The influence of antihypertensive drugs on hemodynamic parameters of cerebral arteries assessed by transcranial Doppler

Abstract

Abstract Arterial hypertrophy and remodeling are adaptive responses present in the systemic arterial hypertension (SAH). As a result, antihypertensive drugs (AHD) begin to play an important role in controlling the cerebral blood flow. To evaluate the influence of AHD on cerebral hemodynamic parameters (CHP). Three groups of patients were compared: hypertensive with systolic blood pressure (SBP) < 140 and diastolic blood pressure (DBP) < 90 mmHg (n = 54), hypertensive with SBP > 140 or DBP > 90 mmHg (n = 31) and normotensive (n = 30). Simultaneous measurements of systemic blood pressure (BP) and middle cerebral artery (MCA) blood flow velocity (CBFV) were obtained from digital plethysmography and Transcranial Doppler. The use of diuretics (p = 0.047) and α-agonists (p = 0.009) reduced the pulsatility index (PI) among uncontrolled hypertensives, but did not change their arterial stiffness in relation to the others groups (RAP 1.7 [± 0.7], p < 0.001). There was no correlation between ADH and other CHP, although the RAP of controlled hypertensives was comparable to that of normotensives. Among uncontrolled hypertensives, the use of AHD with direct vasodilating action actively reduces PI, so it does not reflect a real cerebrovascular resistance of adaptive histological changes. This effect seems to be smaller among controlled hypertensives, due to their lower arterial stiffness, probably resulting from the attenuation of these changes.