Hypertension and Stroke

Hypertension is the most prevalent and powerful modifiable risk factor for stroke. Persons with hypertension are about 3 or 4 times more likely to have a stroke. Hypertension remains the single most important modifiable risk factor for stroke, and the impact of hypertension and nine other risk factors together account for 90% of all strokes. The two major types of stroke include ischemic stroke (caused by blood clots), which accounts for 85% of strokes, and hemorrhagic stroke (bleeding in the brain), which accounts for 15% of strokes.

Prevention of stroke is a major public health priority but needs to be based on a clear understanding of the key preventable causes of stroke. Therefore, although the highest BP levels predict the highest relative risk of stroke, the conceptual pendulum has swung in the direction of the continuum of absolute BP levels and somewhat away from the construct of “hypertension”. Furthermore, as discussed below, recent evidence points to the fact that mediators of hypertension, such as Angiotensin II, may influence stroke risk independently of Blood pressure elevation.

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