Pathophysiology of Cerebral Vascular Dysfunction in Pregnancy-Induced Hypertension

• Published in: Current hypertension reports Vol. 21; no. 7; pp. 52 - 8
• Main Authors: Younes, Subhi Talal, Ryan, Michael J.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.07.2019; Springer Nature B.V
• Subjects: Blood-Brain Barrier; Brain research; Cardiology; Cerebrovascular Circulation; Edema; Endothelium, Vascular; Family Medicine; Female; Flow velocity; General Practice; Headaches; Homeostasis; Humans; Hypertension; Hypertension, Pregnancy-Induced - physiopathology; Internal Medicine; Mechanisms of Hypertension and Target-Organ Damage (JE Hall and ME Hall; Mechanisms of Hypertension and Target-Organ Damage (JE Hall and ME Hall, Section Editors); Medicine; Medicine & Public Health; Metabolic Diseases; Nephrology; Pre-Eclampsia; Preeclampsia; Pregnancy; Primary Care Medicine; Section Editors; Topical Collection on Mechanisms of Hypertension and Target-Organ Damage; Tumor necrosis factor-TNF; Vascular endothelial growth factor; Womens health; Endothelial dysfunction; Myogenic response; Preeclampsia; Cerebral circulation; Blood–brain barrier
• ISSN: 1522-6417; 1534-3111
• DOI: 10.1007/s11906-019-0961-8

Purpose of Review To review and summarize what is known about cerebrovascular derangements during preeclampsia. Recent Findings Preeclampsia is a devastating disorder of pregnancy with no known cure. Little is known about the pathophysiological mechanisms which lead to the symptoms of the disorder, particularly with regard to individual vascular beds such as the cerebral circulation. Studies suggest that the cerebrovascular dysfunction characteristic of the preeclampsia syndrome is characterized by alterations in cerebral blood flow autoregulation and opening of the blood–brain barrier. Mechanistic studies demonstrate that the same circulating factors implicated in the pathophysiology of other vascular beds may be operative in the cerebral circulation as well. However, significant knowledge gaps still exist, highlighting the need for more intense research in this field. Summary Little is known about cerebrovascular dysfunction during preeclampsia, and detailed mechanistic studies are needed to identify the molecular pathways involved, the interactions thereof, and how those pathways lead to clinical disease.