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Related Experiment Videos

Cerebral blood flow changes with enalapril.

S C Fagan1, S Robert, J R Ewing

  • 1College of Pharmacy, Wayne State University, Detroit, MI 48202.

Pharmacotherapy
|January 1, 1992
PubMed
Summary

Elderly patients with carotid artery occlusive disease (CAOD) face higher risks of cerebral hypoperfusion after enalapril. Younger patients with CAOD showed increased cerebral blood flow (CBF), while older patients experienced a decrease.

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Editorial commentary.

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Area of Science:

  • Neurology
  • Cardiology
  • Pharmacology

Background:

  • Carotid artery occlusive disease (CAOD) poses a risk for iatrogenic cerebral hypoperfusion.
  • Understanding the impact of antihypertensive medications on cerebral blood flow (CBF) is crucial for patient safety.

Purpose of the Study:

  • To evaluate the effects of enalapril on regional cerebral blood flow (CBF) in patients with and without CAOD.
  • To identify patient subgroups at risk for adverse CBF changes following enalapril administration.

Main Methods:

  • Utilized the 133xenon-inhalation technique to measure regional CBF.
  • Assessed CBF and blood pressure in 14 hypertensive patients (7 with CAOD, 7 without) before and 60 minutes after a single dose of enalapril.

Main Results:

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  • No significant differences in mean arterial pressure or mean CBF changes were observed between CAOD and no CAOD groups after enalapril.
  • In the CAOD group, CBF changes correlated significantly with age (r = -0.9253, p < 0.01).
  • Elderly CAOD patients (≥65 years) showed a trend towards decreased CBF, while younger patients exhibited increased CBF.

Conclusions:

  • Elderly patients with CAOD may be particularly susceptible to iatrogenic cerebral hypoperfusion when treated with enalapril.
  • Prospective evaluation of antihypertensive medication effects on CBF in at-risk populations is warranted.