Stroke and hypertension: An appraisal from pathophysiology to clinical practice

Stroke as a cause of long-term disability is a growing public health burden. Therefore, focusing on prevention is important. The most prominent aim of this strategy is to treat modifiable risk factors, such as arterial hypertension, the leading modifiable contributor to stroke. Thus, efforts to adequately reduce Blood Pressure (BP) among hypertensives are mandatory. In this respect, although safety and benefits of BP control related to long-term outcome have been largely demonstrated, there are open questions that remain to be addressed, such as optimal timing to initiate BP reduction and BP goals to be targeted. Moreover, evidence on antihypertensive treatment during the acute phase of stroke or BP management in specific categories (i.e. patients with carotid stenosis and post-acute stroke) remain controversial. This review provides a critical update on the current knowledge concerning BP management and stroke pathophysiology in patients who are either at risk for stroke or who experienced stroke.