Blood pressure therapy boosts cerebral blood flow

In elderly patients with elevated systolic blood pressure - the upper number in a blood pressure reading - effective blood pressure therapy increases blood flow to the brain, researchers report.

Contrary to widely held beliefs, the elderly have as much or more to gain from aggressive therapy for high blood pressure as young people do, lead author Dr. Lewis A. Lipsitz told AMN Health.

"Many physicians are reluctant to lower blood pressure to recommended levels in elderly people because they believe this will reduce blood flow to the brain through stiff and narrowed carotid arteries," he added.

To investigate the effects of treatment, Lipsitz of the Hebrew Rehabilitation Center for Aged, Boston and colleagues studied patients 65 years old or older. The findings are reported in the journal Hypertension.

The patient groups consisted of 19 with normal blood pressure, 18 with high blood pressure that was effectively controlled with treatment, and 18 with uncontrolled high blood pressure - systolic blood pressure greater than 160 mm Hg at study entry.

The uncontrolled group underwent aggressive treatment with lisinopril and other agents for 6 months. The other two groups were simply observed during this period.

At the end of the 6-month term of successful treatment, the previously uncontrolled group had significant increases in cerebral blood flow velocity and carotid artery flexibility on Doppler ultrasound imaging that was not seen in the other groups. None of the patients developed reduced blood flow to the brain.

These findings show that 6 months of blood pressure treatment improves blood flow to the brain and actually reduces the stiffness of the carotid arteries in elderly patients, Lipsitz concluded.

SOURCE: Hypertension, February 2005.