ABSTRACT
Hypertension is a global concern, contributing to the burden of heart disease, stroke and kidney failure and premature death and disability. This chapter outlines the practical management of hypertension which may be undiagnosed or inadequately controlled leading to stroke. The cause of the hypertension will determine the treatment, for example hypertension due to pregnancy will be managed differently to sub-arachnoid haemorrhage with decompensation. The cause may be due to stress response, chronic hypertension, increased intra-cranial pressure or activation of neuroendocrine system. Severe hypertension may cause cerebral oedema, intracerebral haemorrhage and breakdown of the blood-brain barrier. Hypertension is a significant concern for low- to low-middle income countries, in addition to poorly diagnosed or inadequately controlled hypertension; by 2020 an estimated 1.15 billion hypertensive patients in low-income settings will require healthcare. Issues surrounding under-diagnosis and poor management may result in hypertensive patients only being identified during crises or acute conditions.
