Hypertension, cerebral vascular changes and stroke in Ghana: cerebral atherosclerosis and stroke.

An autopsy study of cerebral atherosclerosis in 310 Ghanaian adults 20 years and over, using a simplified grading system has shown a lower prevalence of severe lesions (necrotic, ulcerated, haemorrhagic and calcified lesions). These severe lesions (Grade 3) were found in 11.0% hypertensives compared to 2.3% normotensives. This difference is statistically significant (p less than 0.005), thus confirming the observation of other workers that hypertension accelerates atherogenesis. Subjects dying of cerebral haemorrhage showed no significant increase in the severity of atherosclerosis of the cerebral vessels over hypertensives dying from other causes. This would suggest that severe atherosclerosis is less involved in the pathogenesis of cerebral haemorrhage in the Ghanaians studied.