Cerebral Circulation in Chronic Arterial Hypertension

Several new concepts have emerged recently regarding the effects of chronic hypertension on cerebral blood vessels. First, hypertrophy of large cerebral arteries in chronic hypertension attenuates increases in pressure of downstream vessels and protects the cerebral microvasculature. Second, In cont...

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Bibliographic Details
Published in:Hypertension (Dallas, Tex. 1979) Tex. 1979), 1988-08, Vol.12 (2), p.89-95
Main Authors: BAUMBACH, GARY L, HEISTAD, DONALD D
Format: Article
Language:English
Subjects:
Animals
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
Blood-Brain Barrier
Cardiology. Vascular system
Cerebral Arteries - physiopathology
Cerebrovascular Circulation
Clinical manifestations. Epidemiology. Investigative techniques. Etiology
Collateral Circulation
Hypertension - physiopathology
Medical sciences
Microcirculation - physiopathology
Rats
Rats, Inbred SHR
Vascular Resistance
Vasodilation
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Summary:Several new concepts have emerged recently regarding the effects of chronic hypertension on cerebral blood vessels. First, hypertrophy of large cerebral arteries in chronic hypertension attenuates increases in pressure of downstream vessels and protects the cerebral microvasculature. Second, In contrast to large cerebral arteries, which become less distensible during chronic hypertension, distensibility of cerebral arterioles increases during chronic hypertension despite hypertrophy of the arteriolar wall. Third, dilatation of cerebral blood vessels with disruption of the blood-brain barrier, and not vasospasm, appears to be the critical factor in the pathogenesis of hypertensive encephalopatby. This concept is supported by the finding that cerebral edema hi stroke-prone spontaneously hypertensive rats is preceded by vasodilatation and disruption of the barrier. Fourth, alterations of endotbeuum-mediated dilatation may impair vasodilator responses in chronic hypertension and predispose to ischemia. Finally, chronic hypertension impairs dilatation of collateral blood vessels hi the cerebral circulation. The implication of this finding is that increased susceptibility to cerebral infarction in chronic hypertension may be related in part to compromised responses of the collateral circulation.
ISSN:0194-911X
1524-4563
DOI:10.1161/01.hyp.12.2.89