Why are people with high blood pressure at a greater risk for having a hemorrhagic (or...

Why are people with high blood pressure at a greater risk for having a hemorrhagic (or bleeding) stroke?

Expert Solution

Hemorrhagic stroke is a result of bursting of a weakened artery in the brain. The bursting of the artery causes bleeding in the surrounding area, causing damage to the cells located in that area. This results in brain damage. There are two types of hemorrhagic strokes, namely, intracerebral stroke and subarachnoid stroke. Intracerebral stroke occurs with the brain. Subarachnoid stroke occurs between the brain and membranes covering the brain.

High blood pressure cause increased intraluminal pressure. This intraluminal pressure will lead to changes in endothelium of blood vessels in intracerebral arteries. Increase in intracranial pressure can also damage the endothelium. These arteries will also exhibit extensive degenerative changes in functioning of smooth muscles.

The structure of blood vessels is altered when the blood pressure increases. This effect is due to vascular remodeling and atrophy. Further, the atherosclerosis is increased in large cerebral arteries. The high blood pressure also causes lipohyalinosis in smaller arterioles. Endothelium-dependent relaxation in blood vessels in often impaired due to increased pressure in arteries due to high blood pressure. Damage to endothelium increases the permeability of the blood brain barrier. The blood brain barrier degeneration and increased permeability will cause increased transport of leukocytes and neuroactive compounds into the brain. As a result, the bleeding during hemorrhagic stroke can damage the brain. Local thrombi and ischemic lesions may form due to defective endothelium-blood cell interaction that leads to stroke. The increased stress on the endothelium will result in rupturing of the blood vessels and causing hemorrhagic stroke. Bleeding may result in blood spilling in ventricles of the brain causing intraventricular hemorrhage. Thus, high blood pressure will cause increased risk of hemorrhagic stroke.

Sydney Mullin answered 1 year ago

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