Pathophysiology and Mechanisms Whereby Hypertension May Cause Stroke

Abstract

Hypertension has deleterious effects on the cerebral circulation. Hypertension alters the structure of blood vessels by producing vascular hypertrophy and remodeling and by promoting atherosclerosis in large cerebral arteries and lipohyalinosis in penetrating arterioles. In addition, hypertension also impairs endothelium-dependent relaxation and alters cerebrovascular autoregulation and neurovascular coupling. With these functional and structural alternations, hypertension facilitates vascular occlusions or degenerative change that is prone to rupture and bleeding, thereby causing both ischemic and hemorrhagic stroke. Recently it has been shown that short-term and also long-term blood pressure variability can play a role in the pathogenesis of stroke.