Abstract
Arterial stiffness is an established cardiovascular risk factor influencing haemodynamic properties in the microcirculation. We tested the hypothesis that increased arterial stiffness is associated with an increase in cerebrovascular resistance in the elderly. Brachial–ankle pulse wave velocity (baPWV), using arterial tonometry, and anterior cerebral blood flow (aCBF), using extracranial ultrasound, were measured in 26 participants (67–92 years). Non-parametric statistics examined relationships between age, blood pressure, baPWV, cerebrovascular resistance (CVRi) and aCBF. Bivariate analysis suggested that baPWV was the only vascular characteristic associated with CVRi (rs=0.59; P=0.002). CVRi was strongly correlated with aCBF (rs=−0.89; P<0.001). Furthermore, compared with participants in the lower three quartiles of baPWV (LO), those in the upper quartile (HI) had elevated CVRi (median (interquartile range); HI: 0.240 (0.143) mm Hg ml−1 min−1; LO: 0.197 (0.072) mm Hg ml−1 min−1; P=0.02), and tended to have lower aCBF (HI: 394 (155) ml min−1; LO: 459 (154) ml min−1; P=0.09). This study found a positive correlation between baPWV and CVRi in the elderly, suggesting that haemodynamic characteristics associated with arterial aging influence cerebral circulation.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 digital issues and online access to articles
$119.00 per year
only $9.92 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Meaume S, Benetos A, Henry OF, Rudnichi A, Safar ME . Aortic pulse wave velocity predicts cardiovascular mortality in subjects >70 years of age. Arterioscler Thromb Vasc Biol 2001; 21: 2046–2050.
Gosse P, Lasserre R, Minifie C, Lemetayer P, Clementy J . Arterial stiffness evaluated by measurement of the QKD interval is an independent predictor of cardiovascular events. Am J Hypertens 2005; 18: 470–476.
Laurent S, Katsahian S, Fassot C, Tropeano AI, Gautier I, Laloux B et al. Aortic stiffness is an independent predictor of fatal stroke in essential hypertension. Stroke 2003; 34: 1203–1206.
O'Rourke MF, Hashimoto J . Mechanical factors in arterial aging: a clinical perspective. J Am Coll Cardiol 2007; 50: 1–13.
Kobayashi K, Akishita M, Yu W, Hashimoto M, Ohni M, Toba K . Interrelationship between non-invasive measurements of atherosclerosis: flow-mediated dilation of brachial artery, carotid intima-media thickness and pulse wave velocity. Atherosclerosis 2004; 173: 13–18.
Munakata M, Sakuraba J, Tayama J, Furuta T, Yusa A, Nunokawa T et al. Higher brachial-ankle pulse wave velocity is associated with more advanced carotid atherosclerosis in end-stage renal disease. Hypertens Res 2005; 28: 9–14.
Ikonomidis I, Lekakis J, Papadopoulos C, Triantafyllidi H, Paraskevaidis I, Georgoula G et al. Incremental value of pulse wave velocity in the determination of coronary microcirculatory dysfunction in never-treated patients with essential hypertension. Am J Hypertens 2008; 21: 806–813.
Suzuki E, Kashiwagi A, Nishio Y, Egawa K, Shimizu S, Maegawa H et al. Increased arterial wall stiffness limits flow volume in the lower extremities in type 2 diabetic patients. Diabetes Care 2001; 24: 2107–2114.
Kim DH, Kim J, Kim JM, Lee AY . Increased brachial-ankle pulse wave velocity is independently associated with risk of cerebral ischemic small vessel disease in elderly hypertensive patients. Clin Neurol Neurosurg 2008; 110: 599–604.
Hirata K, Yaginuma T, O'Rourke MF, Kawakami M . Age-related changes in carotid artery flow and pressure pulses: possible implications for cerebral microvascular disease. Stroke 2006; 37: 2552–2556.
Lipsitz LA, Gagnon M, Vyas M, Iloputaife I, Kiely DK, Sorond F et al. Antihypertensive therapy increases cerebral blood flow and carotid distensibility in hypertensive elderly subjects. Hypertension 2005; 45: 216–221.
Kielstein JT, Donnerstag F, Gasper S, Menne J, Kielstein A, Martens-Lobenhoffer J et al. ADMA increases arterial stiffness and decreases cerebral blood flow in humans. Stroke 2006; 37: 2024–2029.
Guelen I, Westerhof BE, Van Der Sar GL, Van Montfrans GA, Kiemeneij F, Wesseling KH et al. Finometer, finger pressure measurements with the possibility to reconstruct brachial pressure. Blood Press Monit 2003; 8: 27–30.
O'Rourke MF, Pauca A, Jiang XJ . Pulse wave analysis. Br J Clin Pharmacol 2001; 51: 507–522.
Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K et al. Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 2002; 25: 359–364.
Oliver JJ, Webb DJ . Noninvasive assessment of arterial stiffness and risk of atherosclerotic events. Arterioscler Thromb Vasc Biol 2003; 23: 554–566.
Yu WC, Chuang SY, Lin YP, Chen CH . Brachial-ankle vs carotid-femoral pulse wave velocity as a determinant of cardiovascular structure and function. J Hum Hypertens 2008; 22: 24–31.
Yamashina A, Tomiyama H, Arai T, Hirose K, Koji Y, Hirayama Y et al. Brachial-ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk. Hypertens Res 2003; 26: 615–622.
Schoning M, Walter J, Scheel P . Estimation of cerebral blood flow through color duplex sonography of the carotid and vertebral arteries in healthy adults. Stroke 1994; 25: 17–22.
Lipsitz LA, Mukai S, Hamner J, Gagnon M, Babikian V . Dynamic regulation of middle cerebral artery blood flow velocity in aging and hypertension. Stroke 2000; 31: 1897–1903.
