Cerebral Vasomotor Reactivity and Extent of White Matter Lesions in Middle-Aged Men With Arterial Hypertension: A Pilot Study

Background Cerebrovascular reactivity (CVR) impairment and cerebral white matter lesions (WMLs) are associated in elderly or patients with overt cerebral ischemia. Such association has not been confirmed for asymptomatic middle-aged individuals with risk factors for stroke. We assessed the relations...

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Bibliographic Details
Published in:American journal of hypertension 2010-11, Vol.23 (11), p.1198-1203
Main Authors: Kozera, Grzegorz M., Dubaniewicz, Mirosława, Zdrojewski, Tomasz, Madej-Dmochowska, Aleksandra, Mielczarek, Milena, Wojczal, Joanna, Chwojnicki, Kamil, świerblewska, Ewa, Schminke, Ulf, Wyrzykowski, Bogdan, Nyka, Walenty M.
Format: Article
Language:English
Subjects:
arterial hypertension
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
blood pressure
Brain Ischemia - diagnosis
Brain Ischemia - epidemiology
Brain Ischemia - physiopathology
Cardiology. Vascular system
Cerebrovascular Circulation - physiology
Clinical manifestations. Epidemiology. Investigative techniques. Etiology
Female
Humans
hypertension
Hypertension - diagnosis
Hypertension - epidemiology
Hypertension - physiopathology
Leukoencephalopathies - diagnosis
Leukoencephalopathies - epidemiology
Leukoencephalopathies - physiopathology
Magnetic Resonance Imaging
Male
Medical sciences
Microcirculation - physiology
Middle Aged
Middle Cerebral Artery - diagnostic imaging
Middle Cerebral Artery - pathology
Middle Cerebral Artery - physiopathology
Pilot Projects
Risk Factors
Severity of Illness Index
transcranial Doppler
Ultrasonography, Doppler, Transcranial
vasomotor reactivity
Vasomotor System - diagnostic imaging
Vasomotor System - pathology
Vasomotor System - physiopathology
white matter lesions
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Summary:Background Cerebrovascular reactivity (CVR) impairment and cerebral white matter lesions (WMLs) are associated in elderly or patients with overt cerebral ischemia. Such association has not been confirmed for asymptomatic middle-aged individuals with risk factors for stroke. We assessed the relationship between the CVR and the presence of WMLs in a middle-aged population-based cohort of hypertensive men. Methods Magnetic resonance imaging (MRI) and transcranial Doppler (TCD) examination were performed in 54 hypertensive men, all at 60 years of age, without a history of stroke, neurologic deficits, or carotid stenosis. The CVR of the middle cerebral artery (MCA) was expressed as the vasomotor reactivity reserve (VMRr). Results WMLs were detected in 22 men (40.7%); all WMLs were classified as mild (first grade of the Fazekas modified scale). The VMRr was lower in patients with WMLs (mean 55%; s.e. 3%) compared to those without WMLs (mean 65%; s.e. 3%; P = 0.03). The lower VMRr in patients with WMLs was consistent after controlling for confounders. A higher pulsatility index (PI) in subjects with WMLs (mean 1.08; s.e. 0.05) compared to those without WMLs (mean 0.90; s.e. 0.05; P = 0.01) was not consistent after controlling for confounders. Conclusions The CVR was lower in middle-aged hypertensive men with WMLs compared to those without WMLs indicating that even a low load of WMLs may reflect some functional impairment of the cerebral microvasculature.
ISSN:0895-7061
1879-1905
1941-7225
DOI:10.1038/ajh.2010.152