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Angiology
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Cerebral Blood Flow and Metabolism in Hypertensive Patients with Cerebral Infarction

Hiroshi Nakane

the Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Setsuro Ibayashi

the Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Kenichiro Fujii

the Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Katsumi Irie

the Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Seizo Sadoshima

the Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Masatoshi Fujishima

the Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

The authors investigated, by positron emission tomography, the effect of long-standing hypertension on cerebral blood flow (CBF) and oxygen metabolism in patients with chronic atherothrombotic brain infarction. In the nonbrain infarct (non-BI) group (n=13, mean age: sixty-two years), the regional CBF (rCBF) was decreased significantly with a rise in the mean arterial blood pressure (MABP) in the cerebral cortexes (r=-0.575) and the deep gray matter (r=-0.451), whereas the regional cerebral metabolic rate for oxygen (rCMRO2) remained unchanged. In the brain infarct (BI) group (n=22, mean age: fifty-eight years), however, the rCBF as well as the rCMRO2 were reduced even in the normotensive patients and thus did not correlate with the MABP. These results suggest that long-standing hypertension per se causes a reduction in the rCBF but not in the oxygen metabolism with a compensatory increase in the oxygen extraction fraction. On the other hand, patients with brain infarction, even normotensives, show a diffuse decrease in cerebral circulation and metabolism, which is probably due to the more severe sclerotic changes that take place in the cerebral vessels.

Angiology, Vol. 46, No. 9, 801-810 (1995)
DOI: 10.1177/000331979504600906
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