Cerebral Hemodynamics in Hypertension: A Transcranial Duplex Study

Background: Blood pressure reduction has been shown to be beneficial in both primary and secondary stroke prevention. Objective: To study the effect of hypertension on cerebral blood flow hemodynamics and cerebral hemodynamics in relation to age, duration of hypertension, severity of hypertension and body mass index (BMI) by using transcranial color coded duplex. Methods: This study included 40 patients with hypertension: Classified to (Group Ia) Twenty without a history of cerebrovascular stroke and (Group Ib) twenty with evidence of past cerebrovascular stroke) and 20 healthy controls. Blood pressure and body mass index were measured and extracranial and transcranial duplex was performed for all subjects. Results: Comparison between hypertensive patients without CVS and controls showed no significant differences. Comparison of hypertensive patients with CVS and controls showed statistically significant older age (p=0.009), higher Right IMT (p=0.002), lower PSV (0.018), lower TAP (p=0.003) and higher PI (0.004) in hypertensive patients. Comparison of hypertensive patients without CVS to hypertensive patients with CVS showed higher PI (p=0.037). The only significant finding was the correlation between age and increased left CCA-IMT in hypertensive patients with evidence of cerebrovascular stoke (p=0.033). Conclusion: Hypertension may affect cerebral hemodynamics in stroke patients by an indirect mechanism. Age and obesity may not have a direct effect on cerebral hemodynamics in hypertensive patients. TCD appears to be a suitable method for assessment of cerebral hemodynamics and vasculature in hypertensive patients. [Egypt J Neurol Psychiat Neurosurg. 2011; 48(3): 277-284]