3.3.4 Iron overload in the brain caused by hypertension leads to ferroptosis of neuronal cells
Increased iron reserves in the body are associated with adverse outcomes and symptomatic hypertension, and iron overload may offset the beneficial effects of thrombolytic therapy100. Yang et al101. found that elevated iron content, increased lipid peroxide content, and changes in indicators related to ferroptosis were found in the brain tissue of hypertensive rats compared with normotensive rats, suggesting that hypertension may lead to brain iron overload, and iron overload increases lipid peroxidation, thereby inducing ferroptosis in neurons. This suggests that iron homeostasis plays an important role in the development of hypertension. It has been established that hypertension is the most common risk factor associated with stroke because it puts pressure on the blood vessels of the brain, resulting in hemodynamic changes that worsen clinical stroke outcomes102,103. However, how hypertension leads to iron overload in the brain and what is the specific mechanism of ferroptosis in hypertensive brain injury need further study and discussion. As mentioned above, ferroptosis may play a key role in the pathogenesis of hypertension and related brain damage, and inhibition of ferroptosis may be a potential therapeutic target for the prevention and treatment of hypertension and hypertensive heart and brain damage. However, whether ferroptosis plays a key role in the impact of hypertension on stroke severity and clinical outcome still needs further study.