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Cerebral circulation under normal and pathologic conditions.

O B Paulson1, G Waldemar, J F Schmidt

  • 1Department of Neurology, Rigshospitalet, Copenhagen, Denmark.

The American Journal of Cardiology
|February 2, 1989
PubMed
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Cerebral blood flow autoregulation maintains constant brain blood supply across arterial pressure changes. Chronic hypertension shifts this regulation, impairing tolerance to drops but improving tolerance to surges in blood pressure.

Area of Science:

  • Neuroscience
  • Cardiovascular Physiology
  • Cerebrovascular Regulation

Background:

  • Autoregulation of cerebral circulation is crucial for maintaining constant cerebral blood flow (CBF) despite wide variations in arterial pressure.
  • Key limits for autoregulation are typically 60 mm Hg (lower) and 150 mm Hg (upper) mean arterial pressure.

Purpose of the Study:

  • To discuss the mechanisms of cerebral blood flow autoregulation.
  • To explore how sympathetic nervous system and renin-angiotensin system modulate this regulation.
  • To examine the impact of chronic hypertension on cerebral autoregulation limits and implications for treatment.

Main Methods:

  • Discussion of myogenic response and metabolic regulation as primary autoregulation mechanisms.
  • Analysis of neurohormonal modulation (sympathetic nervous system, renin-angiotensin system).

Related Experiment Videos

  • Review of structural and functional changes in cerebral resistance vessels in hypertension.
  • Main Results:

    • Chronic hypertension shifts the autoregulatory curve to higher arterial pressures.
    • This shift impairs tolerance to acute decreases in arterial pressure.
    • Tolerance to acute increases in arterial pressure is concurrently improved in hypertensive states.

    Conclusions:

    • Adaptive changes in cerebral resistance vessels underlie the hypertension-induced shift in autoregulation.
    • These adaptations are partially reversible with antihypertensive treatment.
    • Understanding autoregulation pathophysiology is vital before acute blood pressure-lowering interventions.