Hypertension And Stroke

Abstract

Stroke is the third leading cause of death afrer coronary heart disease and cancer andis the fırst cause of disability. Hypertension is the major risk factor of stroke, independent of its aetiology. The relation between the incidence of stroke and systolic or diastolic hypertension is linear and treatment reduces the incidence of fırst ever stroke in all age groups. Treatment of high blood pressure reduces the incidence of all type of stroke. While the relation between hypertension and recurrent stroke is not well defıned, HOPE study (The Heart Outcome Prevention Evaluation Study)has recently clearly shown that the treatment of hypertension with an ACE inhibitor in patients with high cardiovascular risk, including patients with a history of stroke, reduces the incidence of stroke, independent of the initial blood pressure levels. Treatment of high blood pressure levels early afrer acute stroke is controversial. in the absence of objective data, it is wise not to immediately lower blood pressure levels during the fırst 72 hours or ifpossible during the fırst one-two weeks, unless one is faced with hypertension emergencies such as very high blood pressure levels (systolic > 220-230, diastolic > 130-140 mm Hg), hypertensive encephalopathy, congestive heart failure, evidence of acute myocardial ischaemia, aortic dissection or acute renal failure, necessitating rapid treatment.