Acute arterial hypertension, induced by vasoactive substances or by compression of the thoracic aorta, can increase the permeability of the blood-brain barrier (BBB) in experimental animals (1). The present review deals predominantly with the BBB to macromolecules, since that is the BBB function most commonly studied in experimental hypertension. The abnormal permeability associated with hypertension has a typical, patchy appearance, although the pattern varies somewhat with different experimental models (see beZow and 1-6). This BBB dysfunction, which is rapidly reversible when the pressure returns to normal levels (7), is a direct consequence of the increased mechanical stress on the endothelial cells caused by the high intravascular pressure (1). An early hypothesis stating that the increased permeability was due to ischemia has been refuted for the following reasons: 1) the increased permeability to macromolecules is evident within seconds after the pressure increase, while it takes much longer for ischemia to cause this change in the BBB (1); 2) the cerebral blood flow is higher in areas with disturbed permeability than in surrounding tissue (8,9); and 3) energy metabolism in the brain is not disturbed in shortlasting acute hypertension (10,11). Moreover, a local increase of the intraluminal pressure in a carotid artery, induced by infusion of blood or isotonic saline, results in a similar BBB dysfunction to that caused by acute systemic hypertension (12-15).The ischemia hypothesis was based on the "vasospasm" theory. Cerebral arteries and arterioles constrict during acute hypertension,