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World J Hypertens. Dec 23, 2011; 1(1): 7-9
Published online Dec 23, 2011. doi: 10.5494/wjh.v1.i1.7
Arterial hypertension, cerebrovascular diseases and dementia
Adrià Arboix
Adrià Arboix, Cerebrovascular Division, Department of Neurology, Capio Hospital Universitari del Sagrat Cor, Universitat de Barcelona, E-08029 Barcelona, Catalonia, Spain
Author contributions: Arboix A solely contributed to this paper.
Correspondence to: Adrià Arboix, MD, PhD, Associate Professor of Neurology, University of Barcelona, Head of Cerebrovascular Division, Department of Neurology, Capio Hospital Universitari del Sagrat Cor, Viladomat 288, E-08029 Barcelona, Catalonia, Spain. aarboix@hscor.com
Telephone: +34-93-4948940 Fax: +34-93-4948906
Received: April 12, 2011
Revised: October 18, 2011
Accepted: December 16, 2011
Published online: December 23, 2011

Arterial hypertension (AH) is the most relevant risk factor for acute cerebrovascular disease in general. However, the prevalence of AH is not the same for the different stroke subtypes and is particularly high in lacunar infarcts and atherothrombotic stroke, low in infarcts of unusual cause and undetermined origin, and intermediate in cardioembolic stroke. This risk factor has also been related to vascular dementia and Alzheimer’s disease and their pathological manifestations (senile plaques, neurofibrillary tangles, hippocampal atrophy). The mechanisms linking AH to Alzheimer’s disease remain to be elucidated but some recent studies showed that white matter lesions seen on cerebral magnetic resonance imaging appear to be a good marker of this association. Hypertension-associated pathological changes in the brain and its vasculature include vascular remodelling and impaired cerebral autoregulation like hypoperfusion, ischemia and hypoxia, which may initiate the pathological process of Alzheimer’s disease and the expression of dementia. Therefore, prompt diagnosis and adequate control of hypertension and different vascular risk factors are the rational basis for a more effective strategy in the secondary prevention of cerebrovascular disease and dementia.

Keywords: Arterial hypertension, Acute stroke, Cerebrovascular disease, Vascular dementia, Alzheimer’s disease