You have had a stroke. Hopefully, you went to the hospital when you developed your symptoms of weakness, numbness, altered speech or visual impairment. Your hospital care enabled you to limit the damaging effects of the loss of circulation to a portion of your brain. You’ve made it through the acute phase of stroke management. Now what?

You will want to obtain the best achievable outcome from the impairments you already have. If you have “motor” impairments weakness or clumsiness you can rest assured that randomized, controlled trials — the gold-standard method for determining a treatment’s effectiveness — have shown that physical therapy can improve your level of functioning. If you have speech impairment, then speech therapy might be beneficial, though this has never been proved by means of randomized, controlled trials.

While it is important to focus on rehabilitation following a stroke, there are also other issues to attend to. As a survivor of a stroke you are at increased risk for another.

Researchers at the Mount Sinai School of Medicine and Columbia University in New York studied 655 people who suffered first ischemic strokes. Ischemic strokes are due to plugged blood vessels and not bleeds, and comprise 85-90 of all strokes. Publishing their results in a March 2006 issue of the journal “Neurology,” the investigators found that in the first five years following the stroke there was an 18 likelihood of another. Over the same time period the research subjects also experienced a 5 likelihood of a heart attack.

Can you improve your odds? Absolutely! The process of using information from the first stroke to help prevent another is called “secondary stroke prevention.” The idea is that if there is something that can and should be done to reduce one’s risk, now is the time to do it. There is no point in waiting for yet another attack to occur before getting started.

A blue-ribbon panel from the American Stroke Association and American Heart Association reviewed the state of knowledge concerning secondary stroke prevention for patients with ischemic strokes and published their results in a March 2006 issue of the journal “Circulation.” They found that use of blood-pressure-lowering medications has a powerful effect in reducing the risk of a second stroke — ranging from 24-43 in better studies — and this benefit might even extend to patients who have normal blood pressure to start with.

If you have diabetes, then it is especially important to control high blood pressure. Using a medication from the groups of drugs known as “angiotensin converting enzyme inhibitors” ACEIs and “angiotensin receptor blockers” ARBs will not only help control blood pressure, but will additionally help protect the kidneys. If you have diabetes, then it is also important to consider use of cholesterol-lowering medication, especially from the class of drugs known as “statins.” Statins can additionally benefit people without diabetes and even those without elevated cholesterol levels. Of course, in diabetes it is also important to keep the blood-sugar levels as close to normal as is humanly possible.

Quitting smoking is also pivotal in preventing another stroke, and it is never too late in the game to benefit from this difficult but important change. Consumption of more than two standard drinks of alcohol per day also increases the risk of stroke and should be avoided. If you are obese, then it is in your best interests to lose weight through a combination of calorie reduction and sensible exercise.

If your hospital studies showed that a carotid artery is 70-99 narrowed severe stenosis and your recent stroke was downstream from this blood vessel, then you are much less likely to have another stroke if you have a surgical clean-out endarterectomy by an experienced surgeon whose complication rate is less than 6. If you have severe narrowing, but because of some medical or surgical problem the surgery is considered too risky, then insertion of a stent into the narrowed artery can serve as a substitute for endarterectomy.

The carotid arteries are pulsating blood vessels in the front of the neck that carry blood to much of the brain. If the carotid artery on the same side of the stroke is 50-69 narrowed moderate stenosis, then an endarterectomy can be considered, but the benefit of surgery in these circumstances is much less clear-cut. If the narrowing is less than 50 mild stenosis, then you are better off leaving the artery alone.

The above recommendations are based on studies in people with atherosclerosis hardening of the arteries which is the most common cause of strokes and, for that matter, heart attacks. But not every stroke is caused by atherosclerosis. That’s why medical testing is important in stroke patients — so that treatment can be tailored to individual circumstances.

What about blood-thinners? If you have atrial fibrillation a specific pattern of irregular heartbeats then you are at particular risk to have a stroke due to a blood clot being thrown into the circulation from the heart. In this case warfarin Coumadin is the blood-thinner of choice. If for some reason the warfarin cannot be tolerated or is considered too risky, then aspirin is a second-best choice.

If your stroke was due to atherosclerosis, then studies support the use of an “anti-platelet” drug. Platelets are the building blocks from which blood clots are made, and anti-platelet drugs interfere with the ability of the platelets to clump together to form a clot. Antiplatelet drugs of first choice include aspirin by itself, aspirin in combination with extended-release dipyridamole Aggrenox, and clopidogrel Plavix.

