Intensive Blood Pressure Lowering Increases Cerebral Blood Flow in Older Subjects with Hypertension

Jiabao He¹, Dinesh Tryambake¹, Michael J. Firbank², John T. OBrien², Gary A. Ford¹, Andrew M. Blamire¹

CBF determines brain tissue metabolic supply and is compromised in chronic hypertension which alters autoregulatory function. Blood pressure (BP) lowering therapy has clear clinical benefit but may risk inducing hypoperfusion. Optimal target BP in older subjects with hypertension is unclear, although guidelines recommend target BP of <130/85 mmHg and <140/80 mmHg for patients with and without previous vascular events respectively. We used ASL to determine the effect of usual (<140/85 mmHg) and intensive (<130/80 mmHg) BP lowering on CBF in older hypertensive subjects and demonstrate that intensive BP lowering increases CBF compared to usual BP lowering therapy.