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In spite of the fact that hypertension is the main risk factor for cerebrovascular disease, retrospective studies have not given a clear answer concerning the role of hypertension in vascular dementia. Hypertension predisposes to intracerebral and extracerebral arterial alterations which may cause cerebrovascular events by a number of mechanisms. In addition to the established association between hypertension and stroke, the role of hypertension for silent white matter hyperintensities (WMHIs) observed on magnetic resonance imaging is debated. Data are presented indicating that WMHIs are rare below the age of 55 in normotensive individuals but are not infrequent when the blood pressure is moderately or markedly increased. It is proposed that the possible role of hypertension in vascular dementia should be evaluated in prospective studies of hypertensive populations.
Barbro B. Johansson (Sat,) studied this question.