High blood pressure and stroke

High blood pressure plays a part in about half of all strokes. But although high blood pressure is a serious condition, there are things you can do to reduce your risk of a stroke.

If you can lower your blood pressure by just 10 mmHg, you cut your risk of stroke by over 25%.

What is high blood pressure?

Your heart pumps blood all around your body through a network of blood vessels. Blood pressure is a measure of how strongly the blood presses against the walls of your blood vessels.

Your blood pressure goes up and down over the course of a day. For example, it changes depending if you’re active, resting, calm or stressed. A diagnosis of high blood pressure means that your blood pressure stays high over a long period. The medical term for this is hypertension.

High blood pressure is very common, with around 13.5 million people diagnosed in England alone, and even more who don’t know they have it.

What is the link between high blood pressure and stroke?

High blood pressure can lead to stroke in different ways. It can lead to blood clots in the brain, and can damage the tiny blood vessels deep inside the brain. It can also make a stroke due to bleeding in the brain more likely.

How is high blood pressure treated?

Your GP will advise you about reducing your blood pressure, including medication and lifestyle changes. Lowering your blood pressure, even by a small amount, can help you stay healthy.

Medication for high blood pressure

If you’re diagnosed with high blood pressure and your GP thinks you are at risk of a stroke, they will recommend a medication they think will work for you.

Whether you’re offered medication depends on your individual risk of a stroke. Things that increase your risk include a previous stroke, heart problems, diabetes and taking certain medications.

Before starting medication you will have blood and urine tests, and you may have an electrocardiogram (ECG) to check for heart problems.

If you are aged under 40 and you’re diagnosed with high blood pressure, you should be referred for checks to look for the causes of your high blood pressure.

Tailoring your treatment

There are several different types of medication for high blood pressure, and we know that age, ethnicity and family history affect how they work. Other medications can also affect how they work. So your GP works with you to make sure your prescription is tailored to your needs.

You might need to try different doses or take more than one type, depending how you respond. Blood pressure medications can be more effective in combination.

But if you are taking four different types and your blood pressure remains high, you should be referred to see a specialist.

Quick guide to blood pressure medication

Below is a list of the main groups of blood pressure medication:

1. ACE inhibitors. Abbreviated from angiotensin-converting enzyme.
2. Angiotensin-2 receptor blockers (ARB).
3. Calcium channel blockers.
4. Thiazide-like diuretics.
5. Other types of medication including beta-blockers

You can find more information about these in our Blood pressure and stroke guide. This guide can only give general information.

You should always get individual advice about your own health and any treatment you may need from a medical professional such as a GP or pharmacist.

Lifestyle changes

On top of medication, healthy lifestyle changes can often help to lower your blood pressure even more.

When you’re diagnosed with high blood pressure, you should be given advice about any lifestyle changes you need to make. It’s not always easy to do things like changing your diet or being more active, and people tell us that getting support can really help.

Ask your GP or pharmacist about local support services. Free help is available with quitting smoking, and you may also find support or apps you can use for help with eating healthily, losing weight, getting more active, cutting down on drinking, and reducing stress and anxiety.

Visit our free online self management tool to hear how others manage their risk of a stroke mystrokeguide.com

Lifestyle changes quick guide

• Reduce your salt intake. Have a look at our guide to healthy eating after stroke for some ideas on how to do this.
• Get help with quitting smoking.
• Eat plenty of fruit and vegetables.
• Lose weight if you need to.
• Reduce your alcohol intake and avoid binge drinking.
• Be more active.
• Reduce your stress levels and take time to relax.
• Try to get at least six hours sleep a night.

Monitoring your blood pressure

How often should I get checked?

• If your blood pressure is usually at the high end of normal (between 120/80 and 140/90), you should have an annual check.
• If you have been diagnosed with high blood pressure, you should be monitored until you reach your target blood pressure. Afterwards you should have an annual check.
• All adults should have their blood pressure checked at least every five years.

Home blood pressure monitoring

It’s possible to monitor your own blood pressure at home. In some areas of England, your GP may be able to let you have a home blood pressure monitor.

Some fitness trackers and mobile devices can measure blood pressure and heart rate. These can be useful for keeping an eye on your blood pressure, but most of these are not as accurate as a medical device. Ask your GP if they can use readings made by your device.

If you are thinking of buying a home monitor, ask your GP for advice about how and when to use it. The British Hypertension Society has a list of reliable monitors at bihsoc.org/bp-monitors.

Information guides

• Download Blood pressure and stroke guide (PDF)
• Download Getting active after a stroke guide (PDF)
• Download Healthy eating and stroke (PDF)
• Download How to reduce your risk of a stroke guide (PDF)
• Download Diabetes and stroke guide (PDF)

Where to get help and information from the Stroke Association

Helpline
Call us on 0303 3033 100,from a textphone 1800 0303 3033 100
Email: helpline@stroke.org.uk
Our Helpline offers information and support for anyone affected by stroke, including family, friends and carers.

Read our information
Call the Helpline to ask for printed copies of our guides.

Other sources of help and information

Blood Pressure (UK)
Phone: 020 7882 6218
Provides a wide range of information on high blood pressure.

British Heart Foundation (BHF)
Phone: 0300 330 3311
The helpline is staffed by cardiac nurses.

British Hypertension Society
Publishes a list of blood pressure monitors.

NHS Medicine Service
Pharmacy-based support service (England only)
In England, you can join the New Medicines Service (NMS) by asking your local pharmacist. This gives you three appointments with your pharmacist in a private consultation room. The service helps you with getting started, and supports you with solving any problems.

Disclaimer: The Stroke Association provides the details of other organisations for information only. Inclusion on My Stroke Guide does not constitute a recommendation or endorsement.