Doctor warns uncontrolled blood pressure is driving severe strokes

By Kisean Joseph
kisean.joseph@antiguaobserver.com
Stroke remains one of Antigua and Barbuda’s top five causes of death, with uncontrolled high blood pressure contributing to an increase in severe cases and related disabilities, a local doctor has warned as World Stroke Day was observed on Thursday.
Dr Courtney Lewis, vice-president of the Medical Association of Antigua and Barbuda and chief executive officer of Lewis Medical Associates, said stroke continues to pose a significant public health challenge, with rising cases of uncontrolled high blood pressure contributing to the problem.
“It is very much still a public health concern,” Lewis told Observer. “Doctors work tirelessly year round to try and reduce the amount of incidents of stroke that we’ve been having in Antigua and Barbuda. Unfortunately, it still remains one of our leading causes of not only death but also disability.”
Lewis said there had been no noticeable increase in strokes among young people. However, he has observed more patients suffering severe strokes and debilitating complications.
“What I have noticed is there’s a greater incidence of people having severe strokes and severe disabilities caused by uncontrolled, non-communicable diseases,” Lewis said.
The doctor explained that although stroke affects the brain, the medical profession largely treats it as a heart and blood vessel condition.
“Within medicine, we don’t tend to think of stroke as a neurological disease. We tend to think of it as a cardiovascular one, because most of the reasons why people get strokes originate with the cardiovascular system,” Lewis said.
For that reason, blood pressure, cholesterol and the health of the arteries must be closely watched. Lewis said more people locally are recording high blood pressure and suffering hypertensive crises, which in turn lead to more strokes.
When a stroke strikes, speed is critical. “As we say, with strokes, time is brain,” Lewis said.
How badly a person is affected depends on the type of stroke and how much of the brain is involved, which doctors cannot fully judge until they see inside the brain tissue. The goal, Lewis said, is always fast treatment.
Anyone who believes they or someone nearby is having a stroke should call 911 immediately and get to an emergency room “preferably within the first 60 minutes of symptom onset,” Lewis said. “That is the world standard. We call that the golden hour.”
To help the public recognise the warning signs, doctors use the FAST test. The letter F stands for facial droop, where one side of a person’s face does not move like the other when they speak or smile. A stands for arm drift, where one arm keeps falling when the person tries to hold both arms out in front of them. S stands for slurred or abnormal speech, including mumbling, losing words or speaking in a confused way. T stands for time, meaning it is time to call 911.
Lewis stressed that a person does not need to show every sign. “Any of the signs by themselves is enough to indicate that this person needs to be gotten to the ER,” the doctor said.
Lewis praised improvements in stroke care at the Sir Lester Bird Medical Centre, crediting the hospital’s neurological and emergency teams.
“Even the staff of the ER know what should happen immediately as someone with stroke symptoms is brought to the emergency room,” Lewis said.
Lewis was less certain about emergency stroke care for residents of Barbuda. “I do know that the idea would be if somebody is having a stroke to get them over to the Antigua side as fast as possible, but what facilities really exist in ensuring that that happens, I’m not sure,” the doctor said.
On prevention, Lewis urged people to get yearly check-ups and follow their doctor’s advice on more frequent visits if needed. The doctor also recommended a balanced diet low in salt and unhealthy fats, regular blood pressure monitoring, and taking prescribed medication as directed.
“Please do not let this be the monster under the bed that you ignore,” Lewis said. “This can reach out and touch anyone. No one is safe from the effects of a heart attack or a stroke, especially if you have underlying conditions that you’re not paying attention to.”