DR MOHAMED: Uncontrolled blood pressure the leading cause of preventable strokes

A normal blood pressure reading is usually around 120/80 mmHg. 

Every year, health experts continue to raise concern over the growing burden of high blood pressure and its devastating consequences. Thousands of people suffer strokes that could have been prevented with one simple action: checking and controlling their blood pressure. Yet many people walk around with high blood pressure without knowing it because they rarely get screened or do not feel sick.

The Kenya Ministry of Health estimates that nearly 7 out of 10 Kenyans with hypertension do not know they have the condition. This highlights the urgent need for regular blood pressure screening and public awareness.

In Kenya, the burden of hypertension continues to rise silently. According to findings from the 2015 STEP survey by the Ministry of Health to assess risk factors for Non-Communicable Diseases, 28.6% of Kenyan adults have hypertension, yet only 29.4% of these are aware of their condition. Even more alarming, only 6.5% were taking medication, while just 12.5% had their blood pressure adequately controlled below 140/90 mmHg. These statistics reveal a dangerous gap in awareness, diagnosis, and treatment.

Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps. A normal blood pressure reading is usually around 120/80 mmHg. When the pressure stays consistently high over time, it forces the heart and blood vessels to work harder than they should. When these numbers remain elevated for a long time, the risk of serious health problems increases significantly.

One of the most serious complications of uncontrolled hypertension is stroke, a life-threatening condition that remains one of the leading causes of death and long-term disability worldwide. The tragedy is that many of these strokes are preventable through early detection, routine screening, and proper management of blood pressure.

Hypertension is often referred to as the “silent killer” because many people experience no symptoms. This means many people with high blood pressure do not know they have it. Some people only discover they have high blood pressure after experiencing serious complications such as a stroke, heart attack, kidney failure, vision problems, or severe headaches and dizziness. This is why routine screening is so important, as blood pressure checks are quick, painless, and available at most health facilities, pharmacies, workplaces, and community outreach events.

A stroke occurs when blood flow to part of the brain is interrupted or when a blood vessel in the brain bursts. Uncontrolled high blood pressure is the leading cause of preventable strokes because it weakens and damages blood vessels over time, causing narrowing and hardening of arteries, formation of blood clots, weakening of blood vessel walls, and reduced oxygen supply to the brain. When blood cannot reach the brain properly, brain cells begin to die within minutes, which can lead to paralysis, difficulty speaking, memory loss, disability, or even death. Many stroke survivors are left with long-term physical, emotional, and financial challenges that affect not only them but also their families.

Current trends show an interesting shift in hypertension presentation. Traditionally associated with older adults, hypertension is now becoming increasingly common among younger individuals due to sedentary lifestyles, unhealthy diets, stress, alcohol use, smoking, and rising obesity rates.

However, the prevalence still increases significantly with age, affecting over half of individuals between 60 and 69 years. Hypertension is also common during pregnancy, where uncontrolled blood pressure can endanger both mother and baby.

The good news is that most hypertension-related strokes are preventable, and controlling blood pressure significantly lowers the risk of stroke and other complications such as heart failure, kidney disease, and heart attack. Simple preventive measures include reducing salt intake, eating more fruits, vegetables, and legumes, exercising for 30–45 minutes at least five days a week, maintaining a healthy weight, avoiding smoking, limiting alcohol intake, managing stress, taking prescribed medication consistently, and attending regular medical follow-up appointments. For individuals diagnosed with hypertension, treatment is often lifelong and may involve both lifestyle changes and medication prescribed by healthcare providers. Importantly, antihypertensive medications are safe and highly effective when used correctly, and patients should never stop taking their medication simply because they feel better.

The most effective way to detect hypertension early is through routine blood pressure screening. Health experts recommend that adults check their blood pressure at least once every year, and more frequently for individuals with risk factors such as family history, diabetes, obesity, or previous elevated readings.

Dr Hasham Mohamed is an assistant professor at Aga Khan University Medical College and Consultant Interventional Cardiologist at Aga Khan University Hospital, Nairobi