What is the clinical evidence from this study?

Study design: Observational. Population: Normal aging (n=83). Intervention: Central arterial aging. Primary outcome: Cerebral hemodynamics (CBF, CBFV, CBF pulsatility).

March 19, 2014Open Access

Cerebral Hemodynamics in Normal Aging: Central Artery Stiffness, Wave Reflection, and Pressure Pulsatility

Key Result

Central arterial aging and increased carotid pulse pressure were independently associated with higher cerebral blood flow pulsatility, which correlated with greater white-matter hyperintensity volume.

Study Design

Type

Observational (n=83)

Structured PICO

Population

83 healthy participants aged 22 to 80 years (37 men, 46 women) from the Dallas/Fort Worth metropolitan area. Key exclusions: blood pressure ≥140/90 mm Hg, fasting blood glucose >126 mg/dL, BMI >35 kg/m2, smoking, pregnancy, history of cerebrovascular, metabolic, neurologic, psychiatric, or inflammatory diseases, taking antihypertensive medications.

Outcome

Impact of central arterial aging on cerebral hemodynamics (cerebral blood flow [CBF], CBF velocity [CBFV], and CBF pulsatility)surrogate

Central arterial aging, characterized by increased stiffness and wave reflection, plays a significant role in age-related increases in cerebral hemodynamic pulsatility, which is associated with white-matter hyperintensity in older adults.

Abstract

Blood ejected from the left ventricle perfuses the brain via central elastic arteries, which stiffen with advancing age and may elevate the risk of end-organ damage. The purpose of this study was to determine the impact of central arterial aging on cerebral hemodynamics. Eighty-three healthy participants aged 22 to 80 years underwent the measurements of cerebral blood flow (CBF) and CBF velocity (CBFV) using magnetic resonance imaging (MRI) and transcranial Doppler, respectively. The CBF pulsatility was determined by the relative amplitude of CBFV to the mean value (CBFV%). Central arterial stiffness (carotid-femoral pulse wave velocity), wave reflection (carotid augmentation index), and pressure were measured using applanation tonometry. Total volume of white-matter hyperintensity (WMH) was quantified from MR images. Total CBF decreased with age while systolic and pulsatile CBFV% increased and diastolic CBFV% decreased. Women showed greater total CBF and lower cerebrovascular resistance than men. Diastolic CBFV% was lower in women than in men. Age- and sex-related differences in CBF pulsatility were independently associated with carotid pulse pressure and arterial wave reflection. In older participants, higher pulsatility of CBF was associated with the greater total volume of WMH. These findings indicate that central arterial aging has an important role in age-related differences in cerebral hemodynamics.

Demander à l'IA

Bookmark

View Full Paper