Cerebral hemodynamics in young hypertensive subjects and effects of atenolol treatment

Elio Troisi, Antonio Attanasio, Maria Matteis, Maura Bragoni, Bruno C. Monaldo, Carlo Caltagirone, Mauro Silvestrini

Research output: Contribution to journalArticlepeer-review

Abstract

The aim of this study was to evaluate changes in cerebral hemodynamics in young patients with uncomplicated hypertension before and after effective antihypertensive treatment with a beta-blocker drug. Changes in mean flow velocity in the middle cerebral artery from normal condition to hypercapnia were evaluated by means of a transcranial Doppler in 42 hypertensive patients and 21 healthy subjects comparable for age and sex distribution. We obtained hypercapnia with breath-holding and evaluated cerebrovascular reactivity with the breath-holding index (BHI). After a baseline evaluation (time 0), patients were randomly assigned to a placebo (group 1) or atenolol (group 2) therapy. The evaluation was repeated after 30 (time 1) and 60 (time 2) days of treatment. Before treatment, hypertensive patients had significantly lower BHI values (0.96 ± 0.1 group 1 and 0.85 ± 0.3 group 2) than controls (1.69 ± 0.4) (P <0.0001). During treatment, mean blood pressure significantly decreased in group 2 patients. In the same group, BHI values significantly increased with respect to the pre-treatment evaluation: 1.39 ± 0.2 at time 1 and 1.44 ± 0.2 at time 2 (P <0.0001). On the contrary, mean blood pressure and BHI values remained unchanged in the placebo group. Furthermore, BHI values were significantly higher in group 2 than in group 1 patients at times 1 (P <0.001) and 2 (P <0.0001). These findings suggests that hypertension causes reduced capability of cerebral vessels to adapt to functional changes. This condition, which is reversible after treatment, could be implicated in the increased susceptibility to ischemic stroke in hypertension.

Original languageEnglish
Pages (from-to)115-119
Number of pages5
JournalJournal of the Neurological Sciences
Volume159
Issue number1
DOIs
Publication statusPublished - Jul 15 1998

Keywords

  • Antihypertensive therapy
  • Cerebral blood flow
  • Cerebrovascular reactivity
  • Hypertension
  • Transcranial Doppler ultrasonography

ASJC Scopus subject areas

  • Ageing
  • Clinical Neurology
  • Surgery
  • Developmental Neuroscience
  • Neurology
  • Neuroscience(all)

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