Burden of Neurological Disease Induced by Hypertension

Hypertension is the most prevalent cardiovascular disorder affecting 20%–50% of the adult population worldwide. While the overall prevalence has not changed since 1990, the increased prevalence in some low- and middle-income countries was counterbalanced by a decreased prevalence in high-income countries and in women in Central and Eastern Europe. Despite the stable global prevalence of hypertension, the total number of hypertensive individuals has doubled worldwide. Awareness and treatment of hypertension vary among countries and regions, with better results in high-income countries. Elevated BP is the strongest modifiable risk factor for stroke, both ischemic and hemorrhagic. Lowering BP substantially reduces the risk of stroke, which has been documented by observational studies and large clinical trials. The age-standardized rates of stroke incidence, prevalence, and mortality decreased, while the total number of strokes worldwide increased. This is mostly due to demographic changes. Stroke is the second leading cause of death worldwide, and up to half of stroke survivors are left with short- or long-term disability. Almost 90% of stroke-related death and disability occur in low- and middle-income countries. This is a consequence of poor awareness of stroke risk factors and signs, together with limited access to stroke units and brain imaging. Dementia is one of the main causes of loss of autonomy, the primary reason for institutionalization in the elderly, and the sixth leading cause of death and disability in high-income countries. The prevalence of dementia increases with age, affecting more than 40% of individuals over the age of 80. Hypertension is considered the main modifiable vascular risk factor for preventing or delaying dementia. Several studies have shown that hypertension in middle age is a risk factor for developing dementia later in life. Stroke substantially increases the risk of dementia.