Tortuosity of the White Matter Medullary Arterioles Is Related to the Severity of Hypertension

Background: The clinical implication of the tortuosity of white matter medullary arterioles has never been clarified precisely. We quantitatively investigated the relationship between such vascular tortuosity and the severity of hypertension (HT), which was graded according to the WHO classification. Methods: Forty-seven autopsied brains with age-adjusted stages of HT were evaluated. The largest tortuosity diameter and the largest vascular diameter in the same tortuous lesion were measured by light microscopic observation at the level of the corona radiata and centrum semiovale. A maximum ratio of these diameters was calculated for each patient. Results: Maximum ratios were found in almost all arterioles and were significantly increased according to the HT stages. Conclusions: Arteriolar tortuosity in the hemispheric white matter may reflect the severity of HT and be an indicator of hypertensive small vessel disease of the brain.