Hypertension and Its Impact on Stroke Recovery: From a Vascular to a Parenchymal Overview

Area of Science:

• Neuroscience
• Cardiovascular Medicine
• Pathology

Background:

• Hypertension is a leading modifiable vascular risk factor, linked to millions of deaths globally.
• It is independently associated with stroke risk and poorer prognosis, and implicated in vascular cognitive impairment.
• Parenchymal brain changes due to hypertension, beyond vascular effects, are often overlooked.

Purpose of the Study:

• To review the impact of hypertension on brain atrophy, neurogenesis, and glial cell phenotype.
• To examine the effects of hypertension, with or without stroke, on neuronal connectivity.
• To discuss the influence of antihypertensive treatments on cellular responses and functional recovery.

Main Methods:

• Literature review focusing on preclinical and clinical studies.
• Analysis of research on isolated hypertension and hypertension associated with ischemic stroke.
• Examination of studies investigating cellular and functional outcomes.

Main Results:

• Hypertension contributes to brain atrophy and alters neuronal connectivity.
• It induces changes in microglia and astrocyte phenotypes.
• Antihypertensive therapies show potential in mitigating cellular damage and improving functional recovery.

Conclusions:

• Hypertension has significant parenchymal consequences on the brain, affecting structure and function.
• Understanding these effects is crucial for managing stroke and cognitive decline.
• Further research is needed to optimize antihypertensive strategies for brain health.