[Hypertension].

Abstract

Hypertension is the most important risk factor for stroke. For both primary and secondary stroke prevention, the target blood pressure level is 130/80 mmHg in the current guidelines. Intensive blood pressure lowering is useful for the prevention of intracerebral hemorrhage; therefore, blood pressure control of<120/80 mmHg would be beneficial for patients at a high risk of hemorrhagic stroke, including those with factors such as a history of intracerebral hemorrhage, use of more than two antithrombotic drugs, and the presence of more than two cerebral microbleeds. For people without a history of stroke, the evaluation of cerebral small-vessel disease on brain magnetic resonance imaging(MRI)is useful for risk stratification of incident stroke. Brain MRI reveals white matter hyperintensities, lacunar infarctions, cerebral microbleeds, and enlarged perivascular spaces, which are representative of small vessel disease. The total small-vessel disease score has been developed to evaluate the total small vessel disease burden and ranges 0-4. People with at least one small-vessel disease have a higher risk of incident stroke; therefore, intensive blood pressure control is important for stroke prevention.