Arterial hypertension and cerebrovascular pathology. Current status of the problem

In the process of development and progression of arterial hypertension hypertensive cerebral angiopathy is formed - that is a complex of intricate primarily destructive (acute and recurring) and secondary reparative changes and adaptive processes occurring on all structural and functional levels of cerebral vascular system. Arterial hypertension in patients with cerebrovascular diseases should be treated. Because of heterogeneity of etiology and pathogenetic mechanisms of stroke detailed assessment of the state of cerebral vessels, blood flow, circulatory and metabolic cerebral reserve is a prerequisite of effective and safe antihypertensive therapy, prevention of stroke and other complications. This excludes generalized (leveling-off) approach to treatment and prevention of various types and subtypes of stroke. A notion that hypertension is a most important, independent controllable risk factor of cerebrovascular diseases remains definitely valid. However it is far from being a single cause of stroke.