Age and Carotid Artery Occlusive Disease Are Important Determinants of Cerebral Blood Flow Changes After Antihypertensive Therapy

Study Objective. To determine the short‐term effects of antihypertensive therapy on cerebral blood flow (CBF). Design. Prospective, observational study. Setting. A university‐affiliated teaching hospital. Patients. Twenty‐four patients (age range 53–85 yrs) with chronic hypertension, nine of whom had carotid artery occlusive disease (CAOD). Interventions. The CBF (xenon‐133 inhalation technique) and blood pressure were measured before and at 60 minutes after administration of antihypertensive therapy. Measurements and Main 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. 1995 Pharmacotherapy Publications Inc.