Arterial hypertension; Stroke; Dementia; Antihypertensive drug; Primary and secondary prevention
Abstract :
[en] The relationships between the brain and arterial hypertension are strong. The brain, through the hypothalamus, can quickly adapt the blood pressure level to maintain the cerebral blood flow. An acute increase in blood pressure, if it overtakes the autoregulatory capacities, needs an urgent intervention to decrease neurological problems such as encephalopathy. In chronic situations, arterial hypertension is a frequent cause of stroke, either ischemic or hemorragic, both in patients free and those who have already suffered from brain damage.
Hypertension is also an actor in the genesis of vascular, but also Alzheimer dementia. A strict control of blood pressure (but also in other atherosclerotic risk factors) into the normal range is needed to protect the brain, and this is more important than the choice of a particular class of antihypertensive agents, except the betablockers. The risk starts from the normal values of blood pressure. [fr] Les relations entre cerveau et hypertension artérielle sont étroites. Le cerveau, par l’entremise de l’hypothalamus, contrôle la régulation rapide de la pression artérielle. L’élévation aiguë de la pression artérielle, si elle dépasse les capacités d’autorégulation, génère des situations neurologiques de type encéphalopathie qui nécessitent une intervention urgente. En situation chronique, l’hypertension artérielle est une cause fréquente d’accidents vasculaires cérébraux, ischémiques ou hémorragiques, soit chez un patient naïf pour ce problème, soit ayant déjà souffert d’une pathologie vasculaire cérébrale.
L’hypertension participe aussi à la survenue de la démence vasculaire, ainsi qu'à la maladie d’Alzheimer. La correction complète de l’élévation de pression artérielle (associée à une action sur tous les facteurs d’athérosclérose) protège le cerveau plus qu‘une classe antihypertensive particulière, sauf peut-être les bêta-bloquants. Le risque démarre déjà pour des pressions normales.
Disciplines :
General & internal medicine
Author, co-author :
Milicevic, Martina; Centre Hospitalier Universitaire de Liège - CHU > Médecine Interne
Krzesinski, Jean-Marie ; Université de Liège - ULiège > Département des sciences cliniques > Néphrologie
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