Cataldo et al teresting is the activation of the sympathetic nervous sys- tem and the hypothalamic-pituitary-adrenal axis, which determines an increase in heart rate, peripheric vascular re- sistance, secretion of cortisol, catecholamines, glucose and insulin. All these mechanisms may contribute to the onset or the progression of hypertension [22]. The activation of the hypothalamic-pituitary-adrenal axis plays also a central role in stimulating endothelial growth factors and, consequently, on atherogenesis inflammation-mediated. Some studies have documented in patients with severe depression an elevated activity of the sympathetic nervous system with increased plasma levels of cortisol [3]. In addition to the direct effects on the vascular system, the activation of these biochemical pathways may be associated with an increased release of in- flammatory cytokines, a hypothesis supported by the finding of elevated levels of C-reactive protein in these patients [23]. The relationship between hypertension and depression could evolve, therefore, through a series of biological reactions. Integrating different professional skills to ensure the unity, fullness and coherence of the rehabilitative activities is undoubtedly a major challenge to warrant the quality of care delivered at home. In our social setting, the motor-sensory rehabilitation of a patient who has suffered a cerebral ischemic event aims to prevent the immobilization syndrome, to facilitate the re- covery of and/or to maintain correct posture and functional motions in order to achieve the highest possible degree of autonomy in activities of daily living with reintegration in social life and relations. It is always necessary to consider the patient in his mental and physical unity and complexity in order to implement an effective and efficient therapeutic program. It is always difficult for these patients to achieve the full recovery of previous functional abilities, so counsel- ling is necessary in order to help both the patient and the family group to accept the new situation and to build a new balance. Depression should be considered as a part of the problems of post-stroke patients and clinical practice should pay more and more attention to it because it can be an im- portant element in causing disability and a poorer quality of life. Indeed, depressed patients exhibit poor functional performances which are comparable to or worse than the performances of patients with chronic medical conditions. Therefore, early recognition of depressive symptoms in pa- tients affected by stroke is generally considered to be a criti- cal factor in order to promote a better quality of their life [24, 25]. Currently, strategies for preventive therapy of depres- sion are incompletely formulated. It would be more appro- priate to focus on a better understanding of the neurobiology of depression and hypertension as a basis for developing a rational and effective therapy. Considerations deriving from our findings, though obtained from a limited number of pa- tients, should represent a stimulus for more extensive inves- tigations. J Clin Med Res • 2010;2(1):39-43 “It is not the flexing of the leg that we must seek, but the marching function and the march itself is only one ele- ment of normal human behaviour; in fact we must believe that whoever walks, eats and sleeps, he will also begin to smile... “ Ueberschlag H. References 1. Paolucci S, Antonucci G, Grasso MG, Morelli D, Troisi E, Coiro P, De Angelis D, et al. Post-stroke depression, antidepressant treatment and rehabilitation results. A case-control study. Cerebrovasc Dis 2001;12(3):264- 271. 2. Robinson RG. Poststroke depression: prevalence, diag- nosis, treatment, and disease progression. 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