Current Hypertension Reports

, Volume 13, Issue 3, pp 200–207 | Cite as

Vascular Mechanisms in the Pathogenesis of Stroke

  • Cristina Sierra
  • Antonio Coca
  • Ernesto L. Schiffrin


Stroke is one of the most devastating manifestations of two common diseases, atherosclerosis and hypertension. It represents the second leading cause of death and a major cause of disability worldwide. Besides age (a nonmodifiable risk factor), hypertension is the most important cardiovascular risk factor for developing both ischemic and hemorrhagic stroke, as well as small vessel disease predisposing to lacunar infarction, white matter lesions, and cerebral microbleeds. In addition, hypertension predisposes to atherosclerosis and cardiac diseases (notably atrial fibrillation), thereby promoting cerebral embolism. Inflammatory mechanisms play a central role in the pathogenesis and progression of atherosclerosis, plaque rupture, thrombosis, and stroke. Endothelial dysfunction, in part resulting from excessive production of reactive oxygen species, is an important mechanism of cerebrovascular damage. This article reviews recent data on vascular mechanisms that participate in the pathogenesis of stroke.


Atherosclerosis Cerebral blood flow Hypertension Small vessel disease Cerebrovascular remodeling Aging Oxidative stress Endothelial dysfunction 



No potential conflicts of interest relevant to this article were reported.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Cristina Sierra
    • 1
    • 2
  • Antonio Coca
    • 2
  • Ernesto L. Schiffrin
    • 1
  1. 1.Department of Medicine, Sir Mortimer B. Davis-Jewish General Hospital and Lady Davis Institute for Medical ResearchMcGill UniversityMontrealCanada
  2. 2.Hypertension Unit, Department of Internal Medicine, Institute of Medicine and Dermatology, Hospital Clinic (IDIBAPS)University of BarcelonaBarcelonaSpain

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