High Blood Pressure Brings Stroke and Dementia
The Study: Hypertension: a harbinger of stroke and dementia
The Facts:
a) Hypertension is known to be a major cause of morbidity and mortality.
b) The biggest risk factor for stoke is hypertension.
c) Elevated blood pressure causes changes (hypertrophy and remodeling) in the structures of the cerebral blood vessels themselves.
d) High blood pressure can also lead to atherosclerosis.
e) Fragments can break off of atherosclerotic plaques and cause a stroke.
f) High blood pressure also causes changes in the small vessels supplying the deep hemispheric white matter and the basal ganglia. This is called small artery disease.
g) Hypertension also impacts cerebrovascular autoregulation ( the constriction or dilation of cerebrovascular vessels) which helps keep the blood flow steady in spite of wide fluctuations in arterialpressure.
h) Evidence suggests that reactive oxygen species are mediators in the cerebrovascular damage caused by high blood pressure.
i) Vascular impairment can create a range of dementia from mild to full blown dementia.
j) Vascular cognitive impairment (VCI) has been linked to a number of small vessel lesions including; lacunar infarcts, microinfarcts, cerebral micro and macro bleeds, and diffuse white matter damage (leukoaraiosis), all of which are associated with hypertension.
k) Alzheimer’s disease and vascular cognitive impairment, the two most common causes of dementia in elderly patients, also appear to be related to hypertension.
l) High blood pressure “has profound effects on the brain and contributes in a substantive manner to stroke and dementia…”
m) “Whatever the impact on cognition, however, the great benefits for general health afforded by blood pressure control justify early and aggressive intervention.”
n) “Nonpharmacological strategies based on diet and exercise may be particularly valuable in younger patients facing treatment for a lifetime.” (emphasis ours)
Take Home:
High blood pressure can cause a multitude of problems in the arteries and brain that can bring on stroke and dementia. Chiropractors should be aware of the impact of hypertension and both mental and general health.
Reference: Faraco G, Iadecola C. Hypertension: a harbinger of stroke and dementia. Hypertension. 2013;62:810-7.
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