The effect of beta‐adrenergic receptor blocking drugs on cerebral blood flow.

Griffith, D N; Im, James; Newbury, P.; Woollard, Malcolm

doi:10.1111/j.1365-2125.1979.tb00991.x

Cited by 48 publications

(20 citation statements)

References 15 publications

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“…In long-standing hyper tension, the lower limit shifts to a higher level than that in the normotensives, resulting in a narrowing of the autoregulatory range. A réadaptation of cerebral autoregula tion is also expected in some cases after long-term and effective antihypertensive treatment [13], and the CBF in such cases did not significantly change or even increased despite a reduction in the systemic blood pressure by anti hypertensive treatment [12,14,15]. Thus, a careful and gradual lowering of blood pressure is necessary, and it is of primary importance to maintain a sufficient CBF.…”

Section: Discussionmentioning

confidence: 99%

Effect of Long-Term Antihypertensive Treatment on the Cerebral Blood Flow in Patients with Brain Infarction

et al. 1993

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After long-term antihypertensive treatment (mean 25 months, range 18–38 months), the cerebral blood flow (CBF) in both symptomatic and asymptomatic hemispheres remained unchanged despite a reduction in blood pressure in 24 hypertensive cases with chronic cerebral infarction. However, there was a positive correlation between the change in systolic or mean blood pressure and the change in CBF in the symptomatic hemisphere (p < 0.05). Our data suggest that more than 80% of the pretreatment level of blood pressure or 120 mm Hg of systolic blood pressure might be a preferable lower level of blood pressure for antihypertensive treatment in patients with chronic cerebral infarction.

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Section: Discussionmentioning

confidence: 99%

Effect of Long-Term Antihypertensive Treatment on the Cerebral Blood Flow in Patients with Brain Infarction

et al. 1993

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“…[7][8][9][10][11][12][13] However, the effects of these medications on cerebral blood flow during orthostatic stress have not been established, particularly in elderly patients with systolic hypertension.…”

Section: Discussionmentioning

confidence: 99%

Antihypertensive Therapy Increases Cerebral Blood Flow and Carotid Distensibility in Hypertensive Elderly Subjects

Lipsitz

Gagnon²,

Vyas³

et al. 2005

Hypertension

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Abstract-Many physicians are reluctant to lower blood pressure to recommended levels in elderly hypertensive patients because of concern about producing cerebral hypoperfusion. Because hypertension is associated with potentially reversible structural and functional alterations in the cerebral circulation that may improve with treatment, we investigated whether long-term pharmacological reduction of systolic blood pressure will improve, rather than worsen, cerebral blood flow and its regulation. Three groups of elderly subjects 65 years of age or older were studied prospectively: normotensive subjects (Nϭ19), treated hypertensive subjects with systolic pressure Ͻ140 mm Hg (Nϭ18), and uncontrolled hypertensive subjects with systolic pressure Ͼ160 mm Hg at entry into the study (Nϭ14).We measured beat-to-beat blood flow velocity in the middle cerebral artery (transcranial Doppler ultrasonography), finger arterial pressure (photoplethysmography), and pulsatile distensibility of the carotid artery (duplex Doppler ultrasonography) at baseline and after 6 months of observation or antihypertensive therapy. After baseline hemodynamic measurements, uncontrolled hypertensive subjects underwent aggressive treatment with lisinopril with or without hydroclorothiazide or, if not tolerated, nifedipine or an angiotensin receptor blocker to bring their systolic pressure Ͻ140 mm Hg for 6 months. The other 2 groups were observed for 6 months. After 6 months of successful treatment, uncontrolled hypertensive subjects had significant increases in cerebral blood flow velocity and carotid distensibility that was not seen in the other groups. Treatment reduced cerebrovascular resistance and did not impair cerebral autoregulation. Therefore, judicious long-term treatment of systolic hypertension in otherwise healthy elderly subjects does not cause cerebral hypoperfusion. Key Words: aging Ⅲ angiotensin-converting enzyme inhibitor Ⅲ brain Ⅲ hemodynamics Ⅲ ultrasonography A lthough the treatment of systolic hypertension has been shown in prospective randomized controlled trials to reduce cardiovascular morbidity and mortality in subjects up to age 80, many physicians are reluctant to lower systolic blood pressure (BP) to the recommended level of 140 mm Hg or lower in elderly patients, because of concern that aggressive treatment may cause cerebral hypoperfusion and associated syncope, falls, or cognitive dysfunction. 1,2 Because hypertension is associated with potentially reversible structural and functional changes in the cerebral circulation, we hypothesized that long-term BP reduction would improve, rather than worsen, cerebral blood flow and its regulation. Therefore, we conducted the current study to determine the effects of systolic BP reduction over 6 months on cerebral perfusion in elderly hypertensive patients. We also examined structural and functional changes in the cerebral vasculature potentially affected by BP-lowering, including carotid distensibility and cerebral autoregulation. Methods DesignThe study was a prospective 3-gro...

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“…fect of beta-adrenergic blocking drugs have shown a decrease in CBF [5]; however, chronic administration of such agents apparently causes no significant changes in CBF [6]. As an antihypertensive agent, the converting enzyme inhibitor captopril has been shown to influence CBF autoregulation [7]; this drug shifts the lower and upper limits of autoregulation to the lower-pressure level.…”

Section: Effects Of Carvedilol On Cbf Autoregulation and C02 Reactivitymentioning

confidence: 99%

Effects of carvedilol on cerebral blood flow and its autoregulation in previous stroke patients with hypertension

Kuriyama

Nakamura

Kyougoku

et al. 1990

Eur J Clin Pharmacol

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We studied the effects of oral carvedilol (20 mg/day) on cerebral blood flow (CBF) and CBF autoregulation in ten previous stroke patients with hypertension. Measurement of CBF was done by the argon inhalation method. CBF autoregulation was also studied by the (A-V)O2 method after stepwise reduction in systemic blood pressure. After 1 week of carvedilol administration, the mean arterial blood pressure showed an 18% decrease, with no significant changes in CBF, CBF autoregulation, or other cerebral circulation parameters. From these findings, it can be said that carvedilol is a potent antihypertensive agent that does not affect cerebral circulation parameters.

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The effect of beta‐adrenergic receptor blocking drugs on cerebral blood flow.

Cited by 48 publications

References 15 publications

Effect of Long-Term Antihypertensive Treatment on the Cerebral Blood Flow in Patients with Brain Infarction

Effect of Long-Term Antihypertensive Treatment on the Cerebral Blood Flow in Patients with Brain Infarction

Antihypertensive Therapy Increases Cerebral Blood Flow and Carotid Distensibility in Hypertensive Elderly Subjects

Effects of carvedilol on cerebral blood flow and its autoregulation in previous stroke patients with hypertension

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