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Hypertension mechanisms causing stroke

Johansson, Barbro LU (1999) In Clinical and Experimental Pharmacology and Physiology 26(7). p.563-565
Abstract
1. Although it is well established that hypertension is the main risk factor for stroke, the complexity of cerebrovascular problems related to hypertension is not generally appreciated. 2. Hypertension can cause stroke through many mechanisms. A high intraluminal pressure will lead to extensive alteration in endothelium and smooth muscle function in intracerebral arteries. The increased stress on the endothelium can increase permeability over the blood-brain barrier and local or multifocal brain oedema. Endothelial damage and altered blood cell-endothelium interaction can lead to local thrombi formation and ischaemic lesions. Fibrinoid necrosis can cause lacunar infarcts through focal stenosis and occlusions. Degenerative changes in smooth... (More)
1. Although it is well established that hypertension is the main risk factor for stroke, the complexity of cerebrovascular problems related to hypertension is not generally appreciated. 2. Hypertension can cause stroke through many mechanisms. A high intraluminal pressure will lead to extensive alteration in endothelium and smooth muscle function in intracerebral arteries. The increased stress on the endothelium can increase permeability over the blood-brain barrier and local or multifocal brain oedema. Endothelial damage and altered blood cell-endothelium interaction can lead to local thrombi formation and ischaemic lesions. Fibrinoid necrosis can cause lacunar infarcts through focal stenosis and occlusions. Degenerative changes in smooth muscle cells and endothelium predisposes for intracerebral haemorrhages. Furthermore, hypertension accelerates the arteriosclerotic process, thus increasing the likelihood for cerebral lesions related to stenosis and embolism originating from large extracranial vessels, the aortic arch and from the heart. 3. Adaptive structural changes in the resistance vessels, while having the positive effect of reducing the vessel wall tension, have the negative consequence of increased peripheral vascular resistance that may compromise the collateral circulation and enhance the risk for ischaemic events in connection with episodes of hypotension or distal to a stenosis. 4. Hypertension is clearly a risk factor for vascular dementia. All the mechanisms referred to above may be important. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
arteriosclerosis, blood–brain barrier, brain oedema, hypertension, infarction, intracerebral haemorrhages, stroke, vascular dementia
in
Clinical and Experimental Pharmacology and Physiology
volume
26
issue
7
pages
563 - 565
publisher
Wiley-Blackwell
external identifiers
  • pmid:10405790
  • scopus:0033034966
ISSN
1440-1681
DOI
10.1046/j.1440-1681.1999.03081.x
language
English
LU publication?
yes
id
06ef3e64-fbd4-4dda-8c77-e624d71b9fda (old id 1115185)
alternative location
http://www3.interscience.wiley.com/cgi-bin/fulltext/119092520/HTMLSTART
date added to LUP
2008-07-07 15:23:05
date last changed
2017-08-20 03:36:42
@article{06ef3e64-fbd4-4dda-8c77-e624d71b9fda,
  abstract     = {1. Although it is well established that hypertension is the main risk factor for stroke, the complexity of cerebrovascular problems related to hypertension is not generally appreciated. 2. Hypertension can cause stroke through many mechanisms. A high intraluminal pressure will lead to extensive alteration in endothelium and smooth muscle function in intracerebral arteries. The increased stress on the endothelium can increase permeability over the blood-brain barrier and local or multifocal brain oedema. Endothelial damage and altered blood cell-endothelium interaction can lead to local thrombi formation and ischaemic lesions. Fibrinoid necrosis can cause lacunar infarcts through focal stenosis and occlusions. Degenerative changes in smooth muscle cells and endothelium predisposes for intracerebral haemorrhages. Furthermore, hypertension accelerates the arteriosclerotic process, thus increasing the likelihood for cerebral lesions related to stenosis and embolism originating from large extracranial vessels, the aortic arch and from the heart. 3. Adaptive structural changes in the resistance vessels, while having the positive effect of reducing the vessel wall tension, have the negative consequence of increased peripheral vascular resistance that may compromise the collateral circulation and enhance the risk for ischaemic events in connection with episodes of hypotension or distal to a stenosis. 4. Hypertension is clearly a risk factor for vascular dementia. All the mechanisms referred to above may be important.},
  author       = {Johansson, Barbro},
  issn         = {1440-1681},
  keyword      = {arteriosclerosis,blood–brain barrier,brain oedema,hypertension,infarction,intracerebral haemorrhages,stroke,vascular dementia},
  language     = {eng},
  number       = {7},
  pages        = {563--565},
  publisher    = {Wiley-Blackwell},
  series       = {Clinical and Experimental Pharmacology and Physiology},
  title        = {Hypertension mechanisms causing stroke},
  url          = {http://dx.doi.org/10.1046/j.1440-1681.1999.03081.x},
  volume       = {26},
  year         = {1999},
}