Abstract
Stroke is one of the most-frequent causes of death and the first cause of disability worldwide. Different mechanisms are related to the pathogenesis of stroke, involving multiple biological systems, which are often inter-connected. Besides age, hypertension is the most important risk factor for stroke and may also predispose to the development of more subtle cerebral damage based on arteriolar narrowing or pathological microvascular changes. Age and high blood pressure are responsible for silent structural and functional cerebral changes leading to white matter lesions and cognitive impairment. The clinical significance and pathological substrate of white matter lesions are not fully understood. Hypertensive patients have more white matter lesions, which are an important prognostic factor for the development of stroke, cognitive impairment, dementia and death, than normotensive people. Over the past 10 years, strong evidence has emerged that cerebral white matter lesions in hypertensive patients should be considered a silent early marker of brain damage. The mechanisms that would explain all these relationships remain to be elucidated, but available data suggest that arteriosclerosis of the penetrating brain vessels is the main factor in the pathogenesis of ischemic white matter lesions.
Keywords: Arterial stiffness, cerebral small vessel disease, circadian rhythm, essential hypertension, intima-media thickness, pulse wave velocity, stroke, white matter lesions.
Current Medicinal Chemistry
Title:Essential Hypertension, Cerebral White Matter Pathology and Ischemic Stroke
Volume: 21 Issue: 19
Author(s): C. Sierra
Affiliation:
Keywords: Arterial stiffness, cerebral small vessel disease, circadian rhythm, essential hypertension, intima-media thickness, pulse wave velocity, stroke, white matter lesions.
Abstract: Stroke is one of the most-frequent causes of death and the first cause of disability worldwide. Different mechanisms are related to the pathogenesis of stroke, involving multiple biological systems, which are often inter-connected. Besides age, hypertension is the most important risk factor for stroke and may also predispose to the development of more subtle cerebral damage based on arteriolar narrowing or pathological microvascular changes. Age and high blood pressure are responsible for silent structural and functional cerebral changes leading to white matter lesions and cognitive impairment. The clinical significance and pathological substrate of white matter lesions are not fully understood. Hypertensive patients have more white matter lesions, which are an important prognostic factor for the development of stroke, cognitive impairment, dementia and death, than normotensive people. Over the past 10 years, strong evidence has emerged that cerebral white matter lesions in hypertensive patients should be considered a silent early marker of brain damage. The mechanisms that would explain all these relationships remain to be elucidated, but available data suggest that arteriosclerosis of the penetrating brain vessels is the main factor in the pathogenesis of ischemic white matter lesions.
Export Options
About this article
Cite this article as:
Sierra C., Essential Hypertension, Cerebral White Matter Pathology and Ischemic Stroke, Current Medicinal Chemistry 2014; 21 (19) . https://dx.doi.org/10.2174/0929867321666131227155140
DOI https://dx.doi.org/10.2174/0929867321666131227155140 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
Call for Papers in Thematic Issues
Advances in Medicinal Chemistry: From Cancer to Chronic Diseases.
The broad spectrum of the issue will provide a comprehensive overview of emerging trends, novel therapeutic interventions, and translational insights that impact modern medicine. The primary focus will be diseases of global concern, including cancer, chronic pain, metabolic disorders, and autoimmune conditions, providing a broad overview of the advancements in ...read more
Approaches to the treatment of chronic inflammation
Chronic inflammation is a hallmark of numerous diseases, significantly impacting global health. Although chronic inflammation is a hot topic, not much has been written about approaches to its treatment. This thematic issue aims to showcase the latest advancements in chronic inflammation treatment and foster discussion on future directions in this ...read more
Cellular and Molecular Mechanisms of Non-Infectious Inflammatory Diseases: Focus on Clinical Implications
The Special Issue covers the results of the studies on cellular and molecular mechanisms of non-infectious inflammatory diseases, in particular, autoimmune rheumatic diseases, atherosclerotic cardiovascular disease and other age-related disorders such as type II diabetes, cancer, neurodegenerative disorders, etc. Review and research articles as well as methodology papers that summarize ...read more
Chalcogen-modified nucleic acid analogues
Chalcogen-modified nucleosides, nucleotides and oligonucleotides have been of great interest to scientific research for many years. The replacement of oxygen in the nucleobase, sugar or phosphate backbone by chalcogen atoms (sulfur, selenium, tellurium) gives these biomolecules unique properties resulting from their altered physical and chemical properties. The continuing interest in ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Local Cerebral Blood Flow is Preserved in Sepsis
Current Neurovascular Research The Diagnostic and Prognostic Value of Brain Natriuretic Peptide and Aminoterminal (nt)-pro Brain Natriuretic Peptide
Current Pharmaceutical Design Noninvasive Monitoring of Intracranial Pressure
Recent Patents on Biomedical Engineering (Discontinued) Non-Invasive Methods and Techniques for Central Blood Pressure Estimation: Procedures, Validation, Reproducibility and Limitations
Current Pharmaceutical Design Impact of Periconceptional Undernutrition on the Development of the Hypothalamo-Pituitary-Adrenal Axis: Does the Timing of Parturition Start at Conception?
Current Drug Targets A Stress Repair Mechanism That Maintains Vertebrate Structure During Stress
Cardiovascular & Hematological Disorders-Drug Targets Towards Optimal Heart Failure Care: Couples-Oriented Strategies to Improve Patient Adherence and Health Outcomes
Current Cardiology Reviews Patient Engagement in Randomized Controlled Tai Chi Clinical Trials among the Chronically Ill
Reviews on Recent Clinical Trials Will Sodium Intake Reduction Improve Cardiovascular Outcomes in the General Population? A Critical Review of Current Evidence
Current Hypertension Reviews Biofunctional Peptides from Milk Proteins: Mineral Binding and Cytomodulatory Effects
Current Pharmaceutical Design Angiotensin II-Induced Signaling Pathways in Diabetes
Current Diabetes Reviews Rho Kinase Inhibitors and Novel Ocular Drug Delivery Systems- A Revolutionary Step Towards the Treatment of Glaucoma
Current Drug Delivery Crystal Structures of Phosphodiesterases and Implications on Substrate Specificity and Inhibitor Selectivity
Current Topics in Medicinal Chemistry Mechanisms of Drug Resistance to Vascular Endothelial Growth Factor (VEGF) Inhibitors
Anti-Cancer Agents in Medicinal Chemistry Nanowired Drug Delivery Across the Blood-Brain Barrier in Central Nervous System Injury and Repair
CNS & Neurological Disorders - Drug Targets Global Safety of Coxibs and NSAIDs
Current Topics in Medicinal Chemistry Editorial [Hot Topic: Novel Pharmacological Therapies for Cardiac Hypertrophy and Heart Failure (Executive Guest Editor: Peter M. Kang)]
Current Pharmaceutical Design Targeting Vascular Redox Biology Through Antioxidant Gene Delivery: A Historical View and Current Perspectives
Recent Patents on Cardiovascular Drug Discovery An Assessment of Patients Factors Effect on Prescriber Adherence to Ischemic Stroke Secondary Prevention Guidelines
Current Reviews in Clinical and Experimental Pharmacology MicroRNAs: A Critical Regulator and a Promising Therapeutic and Diagnostic Molecule for Diabetic Cardiomyopathy
Current Gene Therapy