Ageing affects the balance between central and peripheral mechanisms of cerebrovascular regulation with increasing influence of systolic blood pressure levels
- 45 Downloads
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.
We studied the relationship between dynamic CA and BR sensitivity (BRS) in healthy subjects by sex and in different age strata.
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.
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.
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.
KeywordsAgeing Sex Cerebral autoregulation Arterial baroreflex Autonomic nervous system
Arterial blood pressure
Cerebral blood flow velocity
Critical closing pressure
Cerebrovascular resistance index
Diastolic blood pressure
High-frequency spectral band
Heart rate variability
Low-frequency spectral band
Middle cerebral artery
Systolic blood pressure
Standard deviation of normal RR intervals
Transfer function analysis
Very-low frequency spectral band
Time domain cross-correlation BRS
Frequency domain BRS gain
ST, JM, EA and PC conceived and designed research. JM and PC conducted experiments. ST and PC analysed data. ST and PC wrote the manuscript, EA conveyed critical analysis of the results All authors read and approved the manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- Claassen JA, Meel-van den Abeelen AS, Simpson DM, Panerai RB, Network international Cerebral Autoregulation Research (2016) Transfer function analysis of dynamic cerebral autoregulation: a white paper from the international cerebral autoregulation research network. J Cereb Blood Flow Metab 36:665–680CrossRefGoogle Scholar
- Freitas J, Santos R, Azevedo E, Carvalho M, Boomsma F, Meiracker A, Falcao A, de Freitas, Abreu-Lima C (2007) Hemodynamic, autonomic and neurohormonal behaviour of familial amyloidotic polyneuropathy and neurally mediated syncope patients during supine and orthostatic stress. Int J Cardiol 116:242–248CrossRefPubMedGoogle Scholar
- Mancia G, Laurent S, Agabiti-Rosei E, Ambrosioni E, Burnier M, Caulfield MJ, Cifkova R, Clement D, Coca A, Dominiczak A, Erdine S, Fagard R, Farsang C, Grassi G, Haller H, Heagerty A, Kjeldsen SE, Kiowski W, Mallion JM, Manolis A, Narkiewicz K, Nilsson P, Olsen MH, Rahn KH, Redon J, Rodicio J, Ruilope L, Schmieder RE, Struijker-Boudier HA, Van Zwieten PA, Viigimaa M, Zanchetti A (2009) Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. Blood Press 18:308–347CrossRefPubMedGoogle Scholar
- Nation DA, Edmonds EC, Bangen KJ, Delano-Wood L, Scanlon BK, Han SD, Edland SD, Salmon DP, Galasko DR, Bondi MW, Investigators Alzheimer’s Disease Neuroimaging Initiative (2015) Pulse pressure in relation to tau-mediated neurodegeneration, cerebral amyloidosis, and progression to dementia in very old adults. JAMA Neurol 72:546–553CrossRefPubMedPubMedCentralGoogle Scholar
- Otite F, Mink S, Tan CO, Puri A, Zamani AA, Mehregan A, Chou S, Orzell S, Purkayastha S, Du R, Sorond FA (2014) Impaired cerebral autoregulation is associated with vasospasm and delayed cerebral ischemia in subarachnoid hemorrhage. Stroke 45:677–682Google Scholar