Hypertension is an insidious disease and does not have acute symptoms. 23% of hypertension in young is detected during routine family visit. Persistently high values of blood pressure can affect arteries of all organs including brain.
Hypertension is association with other diseases can accentuate its effects on blood supply of brain. Hypertension affects auto regulation of brain which actually maintains perfusion to brain tissue. Hypertension produces changes in the vessel(arteries) wall which would make and narrow and stiff. This narrowing and stiffness will lead to low blood supply to brain tissue.
Hypertension can affect the large blood vessels and small vessels of brain. Large vessels(Atheroma /lipid block) can cause stroke and small vessels (arteriosclerotic)can cause damage to brain tissue due to slow circulation which in turn causes slow metabolism in brain cells.
MRI done on these patients will show:
➤ Minor stroke- Acute or chronic infarcts
➤ Major stroke
➤ Changes in white matter of brain (leucoarteriotic)
➤ Early brain atrophy
Clinical effects produced due to the above changes in the brain are:
- Weakness of limbs
- Decreased vision
- Memory(dementia) and behavioural changes
- Slow mentation(Cognitive decline)
Research suggests that people with hypertension perform more poorly than normotensive individuals on measures including learning and memory, attention, visuospatial skills, psychomotor abilities, and executive functioning
Due to the above facts it may be important to provide appropriate patient education regarding likely risks associated with hypertension. Without such education and the asymptomatic nature of hypertension, many individual may not choose to seek help for this issue. Onset of hypertension in young individuals exposes brain vessels to high pressure changes for a longer duration of time and then more severe are the effects on brain cells.
(Disclaimer: The writer is Dr Sonal Gupta, Director, Neuro Spine Surgery, Fortis Hospital, Shalimar Bagh. Views expressed are a personal opinion.)
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