Related Experiment Videos
Regional cerebral blood flow in chronic hypertension. A correlative study
F Nobili1, G Rodriguez, S Marenco
1Department of Motor Science (Neurophysiopathology), University of Genoa, Italy.
Insights
Essential hypertension can reduce cerebral blood flow, particularly in untreated patients. Effective blood pressure management may preserve brain perfusion and reduce cerebrovascular resistance, highlighting the importance of monitoring brain blood flow in hypertensive individuals.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Medical Imaging
Background:
- Essential hypertension is linked to cerebral hypoperfusion.
- Neurologically asymptomatic hypertensive patients may exhibit reduced cerebral blood flow.
- Understanding cerebral blood flow in hypertension is crucial for identifying target organ damage.
Purpose of the Study:
- To investigate regional cerebral blood flow in asymptomatic hypertensive patients.
- To determine relationships between cerebral blood flow, vascular risk factors, and end-organ damage.
- To assess the impact of hypertension treatment on cerebral perfusion.
Main Methods:
- 101 hypertensive patients (untreated and treated) underwent regional cerebral blood flow measurement using the 133Xe inhalation method.
- Patients were neurologically asymptomatic.
- Comparison with age- and sex-matched healthy controls.
Main Results:
- Significantly reduced cerebral blood flow was observed in untreated hypertensive patients compared to controls (P < .01).
- Treated hypertensive patients also showed reduced cerebral blood flow, though to a lesser extent (P = .047).
- Good blood pressure control in treated patients positively influenced global cerebral blood flow and cerebrovascular resistance.
Conclusions:
- Cerebral hypoperfusion is prevalent in asymptomatic hypertensive patients, especially when untreated.
- Effective blood pressure control can preserve cerebral perfusion and decrease cerebrovascular resistance.
- Regional cerebral blood flow assessment is a valuable, cost-effective tool for evaluating brain perfusion in hypertensive disease.
Background And Purpose:
Cerebral hypoperfusion has occasionally been reported during essential hypertension. We explored regional cerebral blood flow in a large series of neurologically asymptomatic hypertensive patients to determine relations among cerebral blood flow, concomitant main vascular risk factors, and the most common signs of end-organ damage.
Methods:
Regional cerebral blood flow was measured by the 133Xe inhalation method in 101 hypertensive patients without clinically apparent central nervous system involvement, including 39 mild to moderate untreated and 62 mild to severe treated patients.
Results:
Compared with age- and sex-matched normal control subjects, cerebral blood flow was significantly reduced in untreated hypertensive patients (P < .01) and to a lesser extent in treated patients (P = .047). Both regional and global cerebral blood flow reductions were observed in approximately one third of patients in both groups. Analysis of variance failed to show significant correlations between cerebral blood flow and total cholesterol concentration, mean arterial blood pressure, duration of disease, or the presence of retinopathy or left ventricular hypertrophy. In the treated group, the quality of control of hypertension significantly influenced both global cerebral blood flow (P = .007) and cerebrovascular resistance (P < .0001).
Conclusions:
Focal or diffuse cerebral hypoperfusion is present even in neurologically asymptomatic hypertensive patients, especially when untreated; good control of blood pressure may preserve cerebral perfusion and reduce cerebrovascular resistance. Regional cerebral blood flow examination represents a relatively simple and low-cost technique to explore the perfusional condition of the brain, one of the main target organs of hypertensive disease.