Comorbidities Often Associated with Brain Damage in Hypertension: CAD, CKD, and OSAS

Several comorbidities are often associated with patients with essential hypertension. The coexistence of different cardiovascular risk factors and diseases such as diabetes mellitus, chronic kidney disease (CKD), and coronary artery disease (CAD) can increase the incidence of brain damage. Given the shared risk factors, CAD and stroke frequently coexist. Brain damage in CAD patients is not only attributable to the atherothrombotic disease but is also influenced by CAD procedures like coronary artery bypass grafting (CABG) and arrhythmias such as AF, which may predispose independently to a stroke event and brain damage. Moreover, obstructive sleep apnoea syndrome (OSAS) is also associated with an increased risk of stroke and its severity, leading to higher mortality and post-stroke morbidity, and also predicts recurrence of ischaemic strokes. Also cognitive impairment is associated with OSAS including daytime sleepiness, depression, impaired memory, mood disorders, and dementia. This chapter will address the associations between these diseases and conditions in hypertensive patients, and the mechanisms involved in the acceleration of the stroke-related and cognitive decline burden induced by high blood pressure values in these patients.