Low Blood Pressure and Stroke Risk: What You Need to Know

Q: Low Blood Pressure and Stroke Risk: What You Need to Know

Hello： Generally, individuals with high blood pressure have a higher risk of experiencing a stroke. <br>Conversely, low blood pressure can lead to insufficient cerebral circulation, which may cause borderzone ischemia in the brain. <br>I wonder if you have metabolic syndrome (suc

Hypotension Stroke Examination

Hello, Dr.
Jiang.
My blood pressure is low, with a systolic pressure around 100 and a diastolic pressure around 65.
My pulse is often below 60, sometimes dropping to 50 (such as shortly after getting up in the morning or when I feel fatigued in the afternoon).
When I exercise in the park on an empty stomach, especially going uphill or on stairs, I experience dizziness and slight visual blurriness.
This condition has persisted for over six months.
Am I at an increased risk for a stroke? Additionally, I suspect I may have had a mild stroke in the past; what do you think? I would like to know if a brain X-ray or a brain ultrasound can detect whether I have had a stroke.
Which of the two is better, or should I do both? I am currently not interested in a CT scan due to concerns about radiation exposure.
Thank you and best wishes.
Gu Ding, 9/21.

Gu Ding, 70~79 year old female. Ask Date: 2018/09/21

Dr. Jiang Junyi reply Neurology

Hello: Generally, individuals with high blood pressure have a higher risk of experiencing a stroke.
Conversely, low blood pressure can lead to insufficient cerebral circulation, which may cause borderzone ischemia in the brain.
I wonder if you have metabolic syndrome (such as increased waist circumference, elevated fasting blood glucose, or dyslipidemia).
If so, you would also be considered at high risk for stroke.
Additionally, smoking can contribute to cerebrovascular disease.
It is recommended to check for risk factors related to brain and vascular diseases.
If you have concerns about radiation exposure, you may consider undergoing an MRI (Magnetic Resonance Imaging) of the brain at your own expense.
For nerve repair, it is advisable to supplement with B vitamins and manage risk factors.
I suggest consulting a neurologist to discuss testing and treatment options.
Wishing you good health and peace.
Dr.
Jiang, Department of Neurology, Taoyuan Hospital, cares about you.

Reply Date: 2018/09/21

More Info

Hello, Gu Ding. Thank you for your inquiry regarding low blood pressure and its potential relationship with stroke risk. Your reported blood pressure readings of approximately 100/65 mmHg and a pulse rate that occasionally dips below 60 can indeed raise concerns, particularly in the context of symptoms like dizziness and visual disturbances during physical activity.

Low blood pressure, or hypotension, can lead to inadequate blood flow to the brain, which may result in symptoms such as dizziness, lightheadedness, and even fainting. These symptoms are particularly concerning when they occur during exertion, such as climbing stairs or walking uphill, as you've described. The risk of stroke is generally associated with high blood pressure; however, low blood pressure can also pose risks, especially if it leads to insufficient cerebral perfusion.
In your case, the symptoms you are experiencing could indicate a condition known as orthostatic hypotension, where blood pressure drops significantly upon standing or during physical activity. This can be exacerbated by dehydration, certain medications, or autonomic dysfunction. It is crucial to monitor these symptoms closely, as they can sometimes mimic the signs of a transient ischemic attack (TIA) or a minor stroke.

Regarding your concern about having had a mild stroke, it is essential to consult with a healthcare professional who can evaluate your symptoms in detail. While imaging studies like X-rays and ultrasounds can provide some information, they are not typically the best modalities for assessing past strokes. A CT scan or MRI of the brain is more effective for detecting signs of previous strokes, such as areas of infarction or hemorrhage. While you mentioned concerns about radiation exposure from a CT scan, it is important to weigh these concerns against the potential benefits of obtaining a clear diagnosis. MRI is a radiation-free alternative that can also provide detailed images of the brain and is often preferred for assessing stroke.

If you are hesitant about undergoing a CT scan, discussing your concerns with your physician can help you explore the best options for imaging. They may suggest starting with an MRI or even a thorough neurological examination to assess your risk factors and symptoms before proceeding to imaging.

In summary, while low blood pressure can contribute to symptoms that may mimic stroke, it is essential to have a comprehensive evaluation to rule out any underlying conditions. Monitoring your blood pressure regularly, staying hydrated, and discussing your symptoms with a healthcare provider are crucial steps. Additionally, addressing any potential risk factors for stroke, such as managing blood pressure, cholesterol levels, and lifestyle factors, can significantly reduce your overall risk.

Please consider scheduling an appointment with a healthcare professional to discuss your symptoms and concerns in more detail. They can provide personalized recommendations and determine the most appropriate diagnostic approach for your situation. Thank you for reaching out, and I wish you the best in your health journey.

Similar Q&A

Understanding Blood Pressure Changes: Dizziness and Stroke Risks Explained

I usually have low blood pressure around 60-90, but now it's 85-110. Recently, I've been feeling a bit dizzy, as if I've had a little beer; sometimes it feels better, and this has been going on for several days. For someone who usually has low blood pressure, is th...

Dr. Huang Yingzhe reply Neurology
Dear hy11688, This is Dr. Huang Ying-Che from the Neurology Department of Tainan Hospital, Department of Health. Based on your description, it is important to understand why your blood pressure is higher than before. Are you currently experiencing any discomfort, such as dizzine...

Understanding Low Blood Pressure: Symptoms, Risks, and Prevention Tips

Does low blood pressure cause stroke? What are the symptoms of low blood pressure? How can low blood pressure be prevented?

Dr. Yang Guojun reply Internal Medicine
Some women are born with low blood pressure, which should not have any clinical significance. If there are any concerns, please visit the internal medicine clinic, Room 5, for an examination.

Preventing Stroke: Key Strategies for High Blood Pressure Patients

Hello Doctor: For a patient with hypertension undergoing any surgery (such as colorectal surgery), what is the likelihood of experiencing a stroke? Are there methods to prevent a stroke? What preventive measures can be taken before, during, and after the surgery? I am very concer...

Dr. Lin Zijing reply Neurology
Stroke prevention involves identifying and managing controllable risk factors such as hypertension, high cholesterol, obesity, smoking, carotid artery stenosis, and lack of physical activity. Uncontrollable risk factors include age, gender, race, and personal or family history of...

Essential Dietary Guidelines for Managing High Blood Pressure

Hello: My father has experienced two strokes, so I would like to ask how to properly manage the diet of a patient with hypertension. Are there any detailed resources on this topic (rather than general guidelines)? Thank you!

Dr. Liu Yulai reply Nutrition
Hello! I apologize for the delay in responding due to internet connectivity issues. Please forgive me! Generally, stroke can be caused by several factors, one of which is hypertension. Chronic high blood pressure can lead to the degeneration of the walls of small arteries in the ...