Age and carotid artery occlusive disease are important determinants of cerebral blood flow changes after antihypertensive therapy.
OBJECTIVE
To determine the short-term effects of antihypertensive therapy on cerebral blood flow (CBF).


METHODS
Prospective, observational study.


METHODS
A university-affiliated teaching hospital.


METHODS
Twenty-four patients (age range 53-85 yrs) with chronic hypertension, nine of whom had carotid artery occlusive disease (CAOD).


METHODS
The CBF (xenon-133 inhalation technique) and blood pressure were measured before and at 60 minutes after administration of antihypertensive therapy.


RESULTS
Age was inversely related to the change in CBF in patients with CAOD (p < 0.01). In all patients, the change in CBF after taking antihypertensive drugs was significantly inversely associated with baseline CBF (p < 0.01). Changes in regional CBF, measured by asymmetry scores, were significantly greater in patients with CAOD than in those without CAOD (p < 0.05).


CONCLUSIONS
Elderly patients with occlusive extracranial cerebrovascular disease are at risk of drug-induced changes in both mean and regional CBF, and may benefit from a CBF assessment before being prescribed antihypertensive therapy.
Fagan
S C
SC
College of Pharmacy, Wayne State University, Detroit, MI 48202, USA.
Levine
S R
SR
Ewing
J R
JR
Ramadan
N M
NM
Welch
K M
KM
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000503:physiopathology; D001795:Blood Pressure Determination; D002340:Carotid Artery Diseases / Q000150:complications* / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors
D000959:Antihypertensive Agents