Stroke Prevention in Hypertension Based on Pathogenesis Mechanisms

Abstract

Hypertension is a disease that causes death of 6.7% worldwide and is a major risk factor for stroke in Indonesia (79%). Approximately 60% of people with hypertension end in stroke, either hemorrhagic or ischemic stroke. As many as 40% of stroke cases can be prevented through good blood pressure (BP) management, however, other strategies are needed to maximize the reduction in the incidence of stroke in hypertensive patients. This literature study aims to find strategic gaps that can be developed for stroke prevention in hypertensive patients based on the mechanisms involved in its pathogenesis. Keyword combinations were used to search for peer-reviewed literature published on PubMed, Scopus, and Google Scholar. Various mechanisms are involved in the pathogenesis of stroke in hypertensive patients, including increased BP and blood pressure variability (VTD), baroreflex dysfunction, Angiotensin II (Ang II)-induced oxidative stress, and also inflammation involving the innate immune system. Stroke prevention strategies in hypertensive patients can be explored through the mechanisms involved, namely through blood pressure management, specific antioxidant and anti-inflammatory interventions, and administration of agents capable of modulating baroreflex. Prevention of stroke in hypertension based on the mechanism of pathogenesis can be a gap for further studies in reducing the incidence of stroke and preventing recurrent strokes.