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Chapter 31 - Hypertension
Book chapter

Chapter 31 - Hypertension

T.M. De Silva and F.M. Faraci
Primer on Cerebrovascular Diseases, pp.153-157
Elsevier Inc, Second Edition
2017
DOI: 10.1016/B978-0-12-803058-5.00031-X

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Abstract

Of the known risk factors for cerebrovascular disease, hypertension is associated with some of the most profound effects on the cerebral circulation. In this chapter, we highlight the effects of acute and chronic hypertension on vascular function and structure that collectively impact baseline cerebral blood flow (CBF) as well as mechanisms that regulate the moment-to-moment control of CBF. Changes in endothelial function, neurovascular coupling, autoregulation, and blood–brain barrier are summarized along with underlying mechanisms. Profound effects on vascular structure also occur, which can impact resting CBF and vasodilator responses. In addition to these perfusion-related changes, hypertension promotes atherosclerosis, thrombosis, and microhemorrhages. As vascular disease progresses, the process impacts other cell types in the brain including gray and white matter resulting in cognitive deficits and other forms of neurological dysfunction.
Blood–brain barrier (BBB) Cerebral blood flow (CBF) Cerebrovascular disease Endothelium Hypertension Neuromuscular coupling Vascular remodeling

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