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Updated: Nov 25, 2025
Author Spotlight: Noninvasive Cerebral Blood Flow Determination in Human Functional Brain Region for Diagnosis of Neurological Disorders
Published on: May 31, 2024
Longitudinal relation between blood pressure, antihypertensive use and cerebral blood flow, using arterial spin
Jan Willem van Dalen1,2, Henri Jmm Mutsaerts3, Jan Petr4
1Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Insights
This study found no link between blood pressure and cerebral blood flow (CBF) in older adults with hypertension. However, antihypertensive drug use was associated with lower CBF and altered cerebrovascular markers.
Area of Science:
- Neuroscience
- Cardiovascular Medicine
- Medical Imaging
Background:
- Consistent cerebral blood flow (CBF) is crucial for brain function, maintained by cerebral autoregulation.
- Chronic hypertension in older adults can disrupt cerebral autoregulation, potentially impacting CBF.
- Understanding the relationship between blood pressure, antihypertensive use, and CBF is vital for managing cerebrovascular health in aging populations.
Purpose of the Study:
- To investigate the association between blood pressure (BP) levels and antihypertensive drug (AHD) use with concurrent and longitudinal changes in cerebral blood flow (CBF).
- To explore the relationship between BP parameters and CBF in community-dwelling older individuals with hypertension.
- To assess the utility of arterial spin labelling (ASL) signal spatial coefficient of variation (ASL SCoV) as a marker of cerebrovascular health in this cohort.
Main Methods:
- A prospective longitudinal cohort study involving 186 community-dwelling older individuals (mean age 77 years) with hypertension.
- Arterial spin labelling (ASL) MRI was used to measure cerebral blood flow (CBF) and ASL signal spatial coefficient of variation (ASL SCoV).
- Blood pressure parameters (diastolic, systolic, mean arterial, pulse pressure) and antihypertensive drug use were assessed over a 3-year follow-up period for 125 participants.
Main Results:
- No significant associations were found between any blood pressure measures and concurrent CBF.
- Longitudinal changes in blood pressure were not associated with changes in CBF over the 3-year follow-up.
- Antihypertensive drug use was significantly associated with lower grey matter CBF and higher ASL SCoV, suggesting potential alterations in cerebral perfusion and cerebrovascular health.
Conclusions:
- Blood pressure levels and their longitudinal changes do not appear to be directly associated with concurrent or changing cerebral blood flow in older hypertensive individuals.
- Antihypertensive medication use is linked to reduced grey matter CBF and increased heterogeneity in ASL signal, warranting further investigation.
- Future research should focus on the complex interplay between antihypertensive therapies, cerebral perfusion, and cerebrovascular health in aging populations.
Abstract:
Consistent cerebral blood flow (CBF) is fundamental to brain function. Cerebral autoregulation ensures CBF stability. Chronic hypertension can lead to disrupted cerebral autoregulation in older people, potentially leading to blood pressure levels interfering with CBF. This study tested whether low BP and AHD use are associated with contemporaneous low CBF, and whether longitudinal change in BP is associated with change in CBF, using arterial spin labelling (ASL) MRI, in a prospective longitudinal cohort of 186 community-dwelling older individuals with hypertension (77 ± 3 years, 53% female), 125 (67%) of whom with 3-year follow-up. Diastolic blood pressure, systolic blood pressure, mean arterial pressure, and pulse pressure were assessed as blood pressure parameters. As additional cerebrovascular marker, we evaluated the ASL signal spatial coefficient of variation (ASL SCoV), a measure of ASL signal heterogeneity that may reflect cerebrovascular health. We found no associations between any of the blood pressure measures and concurrent CBF nor between changes in blood pressure measures and CBF over three-year follow-up. Antihypertensive use was associated with lower grey matter CBF (-5.49 ml/100 g/min, 95%CI = -10.7|-0.27, p = 0.04) and higher ASL SCoV (0.32 SD, 95%CI = 0.12|0.52, p = 0.002). These results warrant future research on the potential relations between antihypertensive use and cerebral perfusion.