It’s important to realize that patients who address every risk factor for a second stroke are likely to have the best outcome and the lowest chances of another attack. Handling some risk factors and not others is better than doing nothing at all, but in fighting off a second stroke, you want to use every weapon in your arsenal.

C 2006 by Gary Cordingley

All strokes damage the brain by disrupting circulation, but strokes come in multiple varieties. Because different parts of the brain are specialized to perform specific functions, symptoms produced by strokes vary according to what part of the brain was injured. In one patient the symptom might be weakness on one side of the body. In another it might be a partial loss of vision. In still another, a loss of speech. And symptoms can vary in intensity from mild to severe according to how large the area of damage is and whether it occurred in a pivotal location.

Strokes can also vary according to another fundamental difference — whether they involve a blocked blood vessel or a hemorrhage. Most strokes are due to the former in which brain-tissue damaged by lack of circulation is called an infarction. But 10-15 of strokes involve bleeding from ruptured blood vessels within the brain tissue, and while it’s bad enough to have an infarction, hemorrhagic strokes intracerebral hemorrhages can be even more devastating.

One prominent figure with spontaneous intracerebral hemorrhage is Ariel Sharon, whose hemorrhagic stroke occurred while he was still prime minister of Israel. Although some patients with intracerebral hemorrhage recover to a point of being able to enjoy other people and regain some independence in functioning, Sharon’s poor clinical outcome is all too common in patients with this disease.

The additional problem with hemorrhagic strokes is that the new deposit of blood occupies space — sometimes a lot of it — and there is only so much space within the skull braincase to go around. The fresh hemorrhage crowds and distorts the brain-tissue next to it, and additionally subjects the rest of the brain to increased pressure that can itself be damaging. Because of these distortions and pressure-changes, a patient with intracerebral hemorrhage often shows a decreased level of consciousness or even coma.

Another kind of spontaneous bleed within the braincase is subarachnoid hemorrhage, often caused by ruptured aneurysms outside the brain but inside the braincase. While this, too, is a very serious condition, it is not the focus of this particular essay, and spontaneous intracerebral hemorrhages are not caused by aneurysms of this kind. Yet another kind of bleed that can be confused with primary intracerebral hemorrhage is secondary hemorrhage. This occurs in some patients who started out with infarctions of the brain but who had subsequent bleeding from fragile blood-vessels around the infarction’s edges. This kind of bleed is not quite as serious as that which occurs when the bleed is primary the initial event.

How are intracerebral hemorrhages diagnosed? Since the 1970s when computed tomographic CT scans were introduced, this imaging technique has been the most effective and sensitive tool. A fresh hemorrhage within brain tissue is dramatically evident on CT scans. And unlike infarctions that can take a day or two to show up on CT scans, hemorrhages are already visible at the earliest moment a scan can be made.

Although surgical removal of blood-clots from the surface of the brain — called subdural and epidural hematomas — can be life-saving and function-sparing, surgery for a bleed hematoma or blood-clot within the brain tissue itself is another story. Some studies comparing outcome between operated and unoperated patients with intracerebral hemorrhage showed improved outcome, on average, for operated patients, while still others showed worsened outcome. Operated or unoperated, patients had high rates of death and disability.

Because of the limited prospects for meaningful improvement, surgery for intracerebral hemorrhage is often an act of desperation. One crusty old clinician was blunt about the direness of the situation, saying, “Show me a patient with intracerebral hemorrhage whose life was saved by surgery, and I’ll show you a patient you wish you hadn’t operated on.” His point was that survivors of this operation usually show severe impairments.

However, one form of hemorrhage within brain tissue is probably a special case, and that is hemorrhage within the cerebellum, located within the bony braincase just above the nape of the neck. Surgical extraction of blood clots occurring within the cerebellum prevents excessive pressure on the nearby brainstem that handles a lot of basic and necessary functions, like breathing.

Administration of cortisol-type steroids is a nonsurgical treatment that has been studied in a scientific way, comparing treated patients to untreated patients with the same condition. The steroids didn’t help. Decreasing the patients’ blood pressures by administering medication has likewise been studied, but with the same outcome — no benefit. However, in a preliminary study one nonsurgical treatment showed promise. Intravenous administration of activated factor VII a natural component of the blood-clotting system reduced expansion of the intracerebral blood-clot, death and disability when given within four hours of the initial hemorrhage. A larger study is underway to see if this benefit holds up under further analysis.

