TY - JOUR
T1 - Different Relationship between Systolic Blood Pressure and Cerebral Perfusion in Subjects with and without Hypertension
AU - Glodzik, Lidia
AU - Rusinek, Henry
AU - Tsui, Wai
AU - Pirraglia, Elizabeth
AU - Kim, Hee Jin
AU - Deshpande, Anup
AU - Li, Yi
AU - Storey, Pippa
AU - Randall, Catherine
AU - Chen, Jingyun
AU - Osorio, Ricardo S.
AU - Butler, Tracy
AU - Tanzi, Emily
AU - McQuillan, Molly
AU - Harvey, Patrick
AU - Williams, Stephen K.
AU - Ogedegbe, Gbenga
AU - Babb, James S.
AU - De Leon, Mony J.
PY - 2019
Y1 - 2019
N2 - Although there is an increasing agreement that hypertension is associated with cerebrovascular compromise, relationships between blood pressure (BP) and cerebral blood flow are not fully understood. It is not known what BP level, and consequently what therapeutic goal, is optimal for brain perfusion. Moreover, there is limited data on how BP affects hippocampal perfusion, a structure critically involved in memory. We conducted a cross-sectional (n=445) and longitudinal (n=185) study of adults and elderly without dementia or clinically apparent stroke, who underwent clinical examination and brain perfusion assessment (age 69.2±7.5 years, 62% women, 45% hypertensive). Linear models were used to test baseline BP-blood flow relationship and to examine how changes in BP influence changes in perfusion. In the entire group, systolic BP (SBP) was negatively related to cortical (β=-0.13, P=0.005) and hippocampal blood flow (β=-0.12, P=0.01). Notably, this negative relationship was apparent already in subjects without hypertension. Hypertensive subjects showed a quadratic relationship between SBP and hippocampal blood flow (β=-1.55, P=0.03): Perfusion was the highest in subjects with mid-range SBP around 125 mm Hg. Longitudinally, in hypertensive subjects perfusion increased with increased SBP at low baseline SBP but increased with decreased SBP at high baseline SBP. Cortical and hippocampal perfusion decrease with increasing SBP across the entire BP spectrum. However, in hypertension, there seems to be a window of mid-range SBP which maximizes perfusion.
AB - Although there is an increasing agreement that hypertension is associated with cerebrovascular compromise, relationships between blood pressure (BP) and cerebral blood flow are not fully understood. It is not known what BP level, and consequently what therapeutic goal, is optimal for brain perfusion. Moreover, there is limited data on how BP affects hippocampal perfusion, a structure critically involved in memory. We conducted a cross-sectional (n=445) and longitudinal (n=185) study of adults and elderly without dementia or clinically apparent stroke, who underwent clinical examination and brain perfusion assessment (age 69.2±7.5 years, 62% women, 45% hypertensive). Linear models were used to test baseline BP-blood flow relationship and to examine how changes in BP influence changes in perfusion. In the entire group, systolic BP (SBP) was negatively related to cortical (β=-0.13, P=0.005) and hippocampal blood flow (β=-0.12, P=0.01). Notably, this negative relationship was apparent already in subjects without hypertension. Hypertensive subjects showed a quadratic relationship between SBP and hippocampal blood flow (β=-1.55, P=0.03): Perfusion was the highest in subjects with mid-range SBP around 125 mm Hg. Longitudinally, in hypertensive subjects perfusion increased with increased SBP at low baseline SBP but increased with decreased SBP at high baseline SBP. Cortical and hippocampal perfusion decrease with increasing SBP across the entire BP spectrum. However, in hypertension, there seems to be a window of mid-range SBP which maximizes perfusion.
KW - blood pressure
KW - brain
KW - hippocampus
KW - hypertension
KW - perfusion
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U2 - 10.1161/HYPERTENSIONAHA.118.11233
DO - 10.1161/HYPERTENSIONAHA.118.11233
M3 - Article
C2 - 30571554
AN - SCOPUS:85058926520
VL - 73
SP - 197
EP - 205
JO - Hypertension
JF - Hypertension
SN - 0194-911X
IS - 1
ER -