High blood pressure, or hypertension, is often called the silent killer – and for good reason. It creeps up with little to no symptoms, yet it can cause life-altering complications, the most devastating of which is a stroke.

How hypertension leads to stroke

According to Dr Soko, Life Rehabilitation’s Chief Medical Officer, “The main risk factor in South Africa for the development of stroke is high blood pressure. Others include diabetes, high cholesterol, smoking and obesity. But hypertension is by far the leading cause.”

To understand the connection, it helps to think of blood pressure as the force of blood pushing against the walls of your arteries. When that force stays too high, it damages blood vessels over time – weakening them, narrowing or hardening their walls, and raising the risk of blockages or ruptures.

“There are generally two types of stroke,” explains Dr Soko. “The first is an ischemic stroke, which occurs when a blood vessel is blocked, often by a clot or plaque, cutting off blood flow to the brain. The second is a haemorrhagic stroke, which happens when a weakened blood vessel ruptures, causing bleeding into the brain.”

Approximately 75% of strokes are ischemic, making them the most common type. Both forms are life-threatening, and both can result in permanent brain damage, disability, or death if not treated urgently.

Recognising the signs: The FAST test

Time is the most critical factor in saving a stroke patient’s life. The sooner a stroke is recognised and treated, the better the outcome. If you suspect someone is having a stroke, do the fast test.

• F – Face: Check for facial drooping or unevenness when the person smiles.
• A – Arms: Ask them to lift both arms; one may drift downward or feel weak.
• S – Speech: Listen for slurred or strange speech.
• T – Time: If you notice any of these signs, it is time to get emergency help immediately.

“The turnaround time from picking up the signs and symptoms of stroke at home is critical,” stresses Dr Soko. “The sooner you rush the patient for emergency care, the better the outcome. Don’t wait for an ambulance if you have access to a car, get to the emergency unit immediately.” 

Inside the emergency room: Scans and the Golden Window

Once at the hospital, speed continues to be of the essence. “It’s very, very important that we rush those patients to the emergency units,” says Dr Soko. “The next key milestone is to send the patient for a brain scan to determine what type of stroke it is.” This distinction is vital because treatment pathways differ completely. Ischemic strokes are treated with clot-dissolving medication, while haemorrhagic strokes require management to control bleeding. Giving the wrong treatment can make the situation far worse. “The golden window is about four hours from the onset of symptoms,” notes Dr Soko. “If we can open the blocked blood vessel and restore blood flow within that period, we can often limit the damage. After that, the brain tissue is damaged extensively.”

The first 24 hours: Saving lives through careful monitoring

In the first day after a stroke diagnosis, a patient’s condition can change rapidly. The Life Healthcare team keeps a close watch on vital functions like swallowing, temperature and blood glucose levels. “One of the biggest risks in the first 24 hours is the inability to swallow,” says Dr Soko. “If patients aren’t being observed properly, they can choke because of nerve coordination problems caused by the stroke.”That’s why stroke patients are often managed in intensive care during the acute phase, where multidisciplinary teams, including nurses, doctors and speech therapists, work together to stabilise them.

From survival to recovery: The role of rehabilitation

Treatment doesn’t end with survival. Regaining function and independence after a stroke is a long journey, one that requires focused rehabilitation. “Life Healthcare is one of the few private hospital groups that offers integrated care, from acute management of stroke to acute rehabilitation,” says Dr Soko. “When patients move from our acute hospitals to our acute rehabilitation facilities, their recovery continues seamlessly under an interdisciplinary team of physiotherapists, occupational therapists, speech therapists, dietitians and doctors.” Progress is measured scientifically using Functional Independence Measures (FIM) and Functional Assessment Measures (FAM), which track improvements in mobility, speech and daily activities. “This means we can prove our patients are getting better,” Dr Soko adds. “It’s not just subjective, it is measurable.”

Driving global standards in stroke excellence

Life Healthcare demonstrates its dedication to stroke care through its Stroke Restore programme, which standardises the management of stroke patients across its facilities. Additionally, Life Healthcare's excellence is recognised by the World Stroke Organization’s Angels Awards, a global initiative aimed at improving stroke outcomes. This programme helps coordinate care, educate communities and acknowledge hospitals for their outstanding stroke response. "Life Healthcare hospitals frequently receive gold, platinum or diamond awards based on our clinical outcomes," says Dr Soko. "This reflects our commitment to speed, accuracy and patient recovery."

Prevention starts with you

The most effective way to prevent a stroke is to control your blood pressure. Regular screening, exercise, reducing salt intake, maintaining a healthy weight and quitting smoking can all dramatically lower your risk. “We can’t overstate the importance of prevention,” says Dr Soko. “Stroke doesn’t happen out of nowhere. If you have hypertension or diabetes, you need to manage it. These are the same risk factors that can cause heart disease, and they’re largely preventable.” Dr Soko concludes, “Don’t try to be a hero at home. The best thing you can do for someone having a stroke is to act fast. Every minute counts, and every minute can mean the difference between recovery and permanent disability.”

Disclaimer: The information is shared on condition that readers will make their own determination, including seeking advice from a healthcare professional. E&OE. Life Healthcare Group Ltd does not accept any responsibility for any loss or damage suffered by the reader as a result of the information provided