Otherwise, what can be done acutely for this condition? Individualizing treatment seems rational, even if unproved. For example, if the patient had a bleed while taking a blood-thinner as was the case with Ariel Sharon then it makes sense to stop the blood-thinner or reverse its effects. Supportive management, like administering intravenous fluids to prevent dehydration, monitoring for irregular heartbeats and protecting the patient’s airway also make sense. If the patient can’t consume food in the usual way, feeding through tubes or intravenous lines can be considered, though this decision can be postponed until the patient’s prospects are more apparent.

Who is at risk for intracerebral hemorrhage? Neurologists at Malmo University Hospital in Malmo, Sweden, compared 147 patients with intracerebral hemorrhage with 1029 similar but stroke-free patients in order to determine risk factors. They found that hypertension high blood pressure, diabetes, elevated triglyceride levels in the bloodstream, history of psychiatric problems, smoking and surprisingly short stature were more frequent in patients with intracerebral hemorrhage.

However, when it comes to modifiable risk-factors those that one can do something about a variety of studies indicate that hypertension is the single most important factor. Thus, treatment of hypertension, when present, is probably the single most effective thing that one can do in order to prevent this disease.

C 2006 by Gary Cordingley

High blood pressure, or hypertension, is a serious condition and is often dubbed the silent killer because it can do so much damage to your body before you even know you have it.
High blood pressure can cause heart failure, stroke and even death in the most serious cases. And, did you know that some of the medications your doctor may prescribe could do almost as much damage as the high blood pressure itself? Such medications can have rather serious side effects including dizziness, nausea, stomach problems, loss of appetite, fatigue, impotence and insomnia.

Herbs for Hypertension

There are a number of scientific studies that indicate that a natural approach or treatment for your high blood pressure could be an effective alternative. There are many different herbs that are used to treat hypertension, including the following

Hawthorn, also known as Crataegus Oxyacantha, is a well-known heart tonic and is one of the best safe herbal supplements to help treat hypertension. By dilating the blood vessels Hawthorn can provide your heart with the level of energy it needs to pump your blood. Hawthorn is full of anti-oxidants, which can keep plaque from building up on the arterial walls and reduce the risk of a heart attack. It works only it its taken consistently for a long period of time.

You can find hawthorn in herbal formulas designed to treat high blood pressure. Also, you can make a tea with this herb by adding two teaspoons of crushed leaves and berries to a cup of boiling water. Let it steep for approximately twenty minutes, then strain and drink. You may drink up to two cups of this tea per day.

Another highly studied herb that is used to treat hypertension is Passiflora Incarnata. This herb contains different natural chemicals that help to calm the entire body, relax the blood vessels and help reduce overall blood pressure. To make a tea using passion flower mix a teaspoon of dried leaves with a cup of boiling water and let it steep for about fifteen minutes. Strain and drink before going to bed.

Viburnum Opulus, also known as Guelder Rose bark is considered a cardiac tonic. It helps to relax the body and get rid of the tension that usually is associated with high blood pressure.
To learn about other herbs used to treat hypertension visit

Pulmonary hypertension is due to increase in pressure of pulmonary artries. Some diseases can narrow the blood vessels in the lungs, which leads to high blood pressure in the lungs even when blood pressure in the rest of the body is normal. It may be due to lung diseases or heart diseases. Pulmonary hypertension is a highly fatal disorder since the strain of pumping blood through narrowed vessels often leads to failure of the heart muscle. When the heart muscle fails, the lungs cannot supply enough oxygen to meet the body’s needs.

There are various treaments available for pulmonary hypertension. Goals of treament are
Dilate pulmonary vessels
Decrease thickening of blood
Decrease preload on heart
Increase oxygen supply to lungs
Prevention and treatment of respiratory infection
Increase cardiac output
Treat cause of secondary Pulmonary hypertension.
Any treatment which dilates pulmonary vessels can decease pulmonary hypertension. Treatments for this disorder widen the damaged blood vessels in the lung and make it easier for the heart to pump blood through the lungs. How can we dilate these pulmonary vessels?

