Impact of arterial hypertension on the brain.

Even mild arterial hypertension dramatically increases the risk of vascular brain disease. Cerebral infarction is most commonly attributable to large-vessel thromboembolic disease. Lacunar infarcts, due to lipohyalin degeneration of vessel walls, are a particular hazard in the hypertensive patient. Hypertensive encephalopathy is associated with hypertension from any cause and may occur at any age. Brain hemorrhage is associated with arterial hypertension and is almost always fatal, regardless of treatment. Hypertension plays a major causal or complicating role in all cerebrovascular disease. The decline in the incidence of stroke over the past decade coincides with improving detection and treatment of hypertension.