Measurement and Changes in Cerebral Oxygenation and Blood Flow at Rest and During Exercise in Normotensive and Hypertens
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HYPERTENSION AND THE BRAIN (I NASRALLAH, SECTION EDITOR)
Measurement and Changes in Cerebral Oxygenation and Blood Flow at Rest and During Exercise in Normotensive and Hypertensive Individuals Georgios A. Triantafyllou 1,2 & Konstantina Dipla 3 & Areti Triantafyllou 1 & Eugenia Gkaliagkousi 1 & Stella Douma 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Summarize the methods used for measurement of cerebral blood flow and oxygenation; describe the effects of hypertension on cerebral blood flow and oxygenation. Recent Findings Information regarding the effects of hypertension on cerebrovascular circulation during exercise is very limited, despite a plethora of methods to help with its assessment. In normotensive individuals performing incremental exercise testing, total blood flow to the brain increases. In contrast, the few studies performed in hypertensive patients suggest a smaller increase in cerebral blood flow, despite higher blood pressure levels. Endothelial dysfunction and increased vasoconstrictor concentration, as well as large vessel atherosclerosis and decreased small vessel number, have been proposed as the underlying mechanisms. Summary Hypertension may adversely impact oxygen and blood delivery to the brain, both at rest and during exercise. Future studies should utilize the newer, noninvasive techniques to better characterize the interplay between the brain and exercise in hypertension. Keywords Brain oxygenation . Cerebral blood flow . Exercise . Hypertension . Microcirculation . Near-infrared spectroscopy
Introduction Hypertension is one of the most prevalent diseases affecting more than 874 million people globally [1]. In 2015, it accounted for 143,000,000 disability-adjusted life years (DALYs) [1]. It increases stroke risk [2], inflicts dementia [3], and may accelerate its course [4–6]. Subclinical brain lesions, such as white matter hyperintensities, silent lacunar This article is part of the Topical Collection on Hypertension and the Brain * Areti Triantafyllou [email protected] 1
3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Ring Road Nea Eukarpia, 56403 Thessaloniki, Greece
2
Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh Medical Center, 3459 Fifth Avenue, Pittsburgh, PA 15213, USA
3
Exercise Physiology and Biochemistry Laboratory, Department of Sports Science at Serres, Aristotle University of Thessaloniki, Agios Ioannis, 62122 Serres, Greece
infarcts, and microbleeds, have all been reported in patients with hypertension [7••]. Recent data suggest that regular exercise training can assist with better blood pressure control [8] as well as with maintenance of cognitive function [9, 10]. Taking these into account, a better understanding of the adaptations of cerebral perfusion and oxygenation during exercise is of paramount importance, as it could identify molecular pathways activated or inhibited during exercise, which could constitute new therap
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