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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Cerebrovascular mental stress reactivity is impaired in hypertension

Tasneem Z Naqvi1, Hanh K Hyuhn

  • 1Division of Cardiology at Cedars Sinai Heart Institute, Cedars-Sinai Medical Center, University of Southern California, Los Angeles, CA, USA. tnaqvi@usc.edu

Cardiovascular Ultrasound
|July 7, 2009
PubMed

Insights

Mental stress causes carotid artery vasodilation in healthy individuals, but this response is blunted in hypertension, suggesting cerebral vascular endothelial dysfunction. This study highlights a novel ultrasound method for assessing hypertension

Area of Science:

  • Cardiovascular physiology
  • Cerebrovascular research
  • Hypertension studies

Background:

  • Brachial artery reactivity is impaired in hypertension.
  • Endothelial dysfunction is generalized in hypertensive individuals.
  • Carotid artery (CA) reactivity may also be affected by hypertension.

Purpose of the Study:

  • To compare CA endothelium-dependent vasodilation in response to mental stress in normal and hypertensive subjects.

Main Methods:

  • Evaluated CA reactivity to mental stress in young healthy volunteers, older healthy volunteers, and patients with essential hypertension.
  • Utilized transcranial Doppler ultrasound to measure middle cerebral artery (MCA) blood flow before and after mental stress in a subset of participants.

Main Results:

  • Mental stress induced CA vasodilation and increased CA and MCA blood flow in healthy subjects (young and old).
  • Hypertensive subjects showed no significant CA vasodilation or increase in CA blood flow in response to mental stress.
  • No difference in CA response to nitroglycerin was observed between healthy and hypertensive subjects, indicating preserved smooth muscle function.

Conclusions:

  • Mental stress induces CA vasodilation and enhances cerebral blood flow in healthy individuals.
  • This response is attenuated in hypertensive subjects, suggesting impaired cerebrovascular endothelial function.
  • Ultrasound assessment of mental stress-induced CA reactivity is a novel method to evaluate hypertension's impact on cerebrovascular function and blood flow reserve.
Abstract

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