One such drug epoprostenol is effective only if given intravenously through a small plastic tube that must remain in the vein permanently. Another treatment involves continuous inhalation of a gas nitric oxide that also widens blood vessels in the lungs. A newer approach has been an inhaled mist form of epoprostenol called iloprost. Because each mist treatment lasts only about 60 minutes, up to 12 treatments each day are required. Each of these treatments has its drawbacks and side effects. You cant take these orally, and have shorter duration of action. Recently, researchers learned that a drug Viagra sildenafil citrate the erectile-dysfunction drug used by more than 26 million men worldwide,can enhance and prolong the actions of both iloprost and nitric oxide.

Viagra’s Active Ingredient Treats Pulmonary Hypertension
New drug Revatio, which contains sildenafil citrate, the same active ingredient found in the erectile-dysfunction drug Viagra, has been approved by the Food and Drug Administration FDA for treating pulmonary hypertension. Revatio is white and round; Viagra is a blue diamond.Will the drug work long-term? “Only time will tell,” says Norman Edelman, medical director of the American Lung Association. “Anything that lowers blood pressure in the lungs and can do it over time will probably prolong life.”

Good thing about this drug “it can be given orally, rather than intravenously or in an injection.” The only other drug that can be given orally, Bosentan, can damage the liver. Studies are underway to see whether Revatio can be given with Bosentan and other drugs to yield an even bigger benefit.

Revatio’s known side effects are typical of those for Viagra blue-tinged vision, muscle aches, flushing. Unwanted erections have been noted but very rare cases.

Although survival rates over 18 months increased from 65 to 95 with the use of Revatio, it is unknown if the drug will work long-term. When combined with standard treatments for pulmonary hypertension, sildenafil may significantly improve control of this fatal disease. Because experience with this treatment is limited, it is too early to make firm recommendations for treatment.

This article for Patients of pulmonary hypertension is presented for informational purposes only. This article is not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician

If you want to know more about , visit our site highbloodpressuremed.com

In Chinese Medicine, many of the symptoms of high blood pressure, such as pounding headaches, dizziness, and pressure behind the eyes are often related to a pattern of Liver Yang Rising or Liver Heat. It is important to see a physician for proper diagnosis and supervision of high blood pressure, but acupuncture and Chinese herbal medicine may also be useful for managing your condition. Certain herbs have been shown to have an anti-hypertensive effect. Certain other herbs have been shown to be useful for controlling cholesterol levels and improving cardiovascular function. Acupuncture has been shown to have a general relaxing effect which can be useful in stress related or essential hypertension. In addition, certain points are commonly used in the treatment of patterns that relate to high blood pressure.

One commonly used herb for symptoms and patterns related to high blood pressure is Tian Ma or gastrodia rhizome. Research in China has shown it to be useful in the treatment of symptoms related to high blood pressure such as dizziness, numbness of extremities, tinnitus, headaches, and pain behind the eyes. It may have a sedative and tranquillizing effect. It has been shown to have usefulness for renal hypertension and essential hypertension. Another useful herb is Ye Ju Hua or chrysanthemum flower, which has been shown to have a prolonged effect of lowering blood pressure through peripheral vessel dilation. It has also been shown to increase blood flow to the heart. Another herb that is used to clear Liver Heat and is commonly used to treat eye problems that may be beneficial for high blood pressure is Xia Ku Cao or prunella. Chinese research has shown that it has a moderate vasodilating effect. These herbs are often used in combination by practitioners of Oriental Medicine in the treatment of patterns related to high blood pressure.

Other herbs may be useful for improving heart and circulatory function. They may also help reduce cholesterol. Shan Zha, or hawthorn berries, have been shown to reduce cholesterol when taken for six weeks or more. It is often used in China to improve circulation and to treat angina pectoris. Another herb that is commonly used in China for cardiovascular problems is Dan Shen, or Salvia. It has also been shown to reduce cholesterol. It also may improve microcirculation in the body. In China, pills of Dan Shen are used in the treatment of angina and in the treatment of coronary heart disease. It also may help promote repair and regeneration of tissues by increasing the bodys metabolism.

Certain acupuncture points are also known to be useful in the treatment of patterns related to high blood pressure. Large Intestine 4 is a point that many people know can help to control headaches. It is on the back side of the hand in between the thumb and index finger. It is also commonly used point for blood pressure related patterns. Another point at the vertex of the head, Du 20, is also commonly used. An acupuncturist or Chinese herbalist always takes an inventory of symptoms, along with looking at a persons tongue and feeling a persons pulse in order to determine the specific combination of points and herbs that a person needs. Different people with high blood pressure are treated differently depending on the pattern they present.

