Have resistant hypertension? Cardiologist says you're at a higher risk of brain stroke

People with resistant hypertension are more prone to getting a heart attack (Picture Credit: Unsplash)

Resistant hypertension (RHTN) should be treated seriously and adequately, as it poses a significant threat to the body by greatly increasing the risk of stroke, especially in individuals whose blood pressure remains high despite using three or more medications. This World Stroke Day (October 29), it’s important to recognise RHTN as a condition that can directly put the brain at risk if left unmanaged.

What is the link between Resistant Hypertension and Brain Stroke?

Persistent high blood pressure puts strain on the vascular system. In RHTN, this pressure often goes unnoticed for years despite medication, steadily damaging arteries and the tiny blood vessels in the brain. Eventually, this leads to thickened and stiffened arteries, microvascular injury, and impaired regulation of cerebral blood flow—all of which increase the likelihood of both ischemic and haemorrhagic strokes.

According to a study, compared with patients without resistant hypertension, patients with resistant hypertension had a 14% increased risk of stroke. Co-existing risks, such as diabetes, kidney disease, obesity, and sleep apnea, often amplify this danger.

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Dr Praveer Agarwal, Chairman of Interventional Cardiology at Fortis Escorts

Heart Institute, New Delhi, said, “Resistant hypertension is not just stubborn blood pressure—it is a silent, serious threat. People with RHTN are at a substantially higher risk of stroke, often without experiencing obvious symptoms until significant damage has occurred. Early recognition, proper monitoring, and tailored management strategies are critical. On World Stroke Day, it is especially important to highlight that controlling resistant hypertension isn’t just about more medications—it’s about a comprehensive approach that includes lifestyle optimisation, adherence support, and, in selected cases, innovative therapies like renal denervation. Awareness among both patients and healthcare providers can truly make the difference between preventing a stroke and managing its devastating consequences.”

How to Reduce Stroke Risk by Treating Resistant Hypertension?

One of the most challenging aspects of RHTN is its quiet progression. Many people do not realise their blood pressure is uncontrolled until significant damage has occurred. Symptoms like headaches, nervousness, or nosebleeds may appear only in extreme cases, while most of the harm accumulates silently over time.

Treating RHTN is more than simply prescribing additional medications—it requires a strategic, layered approach. Clinicians need to rule out secondary causes, such as kidney disease, hormonal disorders, or obstructive sleep apnea. They must also ensure that patients are adhering to therapy and that lifestyle measures—diet, exercise, stress management—are optimised.

Lifestyle interventions remain important. Dietary changes like the DASH diet, which emphasises fruits, vegetables, whole grains, low-fat dairy, and lean proteins, can lower blood pressure even when medications alone are insufficient. Reducing salt intake, maintaining healthy weight, engaging in regular physical activity, and managing stress all contribute to better blood pressure control.

Going Beyond Medications

For patients whose blood pressure remains uncontrolled despite optimised therapy, Renal Denervation (RDN) offers a promising solution. This minimally invasive procedure targets overactive sympathetic nerves in the renal arteries, helping achieve sustained reductions in both systolic and diastolic blood pressure. By addressing the neural contributors to RHTN, RDN can reduce the likelihood of stroke in patients who are resistant to conventional therapies.

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World Stroke Day is a reminder that prevention and awareness can save lives. Resistant hypertension is a silent but powerful driver of stroke risk, often going unrecognised until it manifests as a serious event. Early identification, careful monitoring, and a combination of lifestyle, medication optimisation, and advanced therapies like RDN could significantly reduce the burden of stroke.

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FAQs on correlation between high BP and heart attack:

1. How is high blood pressure linked to heart attacks?

High BP forces the heart to work harder, damaging arteries and increasing the risk of a heart attack.

2. Can long-term high BP cause heart disease?

Yes. Over time, it thickens and stiffens arteries, leading to blocked blood flow to the heart.

3. What BP level increases heart attack risk?

A consistent reading of 140/90 mmHg or higher significantly raises heart attack risk.

4. What are signs that high BP is affecting the heart?

Shortness of breath, chest pain, dizziness, and fatigue may indicate strain on the heart.

5. How can I reduce my risk?

Maintain a healthy diet, exercise regularly, manage stress, and take prescribed BP medications as directed.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.