Antihypertensives and Cerebral Autoregulation: Historical Perspectives and Pathophysiological Insights

Michel Ferreira Machado1*, Henrique Cotchi Simbo Muela2, Valeria Aparecida Costa-Hong2, Natalia Cristina Moraes1, Claudia Maia Memória1, Edson Bor-Seng-Shu1, Luiz Aparecido Bortolotto2, Ricardo de Carvalho Nogueira1

Background: Cerebral Autoregulation (CA) consists of a complex mechanism characterized by the ability of the cerebral microcirculation to contract and dilate in response to variations in Blood Pressure (BP), aiming to keep Cerebral Blood Flow (CBF) constant. Systemic arterial hypertension lead to an increase in cerebrovascular resistance, which can negatively influence this vasomotor response, shifting the CA curve to the right. Thus, a slight hypotension could compromise the CBF and cause damage to brain tissue.

Objective: From a brief historical perspective, the physiological mechanisms by which Antihypertensive (ASAH) contribute to maintaining the integrity of cerebral CA will be reviewed.

Methods: The material for this review was taken mostly from electronic journals. To collect publications, PubMed e Cochrane database of systematic reviews were used.

Results: Studies have shown that the ability of CA remains unchanged in hypertensive, since ASAH is capable of promoting a variable readaptation of CA. This beneficial effect on CA has been verified over the years through experimental and clinical models and occurs through different mechanisms of action.

Conclusion: The human brain is one of the organs that most benefit from ASAH. Short- or long-term BP control does not cause brain hypo perfusion and does not compromise CA.

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Hamdard University
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International Institute of Organised Research (I2OR)
Geneva Foundation for Medical Education and Research
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