Bengaluru: Chronic lifestyle diseases such as hypertension and diabetes are silently fuelling the risk of stroke — one of the world’s leading causes of death and long-term disability — warn neurologists.

Speaking to Mathrubhumi, Dr Shobha N, Consultant - Neurologist and Stroke Physician at Manipal Hospital, Malleshwaram, said that chronic health conditions such as diabetes and high blood pressure are quietly increasing people's chances of having a stroke, which is the world's leading cause of disability and death.

"It weakens arteries, including those in the brain, making them prone to rupture under intense pressure, resulting in haemorrhagic stroke or intracranial haemorrhage,” she added.

She explains that high blood pressure not only narrows arteries and increases resistance but also reduces blood flow to the brain and damages the endothelium, the inner lining of blood vessels.

“This damage can lead to clot formation, blocking vessels, and causing ischemic strokes. Furthermore, hypertension accelerates atherosclerosis, reducing blood supply, and may cause fibrinoid necrosis, another trigger for stroke,” Dr Shobha added.

The presence of diabetes further compounds these risks. “Diabetes stiffens arteries, promotes systemic inflammation, and impairs endothelial function. Often accompanied by hypertension, diabetes heightens stroke risk and can lead to atrial fibrillation — a cardiac condition that further increases the likelihood of stroke by sending clots to the brain,” she notes.

Emphasising the emotional and human side of stroke care, Dr Shobha adds,

“Hypertension and diabetes are not just medical terms; they’re silent thieves, robbing us of cherished memories.

High blood pressure weakens brain arteries, risking catastrophic bleeds or blockages, while diabetes fuels inflammation and vessel damage, often alongside hypertension. I’ve held the hands of patients relearning to speak, their eyes reflecting lost dreams.

Yet, every small step – controlling blood pressure, managing diabetes with lifestyle changes – is a victory. Let’s protect our loved ones by choosing health, turning potential heartbreak into stories of hope and resilience.”

Echoing similar concerns, Dr Shivananda Pai, Consultant - Neurology, KMC Hospital, Dr BR Ambedkar Circle, Mangalore, says both diabetes and hypertension are “important risk factors for stroke,” contributing to both large vessel and small vessel strokes.

“If the patient has other co-morbidities, the incidence of stroke magnifies further. Uncontrolled sugars and hypertension lead to accelerated atherosclerosis and increase the incidence of stroke,” he says.

Dr Pai adds that when these disorders are well controlled through medicines such as antiplatelets and cholesterol-lowering drugs like statins, the risk of recurrent strokes reduces significantly.

“Most patients have dyslipidaemia associated with these diseases. When controlled with statins and cholesterol-lowering medicines, the incidence of stroke reduces significantly,” he explains.

He also stresses that lifestyle modification, including regular exercise, a balanced diet, and behavioural changes, can help maintain normal blood pressure and sugar levels, thereby cutting stroke risk.

“Diabetes and hypertension put together account for about 20–30% of stroke cases directly, and around 20% through indirect causes,” Dr. Pai estimates.

How These Conditions Increase Stroke Risk

  • Blood vessel damage: High blood sugar and blood pressure damage vessels over time, making them stiff and narrow, which can impede blood flow to the brain.
  • Atherosclerosis: Both conditions accelerate plaque buildup in arteries, causing blockages that can trigger a stroke.
  • Blood clots: Diabetes makes the blood more prone to clotting, heightening stroke risk.
  • Co-occurrence: When hypertension and diabetes occur together — as they often do — the risk of stroke rises dramatically.

“Hypertension is the leading cause of stroke, and its prevalence is high in people with diabetes,” Dr Pai concludes.