Prospective analysis of long term control of mild hypertension on cerebral blood flow.

A group of 12 otherwise normal elderly volunteers (mean age = 69.8 years), were detected to have mild hypertension. Cerebral blood flow (CBF) values were measured using 133Xe inhalation method prior to initiating medical treatment and repeated at 6, 12, 24 and 36 months after BP was adequately controlled and restored to normal (below 150/90). Results indicate that CBF values increased markedly during follow-up intervals at 6, 12 and 24 months but not at 36 months. Hypertension is known to be a risk factor for stroke and 4 of the 12 subjects subsequently developed symptoms of cerebrovascular disease (stroke, multi-infarct dementia or transient ischemic attacks) despite control of hypertension. Analyses separating asymptomatic and symptomatic groups indicated that the eight asymptomatic patients continued to maintain increased CBF levels throughout the entire three year interval, whereas the 4 symptomatic patients developed declines in CBF which began, and progressively decreased below the initial pretreatment values, during the second and third years.