Hypertension and Stroke: Pathophysiology and Management PDF
Preview Hypertension and Stroke: Pathophysiology and Management
Clinical Hypertension and Vascular Diseases Series Editor: William B. White Venkatesh Aiyagari Philip B. Gorelick Editors Hypertension and Stroke Pathophysiology and Management Second Edition Clinical Hypertension and Vascular Diseases Series Editor William B. White More information about this series at http://www.springer.com/series/7673 Venkatesh Aiyagari • Philip B. Gorelick Editors Hypertension and Stroke Pathophysiology and Management Second Edition Editors Venkatesh Aiyagari, MBBS, DM Philip B. Gorelick, MD, MPH, FACP Department of Neurological Surgery and Department of Translational Science and Neurology and Neurotherapeutics Molecular Medicine University of Texas Southwestern College of Human Medicine Medical Center Michigan State University Dallas , TX , USA Grand Rapids , MI , USA Medical Director Mercy Health Hauenstein Neurosciences Grand Rapids, MI, USA Clinical Hypertension and Vascular Diseases ISBN 978-3-319-29150-5 ISBN 978-3-319-29152-9 (eBook) DOI 10.1007/978-3-319-29152-9 Library of Congress Control Number: 2016947964 © Springer International Publishing Switzerland 2016 T his work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper This Humana Press imprint is published by Springer Nature The registered company is Springer International Publishing AG Switzerland Clinical Hypertension and Vascular Diseases Hypertension and Stroke: Pathophysiology and Management, Second Edition Aiyagari, Venkatesh, Gorelick Philip B. (Eds.) 2016 Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics, Third Edition White, William B. (Ed.) 2016 Hypertension in High Risk African Americans Ferdinand, Keith C (Ed.) 2015 Chronic Kidney Disease and Hypertension Weir, Matthew R, Lerma, Edgar V (Eds.) 2015 Pediatric Hypertension, Third Edition Flynn, Joseph T, Ingelfi nger, Julie R, Portman, Ronald J (Eds.) 2013 Hypertension and Stroke Aiyagari, Venkatesh, Gorelick, Philip B (Eds.) 2011 Pediatric Hypertension, Second Edition Flynn, Joseph T, Ingelfi nger, Julie R, Portman, Ronald J. (Eds.) 2011 v vi Clinical Hypertension and Vascular Diseases Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics, Second Edition White, William B (Ed.) 2007 Lower Extremity Arterial Disease Caralis, Dennis G, Bakris, George L. (Eds.) 2005 Hypertension in the Elderly Prisant, L. Michael (Ed.) 2005 Pediatric Hypertension Portman, Ronald J, Sorof, Jonathan M, Ingelfi nger, Julie R. (Eds.) 2004 Secondary Hypertension Mansoor, George A (Ed.) 2004 Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics White, William B. (Ed.) 2000 William B. White, MD Dedicated to my mother Shakuntala Aiyagari for her love and affection and to my wife Veena for her unwavering support and friendship. Venkatesh Aiyagari, MBBS, DM In honor of my family: Ruth and Harold, Bonnie, Jessica, David and Leah, Alissa, Kevin, Lilah Rose, and Emerson. Philip B. Gorelick, MD, MPH, FACP Foreword H ypertension experts have long recognized the direct relationship between uncon- trolled hypertension and both hemorrhagic and ischemic types of stroke. In just 5 years since the fi rst edition of Hypertension and Stroke was published, the fi eld related to hypertension and cerebrovascular disease has advanced in the understand- ing of pathophysiology and blood pressure goals as well as in improvements in imaging and intervention. Hence, the second edition of H ypertension and Stroke remains an important and clinically relevant textbook in the subject of stroke neu- rology—once again, this book brings together the basic pathophysiologic, epide- miologic, diagnostic, and therapeutic advances in the evaluation of hypertension in patients with stroke or who are at great risk of stroke. D rs. Aiyagari and Gorelick, both of whom are experts in vascular neurology, have organized this volume into sections that cover the importance of blood pres- sure in patients with cerebrovascular disease including overviews of the epidemiol- ogy of stroke and its relationship to hypertension; clinical evaluation that covers a variety of topics such as brain imaging, diagnostic evaluation, and cognitive assess- ment; and pharmacologic approaches to the management of high blood pressure in primary and secondary stroke prevention. The treatment of stroke in acute settings is nicely detailed in this book and an area of great importance in hospital medicine. As the editors note, since the prior edition, there are new sections on blood pres- sure regulation, the evaluation and management of hypertensive encephalopathy including eclampsia, the importance of short- and long-term blood pressure vari- ability, and recommendations for choice of antihypertensive therapies and goals of that therapy. The chapters in H ypertension and Stroke have been written by many of the most well-known authors in the fi eld of clinical hypertension, clinical trials, and stroke neurology who have provided comprehensive, scientifi cally sound, and clinically appropriate information. As series editor of C linical Hypertension and Vascular Diseases , I am once again delighted by the publication of this second edition of ix x Foreword Hypertension and Stroke —I believe it is the foremost textbook in the fi eld for spe- cialists in neurology and cardiovascular medicine as well as any physician who takes care of older adults at risk for cerebrovascular disorders. William B. White, MD Hypertension and Clinical Pharmacology Calhoun Cardiology Center University of Connecticut School of Medicine Farmington, CT, USA Pref ace Hypertension is one of the most prevalent public health problems of our time. It is estimated that in the year 2000, nearly a quarter of the world’s population—nearly one billion individuals—had hypertension. This proportion is expected to increase to nearly 30 %—more than 1.5 billion individuals—by the year 2025. Hypertension is the most signifi cant modifi able risk factor for cerebrovascular diseases and is linked to a variety of neurological conditions including ischemic and hemorrhagic stroke and cognitive impairment. It is estimated that nearly 50 % of strokes could be prevented by blood pressure control. Although improvements have been made in detection and treatment of hypertension in some developed countries, on a global scale, rates of control remain inadequate. O n a more practical level, the practitioner taking care of patients with hyperten- sion and cerebrovascular disease is often faced with several questions. For example, when is it safe to initiate antihypertensive therapy after acute ischemic stroke? What should be the target blood pressure in patients presenting with acute cerebral hem- orrhage? Which blood pressure lowering agent is most safe and effi cacious for pri- mary or secondary prevention of stroke? In this book we explore answers to these and several other important aspects of hypertension and stroke. Since the publication of the fi rst edition of H ypertension and Stroke : Pathophysiology and Management , there have been several advances in this area. Several large clinical trials addressing the management of hypertension in patients with ischemic and hemorrhagic stroke have been published, and several national guidelines on the management of hypertension and stroke have been revised or updated. In the second edition of H ypertension and Stroke , we have attempted to collate and synthesize this rapidly expanding knowledge base into an up-to-date handy reference for clinicians. The chapters in this multiauthor monograph have been written by leading experts in the fi elds of vascular neurology, neuroepidemiol- ogy, critical care neurology, cardiology, nephrology, pharmacology, neuropsychol- ogy, and cognitive function and brain imaging. Several international experts bring a unique perspective from different geographic regions and healthcare systems. xi
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