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Hypertension and hypertensive encephalopathy

Raymond S Price1, Scott E Kasner1

  • 1Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.

Handbook of Clinical Neurology
|December 25, 2013
PubMed

Insights

Hypertension, defined as blood pressure over 140/90mmHg, is a common condition, especially in older adults. Managing hypertension effectively significantly reduces stroke risk.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Public Health

Background:

  • Hypertension prevalence affects 25% of US adults, increasing with age.
  • It is the primary risk factor for stroke, causing arterial damage.
  • Current definitions evolve, with 140/90mmHg as the threshold.

Observation:

  • Hypertension damages small arteries, leading to ischemic stroke or hemorrhage.
  • Hypertensive emergency (BP > 180/120mmHg) involves end-organ dysfunction.
  • Acute failure of cerebrovascular autoregulation causes hypertensive encephalopathy.

Findings:

  • Blood pressure reduction via diuretics, beta-blockers, calcium channel blockers, and ACE inhibitors lowers stroke incidence.
  • Intravenous agents reduce BP by 25% within the first hour during hypertensive emergencies.
  • New trials explore inhibiting cerebrovascular permeability for hypertensive emergencies.

Implications:

  • Effective hypertension management is crucial for stroke prevention.
  • Prompt treatment of hypertensive emergencies is vital to prevent severe outcomes.
  • Emerging therapies may offer new avenues for treating hypertensive emergencies.

Keywords:
Cerebral infarctionHypertensioncerebral autoregulationcerebral hemorrhagehypertensive encephalopathy

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