Key result
Arterial hypertension, whether controlled or uncontrolled, did not significantly impair cerebral autoregulation capacity compared to normotensive individuals (ARI 5.91 and 5.88 vs 5.54, p=0.6).
Why the study?
To evaluate whether cerebral autoregulation is impaired in hypertensive patients and whether this impairment differs based on blood pressure control.
Does systemic arterial hypertension on drug treatment impair cerebral autoregulation in adult patients?
Observational (n=115)
No
Does systemic arterial hypertension on drug treatment impair cerebral autoregulation in adult patients?
Absolute Event Rate: 5.91% vs 5.54%
p-value: p=0.6
Hypertensive patients on drug treatment maintain intact cerebral autoregulation capacity regardless of their blood pressure control status.
Supports preserved autoregulation in treated hypertension regardless of control; leaves open prospective validation of cerebrovascular outcomes.
Cerebral autoregulation (AR) keeps cerebral blood flow constant despite fluctuations in systemic arterial pressure. The final common AR pathway is made up of vasomotor adjustments of cerebrovascular resistance mediated by arterioles. Structural and functional changes in the arteriolar wall arise with age and systemic arterial hypertension. This study evaluated whether AR is impaired in hypertensive patients and whether this impairment differs with disease control. Three groups of patients were prospectively compared: hypertensive patients under treatment with systolic blood pressure (SBP) <140 and diastolic blood pressure (DBP) <90 mm Hg (n = 54), hypertensive patients under treatment with SBP > 140 or DBP > 90 mm Hg (n = 31), and normotensive volunteers (n = 30). Simultaneous measurements of cerebral blood flow velocity (CBFV) and BP were obtained by digital plethysmography and transcranial Doppler, and the AR index (ARI) was defined according to the step response to spontaneous fluctuations in BP. Compared to the uncontrolled hypertension, the normotensive individuals were younger (age 43.42 ± 11.14, P < .05) and had a lower resistance-area product (1.17 ± 0.24, P < .05), although age and greater arteriolar stiffness did not affect the CBFV mean of hypertensive patients, whether controlled or uncontrolled (62.85 × 58.49 × 58.30 cm/s, P = .29), most likely because their ARIs were not compromised (5.54 × 5.91 × 5.88, P = .6). Hypertensive patients under treatment, regardless of their BP control, have intact AR capacity.
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Machado et al. (2020) conducted an observational in Arterial hypertension (n=115). Arterial hypertension vs. Normotensive individuals was evaluated on Autoregulation index (ARI) (p=0.6). Arterial hypertension, whether controlled or uncontrolled, did not significantly impair cerebral autoregulation capacity compared to normotensive individuals (ARI 5.91 and 5.88 vs 5.54, p=0.6).
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