During my time in China, I did clinical rounds in the cardiology department at the Chengdu Traditional Chinese Medicine Hospital. Modern drugs and diagnostic equipment were used hand in hand with Chinese herbs and acupuncture in order to treat conditions such as high blood pressure, angina pectoris, cardiac arrhythmias, heart enlargement, and stroke. I even saw Chinese herbs, such as Dan Shen, being given in intravenous and in injectable form. The conditions were diagnosed using modern science and traditional Chinese diagnosis. Drugs were used for symptom control and for emergencies. As peoples condition improved with the use of Chinese herbs and acupuncture, their doctors slowly adjusted the dosage of drugs that they received. The results I saw were better than either form of medicine could have achieved alone. We do not have the benefit of experiencing such a deep synthesis of modern medicine and ancient techniques yet in the West. Nevertheless, I believe that as people learn more about the benefits of Asian medicine, we may someday come close to achieving a more integrated system of care in the West that will be more clinically effective, more cost effective, and result in fewer side effects.

Hypertension is another word for high blood pressure. According to the Merriam Webster dictionary, hypertension is abnormally high blood pressure and especially arterial blood pressure.

High blood pressure occurs when the arteriole arteries narrow, making it difficult for blood to pass through them. This forces the heart to pump harder to get the blood through. As the pressure increases above normal and is sustained, the result is high blood pressure.

High blood pressure is a common problem. It is the most common chronic illness in the United States. Almost twenty five percent of Americans have it, and a significant number of them do not realize they have it. That is because high blood pressure causes few, if any symptoms, until it has reached an advanced stage. This makes it important to have your blood pressure checked regularly.

High blood pressure is a very dangerous disease to have and leave untreated. High blood pressure significantly increases a persons risk for stroke, heart failure, heart attack, kidney disease, vision impairment, dementia, and premature death. Left untreated, high blood pressure can shorten a persons life by up to twenty years. Despite these alarming facts, a little over fifteen percent of the people in the United States who have high blood pressure and know they have it do nothing to control it.

There is no cure for high blood pressure but it is very treatable

There have been substantial advances in knowledge about and treatment of high blood pressure in the past several decades. Increased awareness and medical advancements in regards to high blood pressure have helped decrease the number of deaths from strokes by seventy percent and the number of deaths from heart disease by more than fifty percent according to data from the Mayo Clinic.

The risk of developing high blood pressure increases as a person ages. Race is also a determining risk factor. Black Americans have the highest risk of developing high blood pressureabout thirty-three percent of black Americans have it. Approximately twenty-three percent of white Americans have high blood pressure, making them the next highest risk group. Twenty-one percent of American Indians have high blood pressure. Eighteen percent of the American Hispanic population has high blood pressure and sixteen percent of Americans of either Asian or Pacific Islander descent have high blood pressure according to information from the Mayo Clinic.

Family history is a risk factor as well. If high blood pressure runs in a persons family they have a higher risk of developing it. Gender is another factor. Up to age fifty-five, men are more likely to develop high blood pressure. After the age of fifty-five, women have a higher risk of developing high blood pressure.

Other factors that increase a persons chance of developing high blood pressure include being overweight, having a sedentary lifestyle, smoking or chewing tobacco, excessive alcohol consumption, and low potassium levels.

Some illnesses raise a persons risk of developing high blood pressure. If a person has heart disease, diabetes, high cholesterol or sleep apnea they have a greater risk of developing high blood pressure.

There are two different forms of high blood pressure, essential high blood pressure and secondary high blood pressure. Essential high blood pressure is the most common form of high blood pressure. It is also known as primary high blood pressure. It does not have any obvious causes.

Secondary high blood pressure is when the cause of the high blood pressure can be attributed to another disease. Only five to ten percent of high blood pressure cases are secondary. Some of the diseases and disorders that cause secondary high blood pressure are kidney disease, renal artery obstruction, hyperthyroidism, hypothyroidism, hormonal abnormalities, and preeclampsia.

It is common for people with untreated high blood pressure to have plaque accumulate in the major arteries of the heart. The plaque deposits reduce blood flow to the heart and can eventually cause a heart attack. High blood pressure narrows the arteries and blood vessels in the body. Getting oxygen rich blood to the heart becomes more difficult as the arteries get narrower. If the heart cannot get enough oxygen, it will cause a heart attack.