Hypertension and cerebrovascular dysfunction: Acute and chronic brain pathological alterations

Hypertension is one of the main risk factors for cerebrovascular diseases. This article focuses on the pathophysiological mechanisms recruited by hypertension, altering the normal functioning of the cerebral circulation and conditioning the onset of acute and chronic brain injury. In particular, hypertension favours acute ischaemic and haemorragic events and, more insidiously, chronic neurodegenerative diseases. Indeed, vascular cells, in response to haemodynamic insults, signal to neurons and astrocytes that recruit microglia, which, when activated, secrete several proinflammatory cytokines. The various neuroinflammatory milieu involved in the different clinical manifestations of hypertension-induced cerebrovascular events, contribute in different ways to the onset and progression of brain pathology.