Burton AC . Physiology and Biophysics of the Circulation. Year Book Medical Publishers Inc.: Chicago, IL, 1965, pp 84–92.
Hughson RL, Edwards MR, O'Leary DD, Shoemaker JK . Critical analysis of cerebrovascular autoregulation during repeated head-up tilt. Stroke 2001; 32: 2403–2408.
Poels MM, Ikram MA, Vernooij MW, Krestin GP, Hofman A, Niessen WJ et al. Total cerebral blood flow in relation to cognitive function: the Rotterdam Scan Study. J Cereb Blood Flow Metab 2008; 28: 1652–1655.
Beason-Held LL, Moghekar A, Zonderman AB, Kraut MA, Resnick SM . Longitudinal changes in cerebral blood flow in the older hypertensive brain. Stroke 2007; 38: 1766–1773.
Liao D, Wong TY, Klein R, Jones D, Hubbard L, Sharrett AR . Relationship between carotid artery stiffness and retinal arteriolar narrowing in healthy middle-aged persons. Stroke 2004; 35: 837–842.
Cheung N, Sharrett AR, Klein R, Criqui MH, Islam FM, Macura KJ et al. Aortic distensibility and retinal arteriolar narrowing: the multi-ethnic study of atherosclerosis. Hypertension 2007; 50: 617–622.
Sabbatini M, Strocchi P, Vitaioli L, Amenta F . Microanatomical changes of intracerebral arteries in spontaneously hypertensive rats: a model of cerebrovascular disease of the elderly. Mech Ageing Dev 2001; 122: 1257–1268.
Iadecola C, Zhang F . Permissive and obligatory roles of NO in cerebrovascular responses to hypercapnia and acetylcholine. Am J Physiol 1996; 271: R990–R1001.
Tao J, Jin YF, Yang Z, Wang LC, Gao XR, Lui L et al. Reduced arterial elasticity is associated with endothelial dysfunction in persons of advancing age: comparative study of noninvasive pulse wave analysis and laser Doppler blood flow measurement. Am J Hypertens 2004; 17: 654–659.
Farkas E, Donka G, De Vos RA, Mihaly A, Bari F, Luiten PG . Experimental cerebral hypoperfusion induces white matter injury and microglial activation in the rat brain. Acta Neuropathol 2004; 108: 57–64.
Appelman AP, van der GY, Vincken KL, Tiehuis AM, Witkamp TD, Mali WP et al. Total cerebral blood flow, white matter lesions and brain atrophy: the SMART-MR study. J Cereb Blood Flow Metab 2008; 28: 633–639.
Pugh KG, Lipsitz LA . The microvascular frontal-subcortical syndrome of aging. Neurobiol Aging 2002; 23: 421–431.
Rakobowchuk M, Tanguay S, Burgomaster KA, Howarth KR, Gibala MJ, MacDonald MJ . Sprint interval and traditional endurance training induce similar improvements in peripheral arterial stiffness and flow-mediated dilation in healthy humans. Am J Physiol Regul Integr Comp Physiol 2008; 295: R236–R242.
Seals DR, Desouza CA, Donato AJ, Tanaka H . Habitual exercise and arterial aging. J Appl Physiol 2008; 105: 1323–1332.
Choi JC, Lee JS, Kang SY, Kang JH, Bae JM, Lee DH . Limitation of brachial-ankle pulse wave velocity in assessing the risk of stroke: importance of instantaneous blood pressure. Cerebrovasc Dis 2009; 27: 417–425.
Ohmine T, Miwa Y, Yao H, Yuzuriha T, Takashima Y, Uchino A et al. Association between arterial stiffness and cerebral white matter lesions in community-dwelling elderly subjects. Hypertens Res 2008; 31: 75–81.
Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006; 27: 2588–2605.
O'Rourke MF, Hashimoto J . Arterial stiffness: a modifiable cardiovascular risk factor? J Cardiopulm Rehabil Prev 2008; 28: 225–237.
Guerin AP, Blacher J, Pannier B, Marchais SJ, Safar ME, London GM . Impact of aortic stiffness attenuation on survival of patients in end-stage renal failure. Circulation 2001; 103: 987–992.
Acknowledgements
We thank Myra Gonzales for her technical assistance during data collection. This project was supported by NSERC (Grant RGPIN 6473) and RBJ Schlegel-University of Waterloo Research Institute for Aging. Andrew Robertson was supported by the Natural Sciences and Engineering Research Council Canada Graduate Scholarship, an Ontario Graduate Scholarship and University of Waterloo President's Graduate Scholarships.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Robertson, A., Tessmer, C. & Hughson, R. Association between arterial stiffness and cerebrovascular resistance in the elderly. J Hum Hypertens 24, 190–196 (2010). https://doi.org/10.1038/jhh.2009.56
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/jhh.2009.56
Keywords
This article is cited by
-
Significance of pulse pressure variability in predicting functional outcome in acute ischemic stroke: a retrospective, single-center, observational cohort study
Scientific Reports (2023)
-
Cortical Anoxic Spreading Depolarization During Cardiac Arrest is Associated with Remote Effects on Peripheral Blood Pressure and Postresuscitation Neurological Outcome
Neurocritical Care (2022)
-
Carotid pulse pressure and intima media thickness are independently associated with cerebral hemodynamic pulsatility in community-living older adults
Journal of Human Hypertension (2020)
-
The relationship between the time of cerebral desaturation episodes and outcome in aneurysmal subarachnoid haemorrhage: a preliminary study
Journal of Clinical Monitoring and Computing (2020)
-
Cerebral arterial time constant calculated from the middle and posterior cerebral arteries in healthy subjects
Journal of Clinical Monitoring and Computing (2019)