Please use this identifier to cite or link to this item: https://hdl.handle.net/10216/119825
Author(s): Ana Sofia da Cunha Teixeira
Title: Ageing affects the balance between central and peripheral mechanisms of cerebrovascular regulation with increasing influence of systolic blood pressure levels
Issue Date: 2019-05-20
Abstract: BACKGROUND: Arterial baroreflex (BR) and cerebral autoregulation (CA) are two major regulatory mechanisms that maintain constant cerebral perfusion. Little is known about the interplay between these mechanisms, particularly when considering the effects of ageing or sex.PURPOSE: We studied the relationship between dynamic CA and BR sensitivity (BRS) in healthy subjects by sex and in different age strata.METHODS: 95 healthy adults (52% female), 20-80 years-old, were recruited. Arterial blood pressure (Finometer), 3-lead electrocardiogram and cerebral blood flow velocity in middle cerebral arteries (transcranial Doppler) were monitored. We assessed CA by transfer function analysis and BRS in frequency and time domain.RESULTS: With increasing age, BRS diminished (ANCOVA R2 = 0.281, p < 0.001) but CA parameters did not change significantly (p > 0.05). Overall, there was an inverse relationship between the efficacy of BRS and CA low-frequency gain [multivariate linear regression β = 0.41 (0.31; 0.61), p < 0.001]. However, this association suffers changes with ageing: in older subjects BRS and CA were not correlated [β = 0.10 (- 0.41; 0.62), p = 0.369]. Instead, decreasing systolic blood pressure correlated with less efficient CA [lower CA low-frequency gain β = - 0.02 (- 0.03; - 0.02), p = 0.003]. Sex did not affect BRS and CA relationship.CONCLUSIONS: Cerebral blood supply is governed by a tuned balance between BR and CA which is lost with age as BRS decreases dramatically. Low systolic blood pressure values might be harmful to older subjects as they might reduce the ability to keep cerebral blood flow tightly controlled.
Subject: Medicina clínica
Clinical medicine
Scientific areas: Ciências médicas e da saúde::Medicina clínica
Medical and Health sciences::Clinical medicine
TID identifier: 202405516
URI: https://hdl.handle.net/10216/119825
Document Type: Dissertação
Rights: restrictedAccess
License: https://creativecommons.org/licenses/by-nc-nd/4.0/
Appears in Collections:FMUP - Dissertação

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