Prof Rónán Collins
Consultant Physician in Geriatric and Stroke Medicine, Tallaght University Hospital
Clinical Lead, National Stroke Programme and Co-Chair, Stroke Prevention and Atrial Fibrillation Ireland (SPAFI)
Modern gerontological thinking has moved increasingly from just the treatment of older people to engaging with much younger people, in terms of education and preventative intervention, with a view to ageing better.
Many of the more debilitating age-related diseases such as stroke, dementia, blindness, heart failure, atrial fibrillation and kidney disease have origins in cardiovascular disease and in particular blood pressure (hypertension).
Blood pressure is a key component of age-related disease. It is useful to think of our circulation as a closed-circuit system with a pump and pipes. Having high blood pressure is a livelong mechanism by which the heart (pump) and blood vessels (pipes) are put under stress. Continuous high pressure delivered over many years to the organs at the ‘end of the pipeline’ (end organs – brain, kidneys, eyes) causes slow accumulative damage to that organ and eventual failure.
Risk of atrial fibrillation
Blood pressure is a major risk factor for strokes of all types by damaging the vessels supplying the brain, but also through increasing stress on the heart muscle to cause an irregular rhythm known as atrial fibrillation (AF).
AF causes one in three strokes in Ireland and over two thirds of all stroke patients also have high blood pressure.
AF results in blood being inadequately mixed within the atrium of the heart (like a faulty food mixer). Clots can then form along the walls to become dislodged and fall into the main pump of the heart (ventricle) to be ‘fired’ down the blood vessels causing blockage in the brain.
AF causes one in three strokes in Ireland and over two thirds of all stroke patients also have high blood pressure. The good news is that high blood pressure can be prevented and treated. The earlier this is done, the better for your heart, blood vessels and the end organs they supply (your brain, kidneys and eyes).
Living a healthier life
If there is one thing you should do to age better and enjoy a healthier later life it is to know what you can do to prevent high blood pressure and monitor this from your forties onward.
This, coupled with knowing how to check your pulse for the presence of an irregular rhythm (atrial fibrillation) from your sixties onward are important simple measures that may result in an healthier later life.