Hypertension and Stroke: Epidemiological Aspects and Clinical Evaluation
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REVIEW ARTICLE
Hypertension and Stroke: Epidemiological Aspects and Clinical Evaluation Francesca Pistoia1 • Simona Sacco1 • Diana Degan1 • Cindy Tiseo1 Raffaele Ornello1 • Antonio Carolei1
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Received: 23 April 2015 / Accepted: 1 July 2015 Ó Springer International Publishing Switzerland 2015
Abstract The strong relationship between stroke and hypertension has been the object of several studies and trials. These studies addressed the epidemiology of stroke and hypertension, in order to estimate their worldwide distribution and time evolution, and investigated the effects of the management of hypertension on stroke outcomes. Evidences coming from these studies are essential to plan proper health services, optimise economic resources, and estimate the effectiveness of therapeutic strategies in primary and secondary prevention. Additional suggestions are needed to tailor the pharmacologic management of hypertension on the individual needs of patients and to select the most appropriate treatment to avoid stroke recurrences on the basis of the firstever stroke subtype. Moreover, an increasing attention has been given, over the last years, to the relationship between the presence of hypertension and the development of an end-organ brain damage leading to early cognitive dysfunctions. A better understanding of this relationship is the prerequisite to promote successful aging and well-being.
and lost productivity [1–3]. Among modifiable risk factors for stroke, hypertension is the most frequent both in developed and in developing countries. Moreover, the complex interaction between hypertension and other modifiable risk factors, including high cholesterol levels, diabetes mellitus, high body mass index and smoking, greatly increases the cumulative risk for cardiovascular and cerebrovascular diseases in hypertensive patients. Thus, the 8th report of the Joint National Committee on Hypertension (JNC 8) recommended a series of interventions for primary and secondary prevention of hypertension [4]. The former are mainly based on lifestyle changes and modifications of high-risk habits contributing to the development of hypertension, while the latter are aimed at improving detection and management of hypertension once it has developed. The ambition of these strategies is to stem the global burden of cardiovascular diseases [5] and to promote successful aging worldwide. 1.1 Epidemiology of Stroke and Hypertension
Keywords Stroke Hypertension Epidemiology Cerebrovascular disease Dementia
1 Introduction Stroke is the second leading cause of death worldwide and the main cause of disability in adults, thus representing a considerable economic burden in terms of health care costs & Francesca Pistoia [email protected] 1
Department of Biotechnological and Applied Clinical Sciences, Neurological Institute, University of L’Aquila, 67100 L’Aquila, Italy
The incidence rates of stroke range from 1.3/1000 in the United Kingdom to 4.1/1000 in Japan [6]. Incidence is higher in men than in women [7] and in black as comp
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