How often are brain infarcts caused by hypotensive episodes?

Of 135 patients who were resuscitated after cardiac arrest and who died from one day to several weeks later with morphological signs of systemic cerebral anoxia, there were seven patients (5.2%) with brain infarcts probably caused by hypotensive episodes during or after the resuscitation. There was almost no increase in the frequency of recent brain infarcts with an increasing degree of cerebral atherosclerosis (P greater than 0.90). In contrast, the distribution of ten old brain infarcts in the same material showed a significant correlation to the degree of cerebral atherosclerosis (P less than 0.05). The findings suggest that the combination of cerebral atherosclerotic stenoses and hypotensive is not a major cause of brain infarcts in elderly people. It is suggested that the risk of precipitating brain infarcts by lowering BP in hypertensive patients is not much greater in atherosclerotic than in nonatherosclerotic subjects.