title: Changes of cerebral hemodynamics in hypertensives during physical exercise.
abstract: OBJECTIVE
  Previously, 30 untreated hypertensive patients were investigated by transcranial Doppler (TCD) monitoring during physical exercise, and changes of hemodynamic parameters were compared with those of age matched healthy subjects. After 3-year antihypertensive (AHT) treatment, these hypertensives were investigated again. The aim of this study was to compare the cerebral hemodynamic changes in the regularly treated and noncompliant (untreated) hypertensives during ergometer cycling.
  
  
  METHODS
  Nineteen of 30 previously untreated hypertensive patients could be investigated again using the same method as before. Eleven were regularly treated (treated hypertensive [T-HT] group), and 8 did not take their AHT medications due to lack of compliance (noncompliant hypertensive [NC-HT] group). Blood pressure, heart rate, end-tidal CO2 (etCO2; Capnogard capnograph), and bilateral middle cerebral artery mean blood flow velocity (MV) were continuously monitored during ergometer cycling according to the World Health Organization protocol. Values of 2-minute loading were analyzed.
  
  
  RESULTS
  Median loading time did not differ significantly between the T-HT and NC-HT groups. After 2 minutes of cycling in treated patients, the ratio of MV and etCO changes (DeltaMV/DeltaetCO2) showed similar values as before therapy (P = .38), whereas in noncompliant patients, a further worsening of the ratio of DeltaMV/DeltaetCO2 could be observed (P = .04).
  
  
  CONCLUSIONS
  The decrease of arteriolar vasodilation (ie, the ratio of DeltaMV/DeltaetCO2) could be demonstrated in the NC-HT group after 3 years. TCD combined with ergometer cycling is a useful method for evaluation of cerebral hemodynamic changes after AHT therapy.
authors.affiliation: Department of Neurology, Health Science and Medical Center, University of Debrecen, Debrecen, Hungary.
authors.forename: Mária Tünde
authors.initials: MT
authors.lastname: Magyar
authors.forename: Attila
authors.initials: A
authors.lastname: Valikovics
authors.forename: István
authors.initials: I
authors.lastname: Czuriga
authors.forename: László
authors.initials: L
authors.lastname: Csiba
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D017585:Ultrasonography, Doppler, Transcranial
chemical_list: D000959:Antihypertensive Agents