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Cerebral Circulation in Chronic Arterial Hypertension
Journal article   Open access   Peer reviewed

Cerebral Circulation in Chronic Arterial Hypertension

GARY BAUMBACH and DONALD HEISTAD
Hypertension (Dallas, Tex. 1979), Vol.12(2), pp.89-95
08/1988
DOI: 10.1161/01.HYP.12.2.89
PMID: 3044994
url
https://doi.org/10.1161/01.HYP.12.2.89View
Published (Version of record) Open Access

Abstract

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.

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