Cerebral Microangiopathy in Treatment-Resistant Hypertension
Article first published online: 11 JUL 2011
© 2011 Wiley Periodicals, Inc.
The Journal of Clinical Hypertension
Volume 13, Issue 8, pages 582–587, August 2011
How to Cite
Schmieder, R. E., Schmidt, B. M.W., Raff, U., Bramlage, P., Dörfler, A., Achenbach, S., Schwab, J. and Kolominsky-Rabas, P. (2011), Cerebral Microangiopathy in Treatment-Resistant Hypertension. The Journal of Clinical Hypertension, 13: 582–587. doi: 10.1111/j.1751-7176.2011.00493.x
- Issue published online: 1 AUG 2011
- Article first published online: 11 JUL 2011
- Manuscript received November 14, 2010; Revised: April 12, 2011; Accepted: April 20, 2011
J Clin Hypertens (Greenwich). 2011;13:582–587. ©2011 Wiley Periodicals, Inc.
Cerebral microangiopathy is a cause of cognitive impairment and indicates high risk for clinically overt cerebrovascular disease. It develops in patients with or without hypertension, and different pathologies may play a supporting role. In this pilot study, the authors aimed to elucidate risk factors contributing to the deleterious action of hypertension on cerebral small vessels. A cross-sectional study in 42 patients with treatment-resistant hypertension was performed. Microangiopathy was investigated by cerebral magnetic resonance imaging (MRI). Determinants were identified by clinical investigation, computed tomography, intima-media thickness and pulse wave velocity measurement, and urinary albumin excretion. Nineteen of 42 patients had cerebral microangiopathy (23 controls). Patients were different with respect to heart rate (60.5±10.2 vs 69.7±15.1 beats per minute; P=.029) and systolic blood pressure during nighttime (138±13 mm Hg vs 126±18 mm Hg; P=.019). In addition, there were significant differences in pulse wave velocity (10.7±2.0 m/s vs 9.4±1.4 m/s; P=.034), peripheral pulse pressure (70.8±16.3 mm Hg vs 59.2±13.6 mm Hg; P=.016), central pulse pressure (62.9±15.8 mm Hg vs 50.3±14.2 mm Hg; P=.012), and aortic augmentation pressure (15.9±6.0 vs 11.8±6.6; P=.040). Systolic blood pressure and signs of hypertensive vasculopathy such as peripheral and central pulse pressure and pulse wave velocity were associated with cerebral microangiopathy in patients with long-standing treatment-resistant hypertension.