Key result
Uncontrolled blood pressure is linked to impaired intracranial compliance, regardless of antihypertensive drug class.
Why the study?
Do different antihypertensive pharmacological strategies (vasodilators, non-vasodilators, or mixed therapy) and blood pressure control improve non-invasively measured intracranial compliance parameters (P2/P1 ratio and time to peak) in patients with long-standing systemic arterial hypertension?
Cross-Sectional (n=140)
No
Do different antihypertensive pharmacological strategies (vasodilators, non-vasodilators, or mixed therapy) and blood pressure control improve non-invasively measured intracranial compliance parameters (P2/P1 ratio and time to peak) in patients with long-standing systemic arterial hypertension?
In patients with long-standing hypertension, achieving peripheral blood pressure control is significantly associated with better non-invasive intracranial compliance parameters, regardless of the specific antihypertensive drug class used.
Peripheral BP control may relate to intracranial compliance in hypertension; cross-sectional data leaves open drug-class effects and requires prospective validation.
Thiago Oliveira Costa , Sayuri Inuzuka , Mikaelle Costa Correia , Matheus Martins da Costa , Priscila Valverde de Oliveira Vitorino , Gustavo Frigieri , Ana Luíza Lima Sousa , Weimar Kunz Sebba Barroso DOI: 10.36660/ijcs.20260156 Intracranial compliance (IC) refers to the brain’s ability to accommodate variations in intracranial volume without substantial increases in pressure. Alterations in compliance are associated with cardiovascular (CV) conditions such as hypertension. Understanding the relationship between blood pressure (BP) control, pharmacological treatment strategies, and IC may aid in managing cerebrovascular risk. To evaluate the association between IC parameters, BP control, and different antihypertensive therapeutic strategies in patients with systemic arterial hypertension (AH). This cross-sectional study included 140 hypertensive patients followed in a specialized outpatient clinic between November 2022 and August 2023. Clinical data, CV risk factors, antihypertensive drug classes, central and peripheral BP, and IC parameters obtained using the Brain4Care (B4C) system were collected. Patients were classified into Group A (vasodilators), Group B (non-vasodilators), and Group C (mixed therapy). Continuous variables were presented as mean and standard deviation and compared using Student’s t-test. Categorical variables were compared using Pearson’s chi-square or Fisher’s exact tests. Correlations were assessed using Pearson’s correlation coefficient. A significance level of 5% was adopted. A total of 140 patients were included; 77.9% were women, with a mean age of 67.9 ± 11.1 years. All patients were using antihypertensive medication, predominantly combination therapy (62.1%), especially mixed therapy (65%). Uncontrolled peripheral BP was associated with higher P2/P1 values. Among those with P2/P1 > 1.4, 85.7% had uncontrolled BP (p = 0.002). There was no association between type of therapy and changes in IC parameters. In this sample of hypertensive patients followed in a specialized outpatient clinic, no statistically significant differences in IC parameters were observed across the therapeutic groups evaluated. Peripheral BP control was the factor most strongly associated with more favorable IC values. Prospective studies with more balanced groups are needed to confirm these findings.
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Costa et al. (2026) conducted a cross-sectional in Systemic arterial hypertension (n=140). Uncontrolled peripheral blood pressure (vs controlled peripheral blood pressure) and antihypertensive pharmacological strategies (vasodilators, non-vasodilators, mixed therapy) vs. Controlled peripheral blood pressure and comparison across pharmacological groups was evaluated on High risk of intracranial hypertension (P2/P1 ratio > 1.4) obtained via non-invasive Brain4Care intracranial pressure monitoring (p=0.002). Uncontrolled peripheral blood pressure was associated with high-risk intracranial compliance (85.7% of patients with P2/P1 > 1.4, p=0.002), whereas antihypertensive drug classes did not differ.
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