Intensive blood pressure control ‘favours’ cerebral blood flow

Researchers have analysed an imaging sub-study of the landmark SPRINT trial

Intensive blood pressure lowering in elderly patients appears to increase, rather than decrease, cerebral perfusion compared with standard treatment, a study shows.

US clinicians say this modest, yet significant, effect on cerebral blood flow was most pronounced among those with a history of cardiovascular disease.

Results from their sub-study of 547 participants in the SPRINT (Systolic Blood Pressure Intervention Trial)  suggests that, contrary to widely-held beliefs, aggressive antihypertensive therapy is unlikely to cause cerebral ischaemic injury.

“One key barrier to implementation of intensive treatment was a concern that … [it] might reduce the [blood pressure (BP)] below the cerebral autoregulatory limit, leading to cerebral hypoperfusion,” the University of Pennsylvania-led researchers reported.