Autoregulation of Brain Circulation in Severe Arterial Hypertension

• Published in: British Medical Journal Vol. 1; no. 5852; pp. 507 - 510
• Main Authors: Strandgaard, S., Olesen, J., Skinhøj, E., Lassen, N. A.
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 03.03.1973; British Medical Association; BMJ Publishing Group LTD
• Subjects: Adult; Aged; Antihypertensives; Arithmetic mean; Arteries; Autoregulation; Blood flow; Blood Gas Analysis; Blood Pressure; Brain - blood supply; Brain Diseases - etiology; Brain hypoxia; Cerebrovascular Circulation; Cerebrovascular Disorders; Female; Humans; Hypertension; Hypertension - blood; Hypertension - complications; Hypertension - physiopathology; Hypertensive encephalopathy; Hypertrophy; Hypoxia; Male; Middle Aged; Neurology; Oxygen; Oxygen - blood; Papers and Originals
• ISSN: 0007-1447; 1468-5833
• DOI: 10.1136/bmj.1.5852.507

Cerebral blood flow was studied by the arteriovenous oxygen difference method in patients with severe hypertension and in normotensive controls. The blood pressure was lowered to study the lower limit of autoregulation (the pressure below which cerebral blood flow decreases) and the pressure limit of brain hypoxia. Both limits were shifted upwards in the hypertensive patients, probably as a consequence of hypertrophy of the arteriolar walls. These findings have practical implications for antihypertensive therapy. When the blood pressure was raised some patients showed an upper limit of autoregulation beyond which an increase of cerebral blood flow above the resting value was seen without clinical symptoms. No evidence of vasospasm was found in any patient at high blood pressure. These observations may be of importance for the understanding of the pathogenesis of hypertensive encephalopathy.