychological rehabilitation. This is important because the patient’s emotional state can be extremely difficult.

What is a stroke

Apoplexy or stroke is an acute cerebral circulatory disorder that can develop suddenly, for no apparent reason. Pathology, as a rule, is manifested by a deterioration in the patient’s condition, loss of consciousness, and a number of neurological symptoms. In clinical practice, there are two types of apoplexy: ischemic (blockage of a vessel) and hemorrhagic (bleeding in the brain).

Prevention

Primary prevention of hemorrhage involves identifying the patient's risk factors. If they are unchangeable, you need to undergo a detailed examination. If the causes are modifiable, then they can usually be corrected by changing lifestyle and taking medications.

After suffering a stroke, the patient should be observed by a doctor. Secondary prevention involves control of blood pressure, blood cholesterol and the functioning of the coagulation system.

Prevention of hemorrhagic stroke

After a hemorrhagic stroke, the patient needs constant monitoring of blood pressure, ECG, and examination of the fundus vessels. Repeated tomography is required to monitor the state of cerebral hemodynamics.

To restore brain function and prevent the spread of damage, the following medications may be indicated:

neurotrophic drugs;
means for improving cerebral circulation;
antidepressants;
ACE inhibitors;
diuretics.

And also read on our website: Ischemic cerebral stroke - consequences, prognosis and treatment

Sometimes medications are supplemented with surgical treatment.

Hemorrhagic stroke and consequences

With a hemorrhagic stroke, the risk of death will be higher than with an ischemic stroke. Many of the survivors become disabled. The severity of the lesion is determined by its location, blood volume and time of initiation of therapy. A major stroke can cause death in the first day. With a less serious lesion, a person may lose the ability to move normally, speak, and swallow. The thought process may be disrupted. The likelihood of serious consequences becomes lower if therapy is started within a few hours.

Types and symptoms

Stroke (apoplexy) is an acute disturbance of blood circulation in the vessels of the brain, as a result of which nerve cells are damaged or die. A certain area that is responsible for a particular nervous function suffers. The disease is dangerous due to its rapid progression and unpredictable complications.

There can be many reasons for the development of the disease - poor lifestyle, smoking, sedentary work, constant stress. But the most likely prerequisites are:

arterial hypertension;
high blood clotting;
atrial fibrillation;
diabetes;
cerebral atherosclerosis;
obesity;
traumatic brain injuries;
bad habits (alcohol, tobacco, drugs);
age-related changes in the cardiovascular system.

Obesity can lead to stroke

Depending on the degree of damage to blood vessels, stroke is divided into two main types:

Ischemic (cerebral infarction) - develops against the background of narrowing and blockage of blood vessels. Blood flow is disrupted, oxygen stops flowing to tissues, and cells quickly die. This form is most often diagnosed.
Hemorrhagic - rupture of a vessel followed by hemorrhage in the brain. A clot forms in a certain area, which puts pressure on the cells and leads to their necrosis. A more severe form of the disease that is often fatal.

There are other types of the disease:

microstroke - a sudden and short-term blockage of blood flow to the brain that does not cause pathological disorders;
extensive - severe brain damage, accompanied by swelling and paralysis;
spinal – dysfunction of blood flow in the spinal cord;
repeated - occurs in people who have undergone the acute phase as a relapse.

Ministroke – a sudden and short-term blockage of blood flow to the brain

Any, even the most minor, disturbance of cerebral circulation requires emergency medical attention. The disease develops very quickly, so the success of treatment largely depends on the speed of resuscitation measures. To do this you need to know the main signs:

Strong headache;
weakness;
curvature of facial features on one side;
unilateral limb paralysis;
confusion of speech;
violation of movement coordination.

Is it possible to have no symptoms with a cerebral hemorrhage? No, a person in a pre-stroke state looks like a drunk, he does not behave quite adequately, he walks staggering. Speech is difficult and unintelligible in places. If you ask to smile, the curvature of the lips will be unnatural, one-sided. It is important to pay attention to this from the outside, since the patient himself may not understand what is happening to him. Additionally, you need to ask to raise both hands up - the hand on the affected side will fall down of its own accord. And the handshake can be very weak. All these nonspecific signs, in fact, clearly indicate the initial stage of the disorder.

A timely response to the first symptoms of the disease in most cases saves a person’s life.

Severe headache due to stroke