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ICP and Antihypertensive Drugs

Charlotte Rouzaud-Laborde1, Pierre Lafitte2, Laurent Balardy3

  • 1Department of Pharmacy, University Hospital Toulouse, Toulouse, France. laborde.c@chu-toulouse.fr.

Acta Neurochirurgica. Supplement
|March 2, 2018
PubMed

Insights

Antihypertensive drugs may increase brain stiffness, as patients on these medications showed higher elastance and lower pressure volume index. The number of drugs did not significantly alter other intracranial pressure parameters.

Area of Science:

  • Neurology
  • Nephrology
  • Pharmacology

Background:

  • Arterial hypertension is a major mortality risk factor, often managed with multiple antihypertensive drugs.
  • The complex relationship between arterial blood pressure and intracranial pressure (ICP) is not fully understood.
  • The specific effects of antihypertensive medications on ICP and related parameters remain largely unknown.

Purpose of the Study:

  • To investigate the influence of antihypertensive drug use on ICP and cerebrospinal fluid (CSF)/brain parameters.
  • To determine if the number of antihypertensive drugs correlates with changes in ICP-derived metrics.

Main Methods:

  • Prospective cohort study of 95 patients with suspected normal pressure hydrocephalus.
  • Collected drug data using the Anatomical Therapeutic Chemical (ATC) classification.
  • Performed lumbar infusion studies and used ICM+ software to calculate ICP, pulse amplitude, CSF outflow resistance, elastance, sagittal sinus pressure, and CSF production rate.

Main Results:

  • Patients on antihypertensive drugs exhibited significantly higher brain elastance compared to non-medicated individuals.
  • The pressure volume index (PVI) was significantly decreased in patients using antihypertensive drugs.
  • No significant influence of the number of antihypertensive drugs on other ICP parameters was observed.

Conclusions:

  • Antihypertensive drug use is associated with increased brain stiffness.
  • Patients on antihypertensive medications may have altered brain pressure-volume dynamics.
Abstract

Keywords:
Antihypertensive drugsElastanceHypertensionPSSPVI

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