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Unmanaged hypertension, or high blood pressure that is not adequately controlled, is primarily associated with an increased risk of stroke. This is due to the harmful effects of elevated blood pressure on the vascular system, which can lead to damage in the blood vessels over time. When blood pressure is high, it can cause the arteries to become narrowed or hardened (a process known as atherosclerosis), making them less flexible and more susceptible to injury.

This injury can lead to the formation of blood clots, which can subsequently obstruct blood flow to the brain, resulting in a stroke. Additionally, high blood pressure can weaken the smaller blood vessels in the brain, also increasing the risk of hemorrhagic stroke, where bleeding occurs within the brain. Therefore, the long-term effects of unmanaged hypertension highlight the critical importance of maintaining optimal blood pressure levels to mitigate the risk of severe cardiovascular events like strokes.

In contrast, improved renal function, enhanced athletic performance, and decreased blood viscosity are not associated with unmanaged hypertension. Instead, high blood pressure may harm kidney function, limit athletic performance due to cardiovascular strain, and actually increase blood viscosity as a consequence of related conditions such as dehydration or stress on the circulatory system.