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Ageing affects the balance between central and peripheral mechanisms of cerebrovascular regulation with increasing influence of systolic blood pressure levels

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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.

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Abbreviations

ABP:

Arterial blood pressure

BR:

Baroreflex

BRS:

Baroreflex sensitivity

CA:

Cerebral autoregulation

CBFV:

Cerebral blood flow velocity

CrCP:

Critical closing pressure

CVRi:

Cerebrovascular resistance index

DBP:

Diastolic blood pressure

HF:

High-frequency spectral band

HR:

Heart rate

HRV:

Heart rate variability

LF:

Low-frequency spectral band

MBP:

Mean ABP

MCA:

Middle cerebral artery

PP:

Pulse pressure

RAP:

Ratio-area-product

SBP:

Systolic blood pressure

SDNN:

Standard deviation of normal RR intervals

TCD:

Transcranial Doppler

TFA:

Transfer function analysis

VLF:

Very-low frequency spectral band

xBRS:

Time domain cross-correlation BRS

α-index:

Frequency domain BRS gain

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Authors and Affiliations

  1. Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal

    Sofia Cunha Teixeira, João Brandão Madureira, Elsa Irene Azevedo & Pedro Miguel Castro

  2. Cardiovascular Research and Development Centre, Faculty of Medicine, University of Porto, Porto, Portugal

    Elsa Irene Azevedo & Pedro Miguel Castro

  3. Department of Neurology, São João Hospital Centre, Porto, Portugal

    Elsa Irene Azevedo & Pedro Miguel Castro

Authors
  1. Sofia Cunha Teixeira
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  2. João Brandão Madureira
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  3. Elsa Irene Azevedo
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  4. Pedro Miguel Castro
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Contributions

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.

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Correspondence to Sofia Cunha Teixeira.

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The authors declare that they have no conflict of interest.

Ethical approval

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.

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Informed consent was obtained from all individual participants included in the study.

Additional information

Communicated by Massimo Pagani.

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Teixeira, S.C., Madureira, J.B., Azevedo, E.I. et al. Ageing affects the balance between central and peripheral mechanisms of cerebrovascular regulation with increasing influence of systolic blood pressure levels. Eur J Appl Physiol 119, 519–529 (2019). https://doi.org/10.1007/s00421-018-4036-3

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  • DOI: https://doi.org/10.1007/s00421-018-4036-3